Wednesday, August 21, 2013


I’m writing this post as on a flight back home from a weekend course on advanced occlusion. Eversince I graduated from dental school, I’ve been searching around amongst books, courses, lectures, and articles, trying to understand what the role of TMJ is in my day-to-day practice. The more I learn, the more I realize how important it is to understand some of the basics about this joint and how it relates to even the simplest dentistry we do.

I’m shocked at how little knowledge we gain about the TMJ during our dental education. After hours and hours of CE courses, I’ve realized how even the simplest filling we do can have a negative impact on the health of this joint. How many fillings and restorations have I placed in the past years without any attention to this concept? I am only one of hundreds of students who graduate every year. Only a handful of us spend the time and energy to investigate this subject further. It scares me to even think about the magnitude of damages we have potentially caused. But, at the same time, it does relieve me to know that the human body is so sophisticated and self-healing that about 70 percent of it usually adapts to whatever is thrown at it. Thinking about the other 30 or so percent still leaves room for questioning the structure of our education system.

Why is a concept as important as the health of the jaw joint, which is known to be the most complicated joint in the body, touched on so lightly in dental schools? Perhaps it is because of its complicated nature and the amount of controversy that exists in different philosophies. But I would much rather have had this concept dissected for me even with all its uncertainties and left open for me to reach my own conclusions than have it be taken off the shelves and hidden because no one has a solid answer to the questions.

I love the school I graduated from and cherish the education I received. I’m proud of it and would go back in a heartbeat if I ever had to repeat it. But if I had one request to make things better, it would be to add a serious discussion about the TMJ and at least drive home the importance of it in everyday dentistry. We should all continue to pay attention to it as the studies evolve and methods emerge. I know this issue is universal amongst most dental schools, and I wish it could change.

Mona Goodarzi, DDS


DianaNguyenDDS said...

Which course are you taking, Dr. Goodarzi? Would you recommend it to a (relatively) new graduate? I've been looking into occlusion courses and would love some feedback on your experience!

Katie Divine DDS said...

While I was a dental student I ran Into some dentists who were taking a CE course on Occlusion at the Scottsdale Center for Dentistry. I asked them about CE and what courses they'd recommend and they both stressed occlusion! I agree with you that dental school is seemingly the tip of the iceberg. Where would you recommend starting with this topic? Any specific CE courses? Any comment on the CR vs neuromuscular approach? Thanks!

Unknown said...

Doctors Divine and Nguyen,
Thank you for your comments. I'm not sure I can advertise for programs here publically but if you send me a private message,, i would be happy to share my experiences and personal opinions. as for CR vs neuromuscular, in my opinion all these philosophies work well otherwise they wouldn't still be around. what's important is picking one that you feel you can work with perfectly and sticking to it. they are all technique sensitive and mastering what you choose is more important than the actual choice!

thanks again,


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