“TMJ” is a common acronym term for an affliction that plagues a large segment of the population. Actually, everyone has two TMJ’s, or temporomandibular joints. They connect the lower jaw (mandible) to the upper jaw (temporal bone). They are very unique to all the other joints in the body, as they move in and out of their sockets, or “dislocate” so to speak, during normal functions such as chewing, speaking and yawning. All other body joints normally remain within their sockets during motion, and if they dislocate, it is a very traumatic event. The TMJ’s are a ball and socket type joint (condyle and fossa) that can move in many directions during normal function. In a healthy functioning mouth, however they do have a stable “home base” position (left image) when the teeth are closed together. They can, however, also be forced to operate out of their normal, healthy positions, in this case, the cartilage being dislocated in a forward position (right image).


The challenges…

I have found dentistry to be a wonderful and challenging profession, one that is a true blend of art, science and skill. As crucial as it is to provide excellent technical skill, the one type of skill-learning that was missing in dental school was that of interpersonal relations. Which leads me to my next point that was another important realization: No matter how gifted, skilled or technically able the dentist may be, true dental health cannot be achieved by the dentist alone. It must involve the participation and partnership of the patient as well. This is why I take the time to get to know my patients, and to gain their confidence and trust before we even begin dental treatment. If one has a willingness to learn and improve as a patient, combined with my expertise and passion as a dentist, the true formula for success appears! This relationship development and emphasis on patient learning is the core of what has been called the “health-centered” dental practice, to which mine has evolved.

A little insight into the dental profession: Most dentists typically are not the greatest of teachers. We were selected for dental school based mainly on our manual dexterity and analytical skills, not on our ability to interact with people. We were taught to diagnose dental problems and to “fix teeth.” We were expected to perform procedures on patients who sit passively in dental chairs, not to involve them in learning, which is an interactive process. Consequently, most dental offices you see today are designed mainly for “doing” or “fixing” rather than for “teaching” and “learning.” I have made a concerted effort, over time, to gear my practice towards offering learning experiences for my patients that can empower them to take a large portion of their dental health into their own hands.

This may sound simple enough, but there are obstacles that work against the dentist developing a health-centered approach to their practice. For instance, if you are a new dentist starting out today, you are saddled with major debt. It is not uncommon for the new dental school graduate to have an indebtedness of $200,000, to which a return on invested capital including interest, as well as lost income while in school must be realized. Add to this the fact that, unlike a physician for example, who has hospital privileges, which includes staff, the dentist must set up and operate his/her own dental “hospital” with expensive equipment and quality staff. This financial burden puts pressure on the dentist to produce, rather than to take the time to further their studies and teach their patients. These realities are what tempt the dentist to feel the necessity to be concerned more with quantity than quality.