Texas A&M University College of Dentistry’s professor and head of biomedical sciences and his researchers will receive more than $2.87 million over the next five years to study temporomandibular disorders.
Dr. John Neubert is A&M Dentistry’s principal investigator in the world’s most extensive collaborative study of patients with TMDs. TMDs are 30-plus painful conditions that affect the jaw muscles, nerves and joints in the face. The $17 million Collaborative for REsearch to Advance TMD Evidence, nicknamed CREATE, project will collect data on patients’ chronic pain to identify ways to eventually manage TMDs more effectively.
Sufferers may report a variety of symptoms, including facial and jaw tenderness and pain; popping, clicking and grinding sounds when opening and closing their mouths; difficulty chewing; and locking jaws. Some people experience earaches, headaches, dizziness and vision problems.
“This can make everyday activities such as eating and talking difficult, lowering quality of life,” Neubert said. “TMDs are also linked to stress, anxiety and depression, which can make things even worse. Despite how much these problems affect people and society, there are still no consistently effective treatments, partly because research hasn’t fully bridged the gap between lab studies and real-world care.”
Plans are to study 1,000 patients with TMDs and 300 pain-free individuals across five national sites, including A&M Dentistry, collecting brain images, clinical data and more. CREATE is funded by the National Institute of Dental and Craniofacial Research at the National Institutes of Health, and it’s led by the University of Pittsburgh School of Dental Medicine.
Other principal investigation sites include the University of Buffalo School of Dental Medicine and the University of Florida College of Dentistry, where Neubert taught and first contributed to the project’s planning before joining A&M Dentistry in February 2025. Other partnering institutions are Missouri State University, UTHealth Houston School of Dentistry, Colorado State University, HealthPartners Institute and The TMJ Association, a patient advocacy organization.
“We are planning to have our first patient early this year,” said Neubert, who is a nationally respected oral pain specialist.
Data collected will go to UF because it has the most experience managing clinical studies and data, he said. About 200 people will likely participate in A&M Dentistry’s study.
Dr. Madhu Nair, professor and head of diagnostic sciences, is A&M Dentistry’s other co-investigator. Neubert will recruit other clinical faculty at A&M Dentistry, a clinical manager, a clinical research assistant and support staff.
A&M Dentistry will collect data for three years and spend the last two years bringing back some patients for additional studies. Researchers will conduct standardized pain tests, collect biological samples – such as saliva and blood – and complete neuroimaging of the brain and TMJ to collect data for “deep phenotyping” with the goal of investigating molecular mechanisms in the future for those with TMDs.
Neubert, an internationally known expert in TMDs, said the collections will enable more grant-funded studies as science advances.
The temporomandibular joint, often referred to as TMJ, connects the jawbone to the skull. There’s one on each side of the jaw.
Few studies on TMDs exist.
TMDs affect 5-10% of the U.S. population, according to NIDCR. The conditions are at least twice as common in women as in men, and TMDs can occur alone or with other medical conditions such as back pain, migraines, fibromyalgia and arthritis.
The Imaging Center at A&M Dentistry and a regional imaging facility at the Sammons Brain Health Center at The University of Texas at Dallas that specializes in brain imaging will provide imaging support through cone beam computed tomography and high-resolution MRI for generating appropriate image datasets to help further understand the complex pathophysiology associated with TMDs, Nair said.
CREATE’s research will build on the findings of Orofacial Pain: Prospective Evaluation and Risk Assessment, the largest prior study on TMDs.
The new study is part of the larger umbrella TMD Collaborative for IMproving PAtient-Centered Translational Research, TMD IMPACT for short. Developed by NIDCR in partnership with multiple NIH institutes, centers and offices, as well as the Food and Drug Administration, the initiative seeks to advance basic and clinical research, research training and translation to evidence-based treatments and improved clinical care.
This is TMD IMPACT’s second funding round. The first awarded nine planning grants totaling $2.8 million in 2023. CREATE received some of that money. Neubert was a principal investigator and part of UF’s CREATE Award before he joined the A&M Dentistry faculty.
As a companion to his work on the CREATE project, Neubert and others recently published an article in the Journal of Pain, titled “Preclinical Perspectives on Disorders of the Temporomandibular Joint: Tracing the Past, Navigating the Present, and Shaping the Future,” which offers a deep dive into the science behind jaw disorders. It looks back at past animal and lab studies, examines the state of current preclinical research, and suggests ways to improve future treatments.
“This paper is an essential roadmap for translating basic science into real-world solutions for TMD—and it highlights exactly where the field needs to focus next,” he said.