Why do patients travel long distances for TMJ treatment.
What I find is patients have had pain for years and think there is nothing else that can be done and then severity increases and they desperately look for an answer.
They want a comprehensive approach to diagnosis and treatment but most of all they want to QUICKLY IMPROVE THEIR QUALITY OF LIFE.
They come across a world of treatment different than what was ever discussed with their general dentist.
It turns out most dentists know very little about treating TMJ disorders beyond simple splints.
A small group of dentists become obsessed with knowing more and more about the condition and become more and more expert about very arcane little details.
The vast majority of patients get a night guard and simple habit changes and the TMJ problems are fixed. The difficult patients either learn to live with pain or end up seeking speciatly care.
There is no specialty in TMJ treatment so usually patients seeking specialty care first go to the oral surgeons (OS) office. This is appropriate for TMJ surgery but is the last place to go for occlusal therapy for TMJ problems because most OS never look at fine tuning occlusion. OS making splints that don’t work often look for surgical answers. The one rule in TMJ treatment is avoid TMJ surgery whenever possible.
So who are the TMJ Specialists? There is a group who want to create a specialty of Oral Facial Pain and have been denied specialty status by the ADA or American Dental Association so the are creating their own specialty board and declaring themselves specialists in oral facial pain a dangerous precedent but also rather pointless becaust they want to use the medical model of treating everything with drugs.
The real specialists are dentists who come together to study the intricacies of TMJ disorders. I often call them a small group of old doctors who learn more and more about less and less eventually knowing everything about nothing. Joking aside they delve very deeply into the most minute details.
I am currently the Chair of the Alliance of TMD Organizations and there are several groups who focus on different methods of treating the disorders.
I am a Fellow of the International College of CranioMandibular Orthopedics the Physiologic Group most dedicated to the underlying science involved in treatment utilizing physiologic dentistry protocols taught by the father of physiologic dentistry, Dr Barney Jankelson.
I am also a life member of the American Equilibration Society which is the oldest and largest TMJ treatment organization. They approach the disorder from a more mechanistic approach.
I always go to their annual meeting because I learn new aspects from doctors who approach treatment from a completely different approach. This group is also very focused on intricate details of treatment.
Both of these groups treat the same condition coming from a different direction. Doctors in both groups are successful.
The is another group the Academy of Craniofacial Pain (formerly academy of head neck and facial pain)who are very diverse in their approach. I would describe it as knowing less and less about more and more until they know nothing about everything (in jest) I am also a member of this group and I find they bring into the picture a wider scope of treatment possibilities.
Still another group is the American Academy of Physiological Esthetics (formerly American Academy of Comprehensive Esthetics) They are also a Physiologic Group affiliated with the Las Vegas Institute. They are very focused on physiologic Dentistry as approach to esthetic and full mouth reconstruction. LVI teaches a watered down approach to physiologic dentistry and the science but aree excellent (probably best) at hands on teaching of technique. They take a cookbook approach to Physiologic Dentistry and almost all of their work is based on scientific foundation of ICCMO and Barney Jankelson. I learned Physiologic Dentistry at ICCMO and from Barney Jankelson, Jim Garry, Barry Cooper, Dayton Krajiec and others at ICCMO but I learned to efficiently utilize it for Full Mouth reconstruction at LVIn for magnificent rehabilitations.
There are also orthodontic approaches to TMJ disorders as practised byInternational Association of Orthodontics, another excellent group primarily focused on orthodontics and secondarily on TMJ disorders but consider TMJ in all of their cases. This group is actively preventing development of TMJ disorders during orthodontic treatment.
The Sacral Occpital Chiropractic group, The Nucca Chiropractors, the At;as Orthoganol chiropractors and the Cranio/ Chirodontics group all integrate with dentists to trat TMJ disorders as part of full body function.
The field of Epigenetic Orthodontics is very new and is not yet represented by a group but ist is changing the method of treatment . I utilize Epigenetic Orthodontics routinely to finish TMJ cases after pain is resolved.
The Academy of Dental Sleep Medicine does not consider itself a TMJ organization because they treat sleep apnea. As a Diplomate of the organization I will clearly state this is their biggest failing. The American Academy of Sleep Medicine recommends that dentists treating sleep apnea with oral appliances should have expertise in treating TMJ disorders.
The NHLBI (National Heart Lung and Blood Institute) of the NIH consider Sleep Apnea to be a TMJ disorder and wrote a paper “The Cardiovascular and Sleep Consequences of YTemporomandibular Disorders”
There are two other Organizations that, in my mind have lost their way to some extent in treatment philosophy, one is the American Academy of Pain Management of which I am a Diplomat and the other is the American Academy of OroFacial Pain. Both have moved into treating functional and structural problems with drugs rather than correcting the underlying physiological issues.
I am still a member of the American Academy of Pain Management but that group is no longer part of the TMD Alliance.