#108 The Integration of Dentistry into Medicine and TMD/TMJ

“Status Quo” is a Latin phrase meaning “The Existing State of Affairs”.   

Let’s start by describing the current existing state of affairs regarding TMD/TMJ. No one, doctor and patient alike, will disagree that TMD/TMJ is a conundrum, a confusion, an enigma, and has been since the first description of the disease in medical literature in 1934, by Dr. James Costen, an ENT surgeon from St. Louis. Dr. Costen attributed the symptoms to the lack of posterior teeth.  At first the disease was named “Costen’s Syndrome” and ironically, because the first theory about the cause of the symptoms had to do with teeth, the solution for the problem was left to the dentists to figure out.  That, as it turned out, was a mistake.  The dentist of the 1930’s, 40’s and 50’s was trained primarily in the manipulation of teeth and little effort, at that time, was made to emphasize the basic sciences which study and describe the mechanisms of operation of the human body. (anatomy, physiology, biochemistry, microbiology, histology, neurology, cell biology) 

So, Costen’s Syndrome was handed off to the dental profession to solve.  The dental profession and dental schools named the disease after the name of the joint, and for the next 6 decades was referred to as “TMJ”, (Temporomandibular Joint).  Think how funny that would sound if applied to other joints of the body.  If you had symptoms originating from the knees and the disease was called “knees”.  But in fact, most physicians, dentists, and patients today still refer to the symptoms associated with the temporomandibular joint as the name of the joint, “TMJ”.  That was the second big mistake and celebrated how little was known and how confused the status quo became regarding this disease. 

The third and biggest mistake made by the dental profession and the dental schools was teaching every dental student, from the 1930’s to the present time, that the temporomandibular joint was a very different and unique joint.  Dental Schools taught, and continue to teach, that the TMJ is a very complicated joint, and is so complicated that no-one has been able to completely figure it out and explain the many disparate symptoms originating from this small joint in front of the ear. 

Over the past 80 years doctors have empirically agreed that the common symptoms of “TMJ”, now referred to as TMD, (Temporomandibular Joint Disorder), include frequent and recurring headaches, earaches, jaw pain, neck pain, tinnitus, subjective hearing loss, vertigo, upper back and shoulder pain, arm/hand/finger tingling and numbness and various kinds of jaw locking. 

A large void in knowledge was created by the dental schools teaching that the TMJ is unique, complicated, and different than any other joint in the body.  The truth is the TMJ operates like all the other joints of the body and if the control for treating the symptoms of TMD had been left up to the orthopedic physicians who treat the remaining joints of the body, the conundrum of TMD would have been solved decades earlier. 

But this void in knowledge left the door wide open to the entire medical/dental establishment to just treat the symptoms without regard to actual cause of the symptoms.  The real cause of all the symptoms was discovered in 2011.  The cause is chronic inflammation within the TMJ.  Understanding the basic sciences of the body led to the ideal solution for limiting chronic inflammation of the TMJ and is now called the Urbanek Device and Protocol.  When the chronic inflammation is removed, all the symptoms go away.  It’s actually very simple. 

However, the status quo, created by the lack of knowledge and understanding of the true cause of TMD, led to treating symptoms instead of the cause with various neuroleptic drugs, manipulations of muscles and teeth, dry needling, physical therapy, chiropractic, massage therapy, botulinum toxin paralysis of muscles (Botox), acupuncture, orthodontics, occlusal rehabilitation, psychologic and psychiatric treatment, and various types of TMJ surgery.  This is the current status quo in 2024. 

The discovery that the symptoms of TMD originate from chronic inflammation within the TMJ is disruptive science and has now been proven by independent university studies.  And the status quo does not like to be disrupted.