#202 TMD Has Given Dentistry a “Black Eye”

The responsibility to treat Temporomandibular Joint Disorder (TMD) landed square on the shoulders of the dental profession from the first moment the problem was identified and the first article published about the disease by a St Louis ENT surgeon in 1934.  The medical profession did not want anything to do with the joints that were attached to the jaws, that were attached to the teeth.  And the dental profession has made a “Dog’s Breakfast” in its attempt to study and treat this disease since 1934.  The dental profession and the dental research and training system, (Let’s just call it the system”) has totally botched their opportunity to treat one of the most common problems of the human body and thrown away the opportunity to substantially elevate the publics level of esteem and admiration for the dental profession.  Instead, the “system” has allowed all sorts of unscientific unsubstantiated hodge-podge of information and treatments muddy the waters so badly that the average dentist wants nothing to do with the patient who arrives asking for help.  And the patients are shuffled around from provider to provider becoming more frustrated and angry with the “system” with each referral. 

This is exactly why a national conference was called together in March of 2019 that brought scientifically minded stakeholders together at the National Academy of Science, Engineering, and Medicine to try and figure out a solution to this conundrum.  I was personally present at that meeting and experienced each presentation. I have also reviewed the report generated by that august body of scholars. “The 2020 National Academies of Sciences, Engineering, and Medicine report, Temporomandibular Disorders: Priorities for Research and Care.” 

Since this report was published there has been no substantial change or improvement in the situation. 

A 2025 study based on a survey of 469 dental students found: 

• Only 35.6% felt prepared to diagnose it clinically. 

• Only 25.2% felt prepared to treat it clinically. 

• Only 29.4% were confident in their TMD-related knowledge. 

And there’s an almost ironic statistic: another study found TMD signs or symptoms in 90.1% of the dental students studied and 75.7% of faculty 

Tuason D, Sawicki C, Fricton J, Prodoehl J, Palatinus S, Sangalli L.
“Comparison of Different Predoctoral Educational Modalities on Knowledge Levels in Temporomandibular Disorders: A National-Based Cross-Sectional Study.”
Journal of Dental Education. 2026;90(4):551–564.
DOI: 10.1002/jdd.70000
PMID: 40781833. 

Over the past 15 years I have single-handedly attempted to confront these issues of apathy and lack of scientific concern.  After discovering the common denominator for all the disparate symptoms of TMD, and identifying the mechanisms responsible, I made the effort to contact one of the most identifiable, vocal, and published academicians on the topic of TMD, (He wrote the most cited textbook of the subject).  When I told him I wanted to share my discoveries regarding the disease he responded with, “I’m not interested in hearing about what you discovered.”  What arrogance! 

No wonder dentistry and the “system” has achieved the well-deserved feeling of disdain from the public at large regarding the diagnosis and treatment of TMD. 

The prevailing textbook and specialty model classifies TMD as a collection of different disorders. I believe that model has it backwards: the apparent diversity of TMD manifestations, (symptoms) can be explained by a common underlying disease process—chronic inflammation within the TMJ. 

This is supported by our independent MTSU university study based on over 3000 successfully treated patients with TMD symptoms. The dental establishment will eventually have to concede and not oppose the science. But until then, you will need to be satisfied to know there is a solution that changes the paradigm for the treatment of TMD, and that treatment is available at TMJ Services.