A Program Project, TMD LONGITUDINAL STUDIES: CLINICAL/CHRONIC PAIN SYNDROMES, is proposed to initiate a systematic program of multidisciplinary research investigating the onset, clinical course, natural history and prevention of temporomandibular pain and dysfunction (TMD). TMD refers to a range of disorders characterized by pain in the muscles of mastication and/or the temporomandibular joint, mandibular dysfunction, and joint sounds. The proposed Program Project involves the continued collaboration of two institutions: the University of Washington Department of Oral Medicine, School of Dentistry, and Group Health Cooperative of Puget Sound (Center for Health Studies). Under earlier research activity a cohesive team of clinical, behavioral, and epidemiologic researchers has been developed together with a uniquely trained technical staff. The specific aims of the Program Project are: 1. a) To continue prior longitudinal research identifying critical biologic, psychologic and demographic factors influencing the onset, clinical course and natural history of TMD and its subtypes; and b) to assess the natural history of TMD signs and symptoms in persons initially free of TMD (Project 1). 2. To conduct longitudinal studies investigating the nature, occurrence and consequences of a chronic pain syndrome (Project 2). 3. To survey dentists variability in knowledge levels and understanding of biologic, psychologic and psychosocial factors influencing the development and management of TMD and other chronic pain conditions (Project 3). 4. To evaluate the efficacy of early biobehavioral interventions for ameliorating and preventing chronic pain and chronic pain syndrome (Project 4). 5. To support these research objectives through scientific and administrative Core projects providing centralized communication, technical, and support capabilities for Program Project investigators. This broad-based pain research project will enhance the ability of dentists and physicians to provide more effective diagnosis and treatment for TMD and to prevent the most devastating sequelae of chronic TMD pain.