Why isn't regular Dr's trained for TMD?

[MyTau]

It seems that while TMD is in the jaw it should be something that regular Dr's train to take care of. I was diagnosed with TMD almost 2 decades ago, and since I was 18 I have been to the dentist once (I am 45 now) I hate them, don't take this personally but so much pain going tot hem and I have a real fear about going back. I've always taken good care of my teeth, only 2 cavities. They need a cleaning but considering the length of time they look pretty good, but my TMD is causing me great problems. Clicking has gotten worse, constantly grinding and at night I've had my jaw snap shut like a trap and now my front tooth has a fracture down the middle. My tongue has been bitten so hard when I wake up it's sore, and I am surprised I have not snapped it in half. Headaches, jaw, neck, pain, ears ringing, popping, ear and sinus pain, always stuffy, and ears always feel full. This is on top of my Lupus, DDD, OE, Raynuads, costochondritis. Money is tight as I have been battling for my SSD for 3 1/2 years, but I finally have a hearing on Feb 5th. When I finally have money coming in I will finally go to a dentist, but do I have to start with a regular one or should I just go to one that specializes in TMD or do I have to go to a regular dentist and be referred to a specialist? I'm on all kind of meds for my illnesses, pain meds and muscle relaxers so I'm not too bad off, but this morning when I ate I heard kind of a rice krispie sound, that is new, usually it's a popping sound. I have little lumps in my jaw muscles, probably from spasms. I know I have 3 partially herniated discs in my neck, tendinitis, carpel tunnel (I have hard surgery for that), so you see I am dealing with a lot of ****. I have an appointment with my regular Dr on the 3rd,for my 2 month check up and med refills. I haven't talked to her about the TMD because it's something I figure she can do nothing about. I live in Federal Way Wa, south of Seattle so if anyone can recommend a kind of compassionate dentist that can deal with a dental phobia patient I would appreciate it. Thanks!

[TMJDoc]

All of my treatment of TMD patients is billed on medical insurance as it is a medical problem.  The big question is whether or not your insurance policy covers non-surgical treatment of the TMJ.  Physical therapists and Chiropractors submit to medical insurance (and sometimes for the TMJ) so it's not a question of professional degree.  But this is also why you need to find a dentist that 'specializes' (at least more the average dentists) because they will know how to submit the medical insurance.   Patients with TMJ problems more often than not grind and/or clench their teeth and damage them.  TMJDoc

[MyTau]

I forgot to add I notice that both my front teeth now have cracks in them.

[MyTau]

I'm only questioning it because it would be easier financially if it was something PCP could take care of because then my insurance would pay for it, and not because I think it is something Dentists shouldn't handle. I've been researching and found a couple Dental places that have someone who is trained for TMJ/D. Now it's just a matter of waiting until I finally get SS disability coming in to be able to afford it. Thanks for your reply.

[TMJDoc]

Physicians are not trained in treating the TMjoint because it's position and function is directly related to the way your teeth meet--called dental occlusion.  I want to make it clear that how your teeth come together is NOT the cause the TMJ problems, but often the result.  Also, because the most effective treatment (done by a properly trained dentist) would almost always include a splint (aka orthotic, mouth guard, etc.) of which physicians have no interest in learning and shouldn't anyway.  You need to get over your relating dentistry to TMjoint treatment.  I can tell you the only thing they have in common is that a dentist does both.  The only 'dental' work I do is orthodontics when the TMD patients need to re-established a proper 'bite' after successful treatment of the TMJ.  Treating TMJ Disorders is really an orphaned discipline.  It is not taught in medical school, and most dental schools have little time and expertise, truthfully, to teach dentists.  I know that sounds counterintuitive when it is the province of dentistry, but it really is a specialty that has yet to be recognized and fully developed academically.  It's getting there, but the treatment philosophies vary so much it is hard to establish a standard of care.  Frankly it's a political mess in the dental profession and that is not helping patients like you.  And for that I apologize for my profession, but as one person I do what I can, even though sometimes I'm not popular with the politically motivated dentists.  It's also the reason I take the time to pass out advice--for whatever it's worth.  

I think most dentists are used to dealing with dental phobics as there are a lot of you.  You need to find an excellent TMJ specialist and you may have one in Federal Way.  Contact Dr Duane Jones, DDS @ 253-941-8000.  It certainly sounds like you could use some relief from your pain.  Good Luck, TMJDoc.