# 156 Multidisciplinary TMD Treatment

Temporomandibular Joint Disorder is a single disorder from a single cause.  The cause is chronic inflammation within the temporomandibular joint, (TMJ).  The symptoms caused by chronic inflammation within the TMJ include frequent and/or recurring headache, earache, neck pain, jaw pain, ringing or buzzing in the ears, a feeling of fullness in the ears like the ears are full of water, dizziness/vertigo, upper back and shoulder pain and tightness, arm/hand/finger tingling and numbness, and various kinds of jaw locking. 

For 90 years, since the first description of TMD in 1934, the medical and dental processions have shortsightedly directed their research and treatment toward the symptoms rather than the cause. The actual cause was not identified until recently when it was shown how chronic inflammation creates each of the symptoms.  This was followed by identifying how a simple oral device and protocol unload the TMJ decreasing inflammation and eliminating the symptoms.   

But the medical and dental establishments have a vested interest in doing things in a traditional manner.  This is especially true in the dental schools who are responsible for educating the new generation of dental professionals.  Those that operate dental schools find there is economic value for the universities to bring as many partners into the treatment mix as possible.  This is euphemistically called, “The Multidisciplinary Approach to Treatment”.  Apparently, some dental schools want to model the treatment of TMD on the approach that medicine handles disease.   

Over the past century, the medical profession has developed a system of care which begins identification of the diagnosis with the help of supporting diagnostic specialists, technology and staff.  This is followed by selective referrals to doctors who specialize in that diagnosis.  

Most recently some dental schools have attempted to fit the medical multidiscipline approach to treat TMD symptoms.  This has done nothing more than create unnecessary and confusing patient care.  This attempt centers around treating the symptoms rather than the cause.   

One of the common symptoms of TMD is neck pain so referrals are made to physical therapists who attempt to manipulate the neck and apply dry needling for relief.  If not effective prescriptions for a litany of drugs suppressing the central nervous system is recommended. 

The most common symptom of TMD is headache.  So, a pharmacopeia of drugs is applied here too.  Basically, it’s a series of throwing drugs at the wall and seeing what sticks which includes Botulinum Toxin A paralyzing facial muscles. 

It is a well-known fact that people who clench and grind their teeth, (bruxism) can develop symptoms of TMD.  It is also an accepted fact that bruxism is related to stress, anxiety, and worry.  So, the multidisciplinary approach brings psychologists into the mix to use talk therapy to dissuade bruxing and psychiatrists to prescribe neuroleptic drugs to suppress awareness of day-to-day stress.  

It’s also established that various types of malocclusions can stimulate bruxism which generates the need for prosthodontists skilled in dental reconstruction and orthodontists trained in the nuances of moving teeth.   

And then there’s the referral to the Oral and Maxillofacial Surgeon who wants to reconstruct the TMJ using various surgical interventions. 

With physical therapists, psychologists, psychiatrists, prosthodontists, orthodontists, and oral and maxillofacial surgeons competing for care, it’s no wonder the multi-disciplinary approach helps the doctors more than patients. 

Doesn’t it make more sense to address the cause than the symptoms.  Doesn’t it make more sense to eliminate the chronic inflammation which creates the symptoms rather than go from station to station or doctor to doctor adding frustration, complexity, and confusion into the process.