#72 Interprofessional Practice and TMJ/TMD

There is a growing movement in medicine and dentistry to integrate services in order to make them more efficient and convenient for the patient.  According to Robert Pearl MD, the retired CEO of Kaiser Permanente Health Systems, the largest independent healthcare system in the United Staes, research has estimated that inappropriate tests and ineffective procedures account for more than 30% of all money spent on American medical care.

Having experience and training in both our medical and dental health care systems, I would like to add and agree that this same 30 percent of all money spent on American dental care is either inappropriate or ineffective.

The profession of dentistry has only recently begun to understand that treating the mouth and related structures and disease is not separate and distinct from the remaining parts of the body.  The mouth and related structures are an integral part of the body and therefore the science, training, and skills treating the oral cavity and maxillofacial region should be integrated with other practitioners and providers who care for the body. This is the concept behind developing interprofessional practices.

What does an interprofessional approach look like.  It can take on many forms.  A large network of dental practices in the western part of the US with over 1000 offices is now coordinating dental clinics and convenient care clinics within the same facility and space.   Seventy percent of patients who go to convenient care clinics have initial complaints of pain or symptoms in and around the head and neck.  The distinction between what is a medical problem and what is a dental problem can become blurred.

Nothing exemplifies this more than the symptoms related to TMD/TMJ which commonly include headaches confused with migraines, ear pain confused with ear infections, and ringing in the ears, fullness of the ears, and dizziness confused with Meniere’s Disease.  A healthcare organization that brings together all the various services in a single location avoids duplication of effort among providers, unnecessary testing, misdiagnosis, and attempts to treat by well-intended, but uninformed providers.


Just as the practice of medicine has developed into a network of specialists led and triaged by the Primary Care Physician or Physicians Assistant, dentistry is developing into a network of specialists led and triaged by the general dentist who has limited time to adequately train on all the new and necessary technology available while in dental school.  It is increasingly inappropriate for these new dental graduates to be expected to perform their duties according to the generally accepted standard of care in all areas of the dental profession.  It is inappropriate for patients to expect recent dental school graduates to be proficient in everything.  A patient with a damaged knee joint would not expect his PCP to do anything other than refer him/her to a competent Orthopedic Surgeon for care.  The same considerations apply to the field of dentistry and especially care and treatment of temporomandibular joint disease, TMD.

TMD/TMJ is the best example within the dental profession of an integrated service.  Treating TMD/TMJ uses information, experience, and technology from both dental and medical professions and is best delivered by someone with a wide viewpoint.  That was the successful action when I researched and developed the Urbanek Device and Protocol.  I was able to draw and integrate the necessary concepts from both medicine and dentistry, and integrate them to deliver a time tested solution, now validated by independent university studies.

In the future, I predict you will see more integration of medical and dental practices which benefit patients greatly.

If you think your “medical” symptoms may possibly be caused by TMD/TMJ, don’t hesitate to call TMJ Services of Brentwood to schedule a consultation.  You may benefit from our Interprofessional practice.