Patients suffering from temporomandibular joint disorders oftentimes are frustrated by the confusion and disagreement within the field about diagnosis and treatment. Most frequently diagnosis is made without benefit of medical imaging or reliable medical or dental testing. The interpretation of signs, symptoms, and diagnostic tests is often variable, erroneous, or incomplete. Depending upon the consulted specialist, options for management may vary widely from doctor to doctor. As a result, patients may become lost in a maze of confusing opinions. Unfortunately, improper initial management, whether surgical or non surgical, may start a course of failure resulting in progressive pain, bite instability, and recession or asymmetry of the face. Oftentimes after investing in extensive dental work, orthodontics, or surgery, there is further bite change and onset of new pain. All too many patients enter into treatment that they expect will make them better, only to discover that their symptoms have become worse. Patients and doctors alike experience feelings of alienation, inadequacy, and outright fear of additional attempts at management. Ultimately those patients who have not responded or who have worsened with treatment may face the hopelessness of finding no doctor to treat them and no insurance for coverage.

The Piper Clinic has been focused on quality patient management for over twenty-five years. We have not stagnated in our diagnosis and treatment, and we have focused entirely upon the wellbeing of the patient. We have heard every story imaginable, and we have seen thousands of cases of failure at the hands of well intentioned doctors and faithful patients. We know that the fields of TMJ, occlusion, and facial pain are in a severe crisis. Many doctors do not want to treat "TMJ" patients. Older doctors may not want to meet the time demands of the population, and new doctors are often inadequately trained. It is our observation that fewer doctors are knowingly treating the TMJ today than at the end of the 20th century. The bottom line is that many patients have a TMJ problem, and they do not know it because their doctors have not been trained to recognize the early signs that precede actual symptoms such as pain. At the Piper Clinic we have put the temporomandibular joint first. It is the foundation of the jaw structures. This is the foundation that supports the bite. This is the foundation that must be stable to prevent pain. Dental or pain treatment should start with an accurate assessment of this foundation.

The Piper Education and Research Center (PERC) is unlike any other organization in the world. We are dedicated specifically to the promotion of standards that will benefit the temporomandibular joint population. We see this as a maturing field oftentimes besieged by outdated biases and competing ideologies. Like most areas of medicine and dentistry, scientific advancements are often slow to integrate into the practices of the initial treating doctor. Through our educational efforts we seek to change this trend. We identify students who want to obtain the highest standards of training. By networking trained individuals, it is our desire to escalate the pace of scientific advancement. We share these advancements openly for the continual benefit of all patients affected by temporomandibular joint disorders and facial pain.

It is not our objective to debate or belittle other philosophies of management. We believe in the freedom of patients to seek the care or their choice. However, we also believe that every patient deserves to be fully diagnosed, informed of their options, and advised of management alternatives before embarking on any pathway of treatment. We prepare our students to be analytical, objective, educated, thorough, and competent in their care of patients. We may not teach how to make teeth whiter or prettier, but we do train our doctors and other students to recognize when their dental treatment will succeed or fail, based primarily upon the stability or degree of instability of the temporomandibular joints. Thus we teach dentists to work from the foundation of the temporomandibular joint, a concept developed at the Piper Clinic, termed Joint Based Dentistry. Therefore, our students are at the forefront of Joint Based Dentistry because they are trained to perform an assessment of the face that extends beyond the teeth to the underlying facial skeleton and temporomandibular joints.

It is our objective to enhance the quality of patient management. This goal can be fulfilled by identifying doctors and facilities demonstrating consistent effort in developing their expertise and skills. Although we cannot guarantee the work performed by other facilities or treatment given by other doctors, we do believe that patients should be empowered to learn about our PERC doctors and their educational efforts. We want patients to seek the best treatment that they can, and we believe that our students at least have the background knowledge to reliably solve most temporomandibular disorders. It is our intention to network patients with doctors who have been through our training, and we want patients to know the effort that doctors in their community may have made at the Piper Education and Research Center.

	Our promise to patients is to do everything we can to offer them their best options.
	At the Piper Clinic we promise to offer diagnosis and treatment that result in the best care that we can give.
	We promise at the Piper Education and Research Center to train the best doctors in the world.
	It is our promise through this website to be the best resource for information to patients.

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