Most of us will bring a health problem to our family doctor first, especially something nonspecific like a recurring headache. We’ll start by trying to handle it ourselves, then when we realize we need to see a doctor about it, we’ll take it to our family doctor.
But how will your family doctor approach the problem of TMJ? Will they help you to get the care you need? This is a very complex question, and all doctors will come at the problem in subtly different ways, but we can get some idea by looking at the briefing document from the American Academy of Family Physicians.
A Vaguely Defined Disorder
When we look at this document, it’s clear that the author doesn’t have a well-developed sense of the range of temporomandibular joint disorders and how their severity may require different types of treatment or diagnosis. The document acknowledges that TMJ is common, but then lumps all different types of symptoms together: “one or more symptoms, which include jaw or neck pain, headache, and clicking or grating within the joint.” Here, there’s no acknowledgement that clicking and grating sounds are potentially very different symptoms indicating significantly different stages in the development of TMJ.
The briefing document notes that “Research [on TMJ] has been hindered by the lack of clear diagnostic criteria for TMJ disorders,” but then dismisses the comprehensive classification system that had already been developed by the International Consortium for RDC/TMD-based Research and recently accepted by the American Dental Association because it’s too long and in-depth. The emphasis (perhaps rightly for family physicians and other general practitioners who experience serious time pressure in dealing with patients) is on finding a quick and easy test.
The author of the document settles on the use of diagnostic nerve block as a simple yes/no test for TMJ. Basically, if your doctor deadens nerves in your jaw and you still feel pain, the author says, you “should be evaluated for other causes of orofacial pain,” as if all TMJ-related pain originates only in the jaw joint.
Diminishing the Dentist
Another troubling aspect of this briefing document is that it greatly diminishes the role of the dentist in treating TMJ. It takes great pain to stress repeatedly that many, indeed, most, TMJ sufferers get better without treatment. This is true, and it’s also true that noninvasive treatments are best , but when the writer implies that dental treatment is somehow inferior to physical therapy, psychology, relaxation techniques, and even alternative treatments, they are definitely off-base.
It does tell us, though, that if you go to your doctor for help with TMJ, you should not wait for them to refer you to a neuromuscular dentist. They are looking for a quick and easy answer to a complex problem, and they may not understand the complexity that makes neuromuscular dentistry so successful for some people with TMJ.
If you have found that your TMJ is not responding to the quick and easy answer of your family physician, we can help. Please call (803) 781-9090 for an appointment with a Columbia, SC neuromuscular dentist at Smile Columbia Dentistry.
