#140 TMD: The Most Misunderstood Disease on the Planet

TMD, (Temporomandibular Joint Disorder) is a very common disease.  Forty-five percent of females in the United States suffer from TMD symptoms.  It should be classified as a medical disease like any other joint in the body, but it is treated exclusively by dentists.  The vast majority of dentists don’t want to treat it.  In fact, they don’t want anything to do with it because they know they don’t know how to treat it.  They know they don’t know how to diagnose it. They do know it is a very complicated disease because that is what they were told in dental school.  Fifty percent of dentists tell patients they don’t treat it, and 49.99 percent make a night guard for the disease and hope the patient does not return because they know a night guard does not treat TMD.  Then there is the .01% of dentists, I call TMD gurus, who try to treat the disease using smoke and mirrors and game the medical insurance companies to pay for their non-sense treatment.  The most recent example of that is the use of Botulinum Toxin A (Botox) injected into the symptomatic areas paralyzing the muscles and relieving pain because the muscles no longer work at all.  A recent scientific study published in the January issue of the Journal of Oral and Maxillofacial Surgery proved statistically that injecting Botulinum Toxin A and saline into the facial muscles create an identical effect, but there is an increasingly large cadre of dentists who promote the use of Botox because they are sold on the concept that it fixes the problem by the Botox salesmen and advertising literature.   They admit the biggest advantage of Botox is the patient must return for further Botox injections every 3-4 months.  What they don’t want the patient to know is Botulinum Toxin A (Botox) is not approved by the FDA to treat TMD and they are using the drug “Off Label”. 

Physicians, on the other hand, don’t want anything to do with TMD for the same reasons as dentists.  Physicians know they don’t know anything about TMD.  Problems with the TMJ (Temporomandibular Joint) are not addressed anywhere in medical school or specialty training.  If a medical doctor suspects their patient has TMD he will tell them to, “See a dentist”.   Both dentists and physicians agree on one point.  The consensus is that, when it comes to treating TMD, “Nothing Works”. 

You can see how the patients are led around in circles from physicians, to dentists, to gurus, back to physicians, and then back to dentists, sometimes for decades.  There is so much confusion about this disease, they even named it wrong.  Everyone, dentists, physicians, and patients, for the past 60 years have called the disease “TMJ”, which is the name of the joint itself.  Do you go to the Orthopedic Surgeon with knee pain and announce you have “knees”? 

This description is the state of the art for treating TMD in the United States of America in 2025. Very pathetic indeed. 

Dentistry has gotten itself into this conundrum for two reasons.  First, dentists are taught that the TMJ is unlike any other joint in the body.  Second, the symptoms of TMD can be very confusing.  They include frequent and/or recurring headaches, ear-aches, neck pain, jaw pain, ringing in the ears, a feeling of fullness in the ears, dizziness/vertigo, upper back and shoulder pain and tightness, arm/hand/finger tingling and numbness and various kinds of jaw locking.  Also included are limitless kinds of joint noise, visual disturbances, and occasionally what the patient believes is tooth pain.  Dentists and physicians simply try to treat symptoms which change type and location constantly. Physicians misdiagnose TMD as migraines, Meniere’s Disease, and ear infections constantly. 

The truth is the TMJ operates like any other joint in the body.  The TMJ is not different. It is not unique.  The research I did beginning 14 years ago confirms it.  This research, now supported by independent university studies, shows all of the symptoms noted above are directly driven by chronic inflammation within the TMJ.  Instead of trying to treat the constantly changing and disparate symptoms, we treat the cause (inflammation) by unloading the joint with a small intra-oral device which allows the inflammation to dissipate and in turn, make all the symptoms dissipate and go away. It’s very simple, yet elegant.  TMD is no longer the most misunderstood disease on the planet.