#103 What’s so Important about Separating the Posterior Teeth?

One of the earliest patients I ever treated with the Urbanek Device and Protocol was a woman who had just about all the usual symptoms for 30 years.  She was experiencing chronic severe headaches, earaches, jaw and neck pain, ringing in the ears, a feeling of fullness in the ears, frequent episodes of vertigo, upper back and shoulder tightness and pain, arm/hand/finger tingling and numbness, and inability to open her mouth completely. This was her daily experience.  She had traveled all the way from Knoxville to see me because she had head about the Oral and Maxillofacial Surgeon in Nashville who had discovered an innovative and successful way to treat TMD/TMJ non-surgically.   

Having driven 4 hours to see, me I felt compelled to spend some extra time with her during the consultation and wanted to give her a full explanation of how her symptoms were related to chronic inflammation within the jaw joints and give her a complete explanation of how I discovered the relationship between chronic inflammation in the jaw joints and each and every symptom.  And finally, I wanted her to know the simplicity of how the device worked to make the symptoms go away.   

During the consultation, which lasted about 45 minutes, I explained how the device worked along with the protocol that simply dis-occluded or separate the back teeth for a period of time allowing the chronic inflammation to subside like a set of crutches helps an inflamed knee.  I told her how a dozen prior patients had given me the key to the solution by telling me that placing a pencil eraser, their finger, their tongue,  or a piece of cloth between their front teeth made it feel better. 

After listening intently to my long-winded explanation, she looked at me rather quizzically and asked, “Do you mean if I hold a pencil between my front teeth, it will make my symptoms go away?”  Without hesitating I answered, “Yes it will.  If you can figure out how to hold it there 24 hours a day for two months and then every night, all night, for the rest of your life your symptoms will go away.”  I immediately knew this was the wrong approach by the indignant look on her face.  The consultation soon ended, and I sent her to talk with our financial advisor about the payment for treatment.  I found out later, that this patient had not even talked with the financial advisor and had walked straight out of the office without saying anything. 

I felt embarrassed for myself and bad for the patient who had traveled all the way from Knoxville to see me.  Obviously, my answer to her question sounded insensitive and flippant.  It wasn’t my intention to do so.  I was just answering her question directly, without consideration of how that might be experienced by a person who had suffered from these devastating symptoms for more than 30 years.  I thought my answer was a bit humorous, but she didn’t laugh.  Obviously, she felt insulted by my flippant answer. I later tried to contact her and apologize, but she failed to answer my communications. 

There were several lesions I learned from that experience.  The first and most important was that patients who have suffered TMD symptoms for years and have been run in circles visiting doctor after doctor seeking relief do not find anything about their experience funny.  In fact, many are downright agitated when they arrive at the office.  Many are skeptical that anything can be done about it because they have already tried so many other things.  I have learned to spend more time sizing up the patient I am in consultation with before I try to make a joke about it. 

Second, I learned that sometimes the patient can receive too much information which may further confuse the patient about what to do and complicates the decision they are asked to make about treatment. 

What was discovered about the relationship between chronic inflammation and TMD/TMJ symptoms was pretty simple from a doctor’s point of view.  In fact, when I explain what I discovered about TMD/TMJ to another doctor I usually hear something like, “That’s pretty simple.”  But patients are not blessed with all the technical knowledge of a doctor. 

I have learned with this experience and many others to gauge my explanations to the depth and desire for understanding from the patient.  I have learned that if my patient is a doctor, nurse, engineer, or rocket scientist I need to be very specific.  If my patient has limited technical training, I need to portray a more simplified approach.  And if my patient has had 30 years of pain and symptoms, I put my sense of humor on the back burner.