Why Don’t All Dentists Treat TMJ?

I get this question a lot from patients that land in my office. Don’t get me wrong, there are a lot of dentists that want to and have a specific interest in treating jaw dysfunction, but many dentists have NO INTEREST! Do you want to know why? Me too! I think there are a lot of reasons, so consider this more of my opinion than actual fact- but to start with- dental education doesn’t often include a lot of learning in the field of jaw joints. Coming out of dental school (and I went to dental school with Dr. Okeson who literally wrote our book on TMJ), I had a basic knowledge of jaw anatomy and what function and dysfunction look like. I learned enough to know that I could recognize when something wasn’t right, but I didn’t have the tools in my toolbox to know what to do with it. We learn about night guards to protect our dental restorations from clenching and to treat minor jaw discomfort, but beyond that I didn’t have much else to offer. I would say that this most likely applies to many students coming out of school. So, in order to treat TMJ, a dentist would’ve needed additional training through continuing education courses, mentorship, or residency to become fully versed in the diagnosis and treatment of this very complex disorder. And even after that, there is ALWAYS so much more to learn. And to be honest, dentists are pretty busy continually learning and perfecting their every day dental treatment it doesn’t leave a lot of time to learn about everything. When I graduated from dental school in 2013, orofacial pain was not even a recognized specialty of the American Dental Association. Because of this, there wasn’t really a defined pathway through residency to become a specialist. Residencies existed and I was very much interested in them, but I didn’t know much about how to pursue this as a career path. I think this is another reason many dentists haven’t explored this field more thoroughly. In school, we had yearlong courses on orthodontics, fillings, crowns, dentures, but had a limited section devoted to TMJ and we didn’t learn ANYTHING about sleep apnea. Because the majority of this specialized education happens post dental school, not everyone has exposure to it. The other reason I think dentists don’t delve into the world of TMJ is that it is COMPLEX and not straight forward. Managing expectations of outcomes for chronic pain is the most challenging aspect of this job. In the dental world, if you come to my office with a toothache, a cavity, or a broken tooth, I can fix that for you. You can come in with pain and leave without pain. TMJ is not that kind of thing. It’s multifaceted and multilayered and is more of a condition that is managed as opposed to something that can be fixed. Don’t get me wrong, we take people that are a 9/10 pain and can bring them down to a 4/10, or we can even take someone to a 0/10 for a period of time depending on the condition– but joint deterioration, arthritis, and disc dysfunction are managed chronic conditions. Most likely, if you’ve been diagnosed with TMJ dysfunction it will always be some part of your life. My goal is to make it a much smaller part of your life. This can be a major mindset shift for a dentist (typically a perfectionist personality) to wrap their mind around because dentists are in the business of fixing things. Success looks different in this field which can frustrate a dentist for sure. But that is why I exist!!! I am a general dentist. I’ve completed hundreds of hours of continuing education on sleep apnea and TMJ, with more to come. I enjoy the complex challenge of TMJ. To me, it’s like a puzzle that needs to be solved, and I love the process. I really enjoy listening to patient’s stories and helping them feel heard. I like the challenge of management and communication. I like making people’s daily life better. I find it incredibly rewarding. Don’t hold it against your dentist if they can’t give you what you need from a jaw pain perspective. If you need a tooth taken out or a root canal, they’re your person. If you’ve been dealing with daily pain in your head, face, jaw, or ear you might need to visit me! I can’t wait to meet you.