It's time ADA, come on along (an open letter to the American Dental Association).

was going bad?” asks the all too often, perplexed dental patient. “Dental schools don't have enough time to teach about the TMJ in an already crowded curriculum further stressed with new and improved materials and techniques in most disciplines of dentistry. They just don't have any additional time,” I alibi. I'm getting tired of making excuses for the American Dental Association (ADA) and dental schools when the honest truth is that they are just indifferent. How can you continue to ignore the dysfunctional temporomandibular joint while allowing dental students to place restorations on patients’ teeth that are attached to an unhealthy jaw? Shouldn’t the first step be to decide whether or not the main controlling joint is in a stable condition? Why continue to place good dental work on jaws that are destined to cause the patient more pain and problems? Thirty years ago, when most of us were just learning about internal derangements, it was understandable that patients couldn’t find a good TMJ dentist in their immediate area. Now it’s embarrassing that more “good dentists” aren’t diagnosing early onset temporomandibular joint problems. The periodontists have done a fine job of getting all dentists and dental hygienists to probe around in their patients’ mouths for five mm pockets. It takes a lot less time to place your two fingers over the patients’ right and left TMJs and feel for popping, clicking, and locking. This followed by a few well-placed questions should help the practitioner uncover a TM joint problem in the unsuspecting patient who is complaining of headaches. I am not the only one who has asked these questions. I learned from many mentors who were knowledgeable long before I would discover their truths for myself. A few of my mentors were: Weldon Bell, L.D. Pankey, Parker Mahan, Bill Farrar, Robert Ricketts, Clyde Wilkes, Harold Gelb, Peter Dawson, Peter Neff, Mariano Rocabado, Jack Haden, Janet Travell, and the list goes on. Why then has it taken so long to implement these known concepts into the normal dental curriculum? Some would say, “a lack of published information.” In response to that, I would point out the 110 issues of CRANIO: The Journal of Craniomandibular Practice, as well as the Journal of Orofacial Pain, and other scientific journals whose manuscripts have and still are validating the basic concepts over and over again. Also, just this past year (2009), two new excellent resources have been published. One is a book by Clifton Simmons entitled, “Craniofacial Pain: A Handbook for Assessment, Diagnosis and Management” with 17 clinically practicing contributors.1 The other is a book by Noshir Mehta entitled, “Head, Face, and Neck Pain Science, Evaluation, and Management: An Interdisciplinary approach.” It has 37 chapters, 722 pages and some 59 astute contributors.2 I point out these two books to show evidence of the maturity of this field. What if you, ADA, choose not to accept these 30 plus years of labor and knowledge that have been prepared on your behalf to advance the profession of dentistry through better service to our patients? Who will assume the leadership—possibly medical orthopedics, ENT, osteopathic medicine, or even the chiropractic field? This information has been accomplished and undergirded with documentation for you. It’s been a long time since ADA President Robert H. Griffiths held “The President’s Conference on the Examination, Diagnosis, and Management of Temporomandibular Disorders” in Chicago in 1982. You need to show current involvement in this important area of development. You did a good job selecting Oral Maxillofacial Radiology as your 9th specialty area—what about now acknowledging TMD as well? It’s time ADA, come on along. Gordon Christensen said in Dentistry Today (February 2000), “The three major diseases we treat are caries, periodontal disease, and occlusion. Occlusion remains the major untreated disease in dentistry today.”3 I personally would modify occlusion disease to include C O N C E P T S