06 March 2026

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HSDM researchers join national effort to improve care for temporomandibular disorders

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Temporomandibular disorders (TMD), a group of conditions affecting the jaw joints, chewing muscles, and related structures, represent a significant and often underrecognized public health challenge. Affecting up to 10% of the population with chronic pain and compromised joint function, these disorders are the second most prevalent musculoskeletal condition after chronic low back pain.

A new multidisciplinary grant funded by the National Institute of Dental and Craniofacial Research (NIDCR) aims to advance the understanding, diagnosis, and treatment of TMD by bridging research and clinical care. The initiative, known as the 360° Collaborative Hub for AI in TMD Research (360° CHAT-TMD), brings together experts from the Harvard School of Dental Medicine (HSDM), Massachusetts General Brigham, and the University of Michigan to improve outcomes for patients living with these complex conditions.

“Patients often struggle because TMD is not a single disease, but a collection of conditions with different causes and levels of complexity. Some cases are driven mainly by local muscle or joint factors, while others involve central nervous system pain amplification, psychological distress, or overlapping chronic pain conditions,” said Fernando Guastaldi, assistant professor of Oral and Maxillofacial Surgery at HSDM and Massachusetts General Hospital (MGH). 

Guastaldi, along with his colleague, Shruti Handa, assistant professor of Oral and Maxillofacial Surgery at HSDM and MGH, will serve as co-principal investigators on the grant. Both are nationally recognized clinicians and researchers in the field of TMD disorders.

360° CHAT-TMD is designed to address longstanding gaps in TMD care, where patients may be underdiagnosed, overtreated, or receive fragmented care across multiple specialties.

“Historically, care has been overly focused on structural findings or guided by outdated models,” said Handa. “That approach has led to inconsistent diagnoses and treatments that don’t always reflect what individual patients actually need. Our goal is to move away from a one-size-fits-all model toward risk-stratified, evidence-based care.”

A key component of the initiative is the use of artificial intelligence (AI) to analyze large, complex datasets generated through patient evaluations and longitudinal follow-up. Rather than replacing clinical judgment, AI tools will be used to support clinicians by identifying patterns that may not be readily apparent through traditional analysis. 

“AI can help us recognize meaningful relationships across clinical, imaging, and patient-reported data that are difficult for humans to see on their own,” said Guastaldi. “The goal is not automation, but better-informed, more personalized care that supports shared decision-making between patients and clinicians.”

These insights are expected to inform clinical guidelines, improve diagnostic accuracy, and help tailor treatment plans to individual patients based on their specific risk profiles and symptom patterns.

Patients will also play an active role throughout the study, sharing lived experiences and informing outcome measures that matter most to them. 

Through this collaborative effort, the multidisciplinary team hopes to establish more consistent, evidence-based standards for TMD care across dental and medical disciplines. By aligning research findings with clinical implementation, 360° CHAT-TMD aims to reduce care variation and improve patient outcomes nationwide. 

“TMD care improves when we listen to data, to clinicians, and especially to patients. By integrating evidence, technology, and lived experience, this initiative represents a step toward more humane, effective, and sustainable care for people with TMD,” said Handa. 

Source: https://www.hsdm.harvard.edu/