#168 The Solution for TMD Has Been Present for More Than 50 Years, But, Nobody Bothered to Connect the Dots

Would it surprise the reader to learn the breakthrough discoveries for treating TMD had been published within the scientific literature for over 50 years? Would it surprise you that mainstream medicine and dentistry resisted and continues to resist applying these discoveries because it invalidates a century of bias toward drugs and surgery? Hopefully, you are not surprised. It took someone who had training, experience, broad knowledge and degrees in both medicine and dentistry and familiar with reading scientific literature to be able to connect the dots. It also helped for this author to have training and degrees in Cell Biology/Anatomy and research experience with the National Institutes of Health/National Institutes of Dental/Craniofacial Research on Facial Growth and Development. It was this resume that allowed me to cut through decades of non-sense, bias, institutional preservation, and academic indifference attached to the treatment of Temporomandibular Joint Disorder.

The breakthrough arrived once I put all bias aside and focused on the patient rather than previous opinions generated through lectures, congresses, textbooks, and articles in journals written by colleagues, It turned out the patients held the key where to start when 12 of 24 interviewed told me placing their finger, their tongue, or the eraser end of a pencil between their front teeth gave them relief. I wondered what would happen if I placed something between the front teeth that patients could wear comfortably. A simple device that allowed the patient to talk, swallow, and breath easily was constructed and given to the first patient available as an experiment She was asked to keep it in her mouth 24/7 except while eating and return in 3 weeks. Much to my surprise, on return, she announced that after 20 years of struggles, her symptoms had resolved. The surprise on my face must have been apparent as she asked, “Didn’t you expect me to get better?” I didn’t admit she was an experiment. I then followed her up for months to verify the results were consistent over time and added another 20 patients to the experiment. After six months and similar findings in all patients treated I had no idea why placing a device between the front teeth had such a profound effect on alleviating the symptoms of TMD. That’s when I began to use my broad background to investigate why all the disparate symptoms of TMD dissipate over time when a device that separates the posterior teeth, allowing only the front teeth to touch, is used.

The results of my investigation consisted of three facts, known, agreed upon and scientifically published. When connected together like pearls on a string, they explained the phenomenal results.

First, every case of TMD involves chronic inflammation within the Temporomandibular Joint, (TMJ). This was established by my personal experience operating on over 2000 TMD patients and having the pathology reports on all 2000 returning as chronic inflammation. 100% of patients with TMD were found to have chronic inflammation within the joint.

Second, 90% of the loads on the TMJ are transmitted by the posterior teeth. This fact is taught by every dental school in the country. By separating the posterior teeth, 90% of the forces on the TMJ are removed.

Third, this fact comes via orthopedic surgery and neurology literature. As a joint becomes damaged, it sends signals to the brain announcing the damage. The brain responds by sending signals back to the muscles that move the joint instructing them to contract and hold the effected joint motionless in attempt to facilitate healing. As the muscles tighten, they pull on their attachments to the bone stimulating pain. This phenomenon is well known to orthopedic surgeons and explains why inflammation of the elbow creates pain in the forearm and wrist. This sequence is known at “Tennis Elbow”. Too much repetitive motion of the elbow creates distant pains in the forearm and wrist.

Too much repetitive motion of the jaws, (Bruxism) causes distant headaches, earaches jaw pain, neck pain, and upper back and shoulder pain.

Tennis Elbow and TMD are caused by the same physiological/neurological/pathological process. TMD and Tennis Elbow are the same disease.

All dental schools teach that the TMJ operates differently than all other joints in the body. That was the first and most egregious falsehood that kept everyone from discovering the true nature of TMD. After that, nobody bothered to connect the dots.