If you have never experienced a TMJ problem then you may not appreciate the value of having a doctor who knows about the temporomandibular joint. But what you may not realize is that you are even less likely to develop a TMJ disorder if your doctor knows how to practice preventive dentistry by fixing your bite in a way that the joint is not injured. In general, the more complicated your bite, the more likely that you can acquire a TMJ problem if you are not fixed appropriately. We teach our students how to prevent injury to the TMJ by establishing a functional bite that does not stress the joint.

Some TMJ disorders are asymptomatic or painless. Therefore many patients are not aware that they may have a potential problem. This is particularly true in the child patient. When a doctor can pick up an early abnormality, more serious damage can be avoided. Serious damage to the joint can occur with or without pain. Little is gained if you make a big investment in your mouth only to have your bite change and your chin recede. Most dentists never examine the TMJ. We teach our students to recognize when a joint has an early problem that projects to become more serious. We teach our students how to do non invasive screening for abnormal joints. Furthermore, once our students pick up a problem they know how to advise you about your treatment alternatives.

A smaller segment of the population has a serious joint condition or pain. This may be a child whose jaw has failed to grow normally, a teenager who is starting to have headaches, or an adult who is breaking or losing their teeth. Many TMJ patients develop life threatening sleep apnea. When a patient experiences a serious problem or severe TMJ pain, then they will do almost anything to get well. Unfortunately most of these patients are mismanaged because their joints are never imaged, testing is ignored, or treatment is empirical. At PERC we teach our students how to understand the condition of the joint in every patient. For more serious problems we teach them how to order and interpret tests and how to prescribe directed treatment. Most dentists have never seen a scan of an injured TMJ. Our students have seen hundreds of such joint scans, and they know what to do when they find an abnormality.

You may be one of the most unfortunate of TMJ patients suffering from failed previous therapy. Pain patterns may become increasingly worse and non responsive to narcotics. Bite alignment may be distorted and crippled, and the teeth damaged or lost. Appearances sometimes change so dramatically that patients become unrecognizable. At PERC we teach our students how to recognize the complications of failed management. In particular our students have been trained to look at three aspects of every patient. The first is the pain patterning of the patient. More complex patients typically have mixed pain patterning. Some pain layering represents serious nerve damage. The second is the condition and the stability of the joint. For very complex patients this means that the doctor must know what TMJ images to obtain and how to interpret them. The third aspect that PERC students learn about TMJ patients is how the bite and the face are changed by a poorly developed or degenerated joint.

As a patient you have choices to make. We know that these choices are not always easy. In no way are we implying that PERC trained doctors are the only or the best doctors in their given community. We also do not claim exclusivity in the training of doctors. There may be excellent doctors in every community, and as a patient you may be fully satisfied and grateful for the care that you receive. We applaud successful outcomes because that is what treatment should be about. PERC is of value to those patients who have lost confidence or who cannot find expertise. We are simply attempting to network patients and doctors. The doctors on our site are doctors that we have trained. Doctors cannot be listed on this site without having trained in the principles that we teach at PERC. We know the level of care that PERC trained doctors can deliver to patients.

For non doctor facilities we will do the best that we can to rate what we know. At the Piper Clinic we have reviewed thousands of MRI scans from dozens of facilities. Those facilities that have produced acceptable quality will be acknowledged. Our patients have treated with hundreds of physical therapists, massage therapists, pain management doctors, neurologists, and etc. If we have gotten favorable feedback then we will add these to the facilities that patients can access. At PERC we want to help you find facilities that can give you the best care. Please feel free to use this site as a search tool. As our database builds we will try not only to give you the names of PERC doctors but we will also let you know how much training they have obtained.

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