#30 “Don’t Believe Everything you think” “Make Facts Count Again”.

What have I learned over the past 12 years while I’ve been treating TMD/TMJ non-surgically?

I have to admit that I have learned much more about TMD/TMJ during my 42 years as a practicing Oral and Maxillofacial Surgeon over the past 12 years than I learned during the 30 years that I treated TMD/TMJ surgically.  The reason was because I learned to listen to my patients.  I am ashamed to say that. It does not make me happy to admit it.

The fact is, as an Oral and maxillofacial Surgeon I was trained to simply look at the data available, including the patient’s subjective and objective history, x-ray and lab results and make an assessment or diagnosis, then select the appropriate treatment plan derived from a menu of previously approved plans found in textbooks, conferences, and scientific papers.  Now, I must add, the approved treatment plans, more often than not, are established by insurance companies.  This same sequence of patient care applies to just about every type of health care provider in both dentistry and medicine.  For the most part, the patient is left out of the loop.  Other than to ask the patient to describe their symptoms, the patients are never asked their opinions about what works best for treating their problem.

For some types of problems that system works well.  When I saw an x-ray of fractured jaw I did not need to ask the patient what he thought was the best way to treat it.  All that had been previously been worked out and published in accepted protocols.  When a physician makes the diagnosis of Type 1 Diabetes, the treatment has a published protocol.

But the treatment of TMD/TMJ is different.  There are no accepted protocols.  There is no consensus. There is only lack of agreement of, not only how to treat the problem, but how to define the problem, what are the actual symptoms and even the causes for the problem.   TMD/TMJ has been a real conundrum, a real “bag of worms”. If the doctors can’t reach a consensus, how can patients be expected to know what to do when they suffer from the symptoms.

How was anyone ever going to sort out this conundrum?


The answer is to start out with the facts.  Just the facts!!!.  For those of you near my age, you may remember one of the first TV weekly programs named “Dragnet”.  The protagonist detective, Jack Web, would constantly proclaim, “Give me just the facts sir/mam, just the facts!”  That is where science starts also.  Just start with the facts.  Throw out everything else that is not proven to be fact, and just start with facts.

That is how I figured out what was really going on with TMD/TMJ.  I threw out EVERYTHING that I had been taught or previously believed and started accumulating facts and did not accept a fact until proven.

The fact that started the resolution to the problem and the introduction of the Urbanek Device and Protocol came from patients who actually had the problem.  Because I was willing to listen to my patients, and not just apply cookie cut treatments, patients gave me the key as to where to look.  I heard a dozen times, “If I place my finger, my tongue, a pencil eraser between my front teeth it feels better”. That was a fact.  I heard that fact a dozen times.

The second fact was that each pathology report from every one of the 2000 TMJ surgeries that I previously performed found inflammation within the TMJ. That was a fact, actually 2000 facts strung together.

The third fact is taught by every dental school in the county and supported by multiple studies:  “90% of the load on the TMJ is from the posterior teeth.”

The fourth fact is that excess loads on the joints of the body cause inflammation and damage.  A self-evident and well established fact.

The Fifth fact has been known by the orthopedic surgical profession for over 50 years.  “Inflammation within a joint signals the brain that there is damage in the joint and the brain sends a signal to all the muscles that move that joint to tighten up and hold the joint as immobile as possible thus decreasing inflammation.”

These five facts explain how the Urbanek Device came to be and why and how it works so well.  The Urbanek Device and Protocol separates the posterior teeth, takes the load off the TMJ, decreases inflammation within the joint, and makes the symptoms go away when the inflammation within the joint decreases. The Urbanek Device and Protocol works for TMD/TMJ like a set of crutches works for an inflamed knee.  It just that simple.

It is not necessary to know all the facts to figure out a problem, just the facts that matter.  “Make Facts Count Again” and “Don’t Believe Everything You Think”.