There is a great variation among dentists in their interest in treating temporo-mandibular dysfunction (TMD). Some dentists hate doing it – if they have a patient with this problem, they will refer them to another dentist. Other dentists enjoy it immensely. What is the difference?
The temporomandibular joint is very complex. It’s the only joint in the body that has the capacity to slide. There’s a disc that glides along with the joint, and it operates on two separate hinges at the same time. This enables the jaw to move up and down, side to side, and forward and back.
Then there are a number of muscles that connect to the joint, each one with its separate function, and they all aid in these complex movements.
Adding to its complexity is its interaction with the teeth. At its rest position, the teeth should be meshing together evenly all around. If there is any misalignment of the teeth, certain jaw movements can cause pain in the teeth, which can cause spasms in the joint muscles.
Besides this, there are a multitude of symptoms of TMJ disorder. People can develop a habit of grinding their teeth. This grinding can occur at night and the patient can even be unaware of it. There can be pain in the joint, noises in the joint, or pain in the teeth. There can be headaches or neck pain that may even seem to some physicians to be totally unrelated to the teeth or jaw joint. There can be ringing in the ears, difficulty in opening the jaw completely, or difficulty in closing completely.
Because of all of this complexity, there is no way that a basic dental school education can equip a dentist to treat this disorder. It requires extensive study beyond dental school. This is why some dentists like Dr. McKay are referred to as TMJ specialists. He has had extensive training in treating this disorder at the Las Vegas Institute for Advanced Dental Studies. In fact, he has been an instructor at this institute, and continues lecturing to dentists around the country on TMJ treatment. Another TMJ training institute is the Pankey Institute. An example of a dentist some might consider a TMJ specialist who has been Pankey trained would be Dr. Arthur Chal in Phoenix. He has an impressive list of credentials.
Is Dr. McKay truly a TMJ specialist? In actuality, there is not a separate designation in dentistry for TMJ treatment, so it wouldn’t be accurate to call any dentist a TMJ specialist. That’s a shame, because it leaves the patient somewhat vulnerable to judge the qualifications of each dentist on his or her own. It would be nice to have a credentialing body to help the public know who is qualified in this area and who is not.
One factor, however, weighing in favor of the public is that dentists, as a group, tend to be fairly ethical and are sensitive to their lack of knowledge in certain areas. This is especially true in TMJ treatment. As we mentioned in the first paragraph, many dentists are actually quite averse to taking these types of cases because they don’t know what to do and they simply don’t turn out well, so they’re a source of headache for the dentist rather than satisfaction. Still, there are pretenders, and we would caution patients to carefully check the credentials and reviews of dentists before trusting them in this area.
This blog is brought to you by Seattle implant dentist Dr. Brian McKay.
