#142 “The Root Cause of TMD”

Science is the study of cause and effect. Medical scientists who look to find a solution for disease study cause and effect.   They make an observation, and then ask the question, “What is the cause of that observation?”  The observation is the “effect” of a “cause”.  What they really want to know is what was the cause of the observation.  In this way, science and scientists work backwards.  To solve a problem, scientists first observe the “effect” and then they try to figure out the “cause” of the effect.  Sometimes the “cause” they discover is the “effect” of something totally different.  Often, in solving a problem, they find a series of “cause and effects” like a series of dominos lined up one falling on the next, the next falling on the next.  Ultimately, what they want to discover is the “root cause” of the original observation. 

In medicine, a good example is the science behind the root cause of Malaria. The symptoms of Malaria, (High Fever, Headaches, Fatigue, Dry Cough, Nausea, Vomiting, Anemia, Jaundice, Seizures, Kidney Failure, and Coma) often leading to death, had been known for centuries.  It was originally thought Malaria was caused by something in the air.  Thus the name Mal-aria, from Latin, “Bad Air”.  These are very disparate symptoms and did not have any obvious connection.  There appeared to be no common cause until a French army doctor, Charles Alphonse Laveran, in 1880 observed the parasite, Plasmodium Malaria, in the red blood cells of infected North African soldiers.  The common denominator, or root cause for Malaria had been found.  Then it took 17 more years until Major Ronald Ross, a surgeon with the British Indian Medical Service discovered the mosquito Anopheles as the vector that transferred Plasmodium Malaria from one person to the next via their saliva. 

You can see there were several cause and effects discovered before the disease of Malaria was fully understood.  This was followed by studying the cause and effects of several substances or drugs that had the best effect killing the Malaria parasite.  The whole process of solving Malaria was just a series of effects, “observations”, followed by searching for the “cause”.  The root cause of Malaria is the Parasite Plasmodium Malaria. 

Unfortunately, history will show that the doctors who tried to solve  Temporomandibular Joint Disorder, (TMD) did not follow the usual scientific method of observation, (effect), looking for cause.  In 1934, when TMD was handed to the dentists by the medical doctors to investigate and solve, the immediate response from the dentists was to use the dental treatment closest at hand as solution.  This included the oral surgeons who thought surgery was the answer, orthodontists who thought straightening the teeth was the answer, and general dentists who thought fixing the occlusion was the answer.  Additionally, they all prescribed drugs to suppress symptoms. They  worked from the viewpoint of “if your only tool is a hammer, everything looks like a nail”.  Dental investigators were looking for the solution to each of the disparate symptoms of TMD, rather than looking for the root cause. 

This was the state of the art until 14 years ago, having become disenchanted with TMD surgical results, I decided to do an independent investigation simply following the scientific method outlined in the first paragraph.  My dental, medical, and investigational degrees in cell biology and anatomy, including my previous experience as an investigator with the National Institutes of Health in the field of facial growth and development were also of great benefit. 

Following the science and making observations followed by determining the cause, the root cause of TMD was discovered. The dominos involved with the disease were able to be described.  These are as follows. 

There are three circumstances that damage the temporomandibular Joint, (TMJ). 1. Bruxism, 2. Acute Trauma, 3. Functional Malocclusion. Damage from each creates chronic inflammation within the joint.  CHRONIC INFLAMMATION is the root cause or common denominator creating each of the disparate TMD symptoms.  Unloading the TMJ with an oral device and protocol that separates the posterior teeth is the best solution for eliminating the root cause, which is chronic inflammation within the TMJ.