Dr. Scott's Background

"My curiosity has taken me to many places and I love being a student.  In 1982 I began practicing dentistry in Philadelphia.  Even in dental school I was fascinated with complex cases and undiagnosed problems. 

In 1986 I took six months off and traveled around the world with my husband and my view of the world expanded.  I opened a dental office in downtown Nashville that same year.  My patients were all adults with a history of good dental care.  I began to see a pattern of unaccountable restoration and tooth failures, bone and soft tissue loss, and chronic head pain.  None of the problems were due to decay. 

In 1989 I began to focus on solving the problem.   I have been fortunate to recognize excellent learning opportunities.   I took every course offered by the Pankey Institute and took almost all of the courses offered by doctors Pete Dawson, Henry Gremillion, Frank Spear, John Kois, Parker Mahan, Mark Piper, John Droter and Jeff Okeson.

Collectively this group has helped define the best practices in the disciplines and clinical practices that address TMJ disorders.  My focus has been to develop and refine a diagnostic process and treatment protocol for the TMJ patient.  

Approaching the "TMJ problem" slowly from an interdisciplinary perspective helped me see the bigger picture.  TMJ problems are a disintegration between the elements of the chewing system as a whole.  This is not to expand the scope unnecessarily, but treatment protocols have failed because narrower viewpoints fail to address all the components of the system at once.   This is also not to diminish the joints themselves.  They require much better attention than they have received in the past.

All of the hard and soft tissue that make up the joints and the mouth including all of the muscles that position and power the jaw make up the chewing system.  When one element has problems everything in the system suffers.   Most of the time the body adapts by itself.

When problems do not resolve themselves, the diagnostic process is complex.   We may never know what started a problem, but we have to know the current status of all the elements and how they are affecting each other.  The real breakthrough for me was seeing that the treatment  had to be a sequence of results.  Start with rehabilitating the TM joints as the foundation and add joint-based occlusion to protect the joints.  At that point the chewing system is stable. 

It's usually a simple, non-invasive process for the patient, but requires time for the the body to heal and the bony structures to adapt.   It's a complex process for the doctor to diagnose because each patient has a unique set of factors.   Highly specific diagnosis is required.  Treatment never progresses the same for patients so adapt as we go. 

For some treatment plans I had to widen my view to see how specialist could be used to resolve some specific problems.  TMJ Disorders or TMD is actually a multitude of specific medical disorders that fall under one designation.  There was no specialty that brought all the facets together.  There was no generalist for the TMD patient for long term case management.  There was no definition of the scope of the field; the depth of knowledge required; and the clinical practices used.    

In 2001, I became a Master in the Academy of General Dentistry having a great many more hours than was required.  The Academy has been very helpful in establishing the standards to create a new  type of practice.  I refined my business practices with Dr. Mike  Schuster's Center for Professional Development and this allowed me to plan to make a real change.

I realized that a practice limited to TMJ patients was possible and necessary.    Offering medically sound diagnostics and treatment was all that was required.

In 2003  I sold my general dentistry practice and opened a TMJ Rehabilitation Practice in a new location.  Today I offer only TMJ rehabilitation services.   I operate as an unofficial specialty seeing referral patients from dentist, MD’s, chiropractors, physical therapist, and accident attorneys.  

Guiding Principle of TMJ Rehabilitation:  Do whatever is necessary to allow the joints to adapt and develop as much natural stability and function as possible.  Then adjust the occlusion to match the adapted joints.  When the bone and teeth are in harmony, the muscles that issue most of the pain are able to recover and pain subsides.   Other symptoms are resolved or truly minimized.  Outcomes are predictable.

I am committed to refining and establishing a standards-based clinical protocol that is accepted within the medical care delivery network.   

My clinical goals are to refine the diagnostic and treatment protocols to improve outcomes and reduce suffering and costs to the patient.   

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