If you’ve read any of my recent blogs on Temporo-Mandibular Disorder (TMD), you would know that sometimes I get into debates regarding TMD, what causes it, and how to treat it. Yes, this seems to be a hot topic among dentists, and for those reading this that are not in dentistry, we must seem like the oddest bunch. I don’t know why I take this so personally and yet, every time someone says something about TMD I believe to be wrong, I get wildly contentious. So when I started reading an article about this topic, published in our very own Journal of the Canadian Dental Association, I got worried… until I read it (J Can Dent Assoc 2001; 67:83-5). I was so excited when I finished reading it because, finally, our own Journal published a beautiful and well-written article touching on both sides of this debate.
Dr. Randall Dale, the author of the article, starts off by easily defining the relationship between the Temporomandibular Joints TMJ, the masticatory musculature, and teeth. He then describes and summarizes some well known facts about the healthy TMJ position as well as a dysfunctional position, anatomically and on radiographs. He outlines various ways that dentists used to measure the true resting position of the mandible and the current technology that allows us to find it repeatedly. He breaks down treatment phases, which is something that is still debated currently, and the need to start with an orthotic in order to get patients stable first prior to restoring.
But what I loved about this article, and what I highly valued when reading Dr. Dale’s opinion on this topic was how he openly states that “In the past, ignorance has been an acceptable excuse. Today, the disagreement revolves around politics rather than science”. He outlines how insurance companies ignore this topic with lack of coverage, academics lag behind “defending the outdated methods they are still teaching”, and others lag behind, instead of learning from the science and the advanced imaging techniques that have shown us time and time again that certain TMJ related disorders are a result of destabilizing forces acting on the mandible along with the loss of posterior vertical.
So a big Thank You to Dr. Randall Dale for writing this bold and strong article and standing behind new scientific truth that is in the best interest of our patients.
About Dr. Agatha Bis
Oakville Dentist, Dr. Agatha Bis, DDS received her Doctor of Dental Surgery degree from the University of Western Ontario in 1996. With over 25 years of clinical experience creating beautiful and healthy smiles, Dr. Bis offers a unique approach to dentistry, blending modern dental practices with the use of digital technology to optimize health outcomes. With thousands of hours in post-graduate training, her unique focus and expertise in treating TMD and providing options in restorative dentistry, along with digital technology have led to helping numerous patients resolve chronic and debilitating dental challenges.