Impact of the IAPA
Protect Your Freedom To Practice Physiologic Based Dentistry
The Historical Attempt To Restrict Your Physologic Freedom
1960’s – Physiologic Based Dentistry started when Dr. Bernard Jankelson developed the ultralow frequency TENS to relax muscles for denture patients. Also, the orofacial pain groups put forth the psychosocial theory of TMD.
1970’s – NMD expanded and was applied to restorative dentistry, the CR and gnathological camps began to attack Dr. Jankelson’s work.
1980’s – The use of NMD in treating TMDs coalesced with the advent of the personal computer. By 1986 the science of NMD was firmly established in the scientific literature.
The orofacial pain groups saw the objective documentation provided by the computerized Physiologic equipment as a dagger pointed at the heart of their philosophy and began to exploit their positions in the academic communities to attempt to discredit NMD. They failed to stop the ADA from granting its Seal of Recognition to bioelectrical instrumentation in 1986.
This Anti-NMD group moved back to the ADA with attempts to get a specialty in Orofacial Pain. Controlling the educational process and the specialty would have given them the power to outlaw NMD. Several attempts to establish this specialty were defeated at the ADA level around 2000.
2000’s – Our opponents regrouped. They continue to publish scientifically questionable papers misusing the equipment and proclaim that it does not meet their “standards” and hence should be outlawed. In 2005 the Royal College of Dental Surgeons of Ontario convened a court against a Physiologic dentist who successfully treated a patient for TMD who had failed to gain any relief through seven years of treatment by the Dean and Professor of Oral Pathology at Toronto Dental School. The dentist was found guilty at the College trial but on appeal was victorious at a higher court.
2010’s – Their attacks have reached an all-time high using their political academic bases to sneak their agenda into regulatory bodies such as has occurred in Canada as well as 2011 in California. Recently, the College of Dental Surgeons of Saskatchewan has proposed restrictions on general dentists treating TMD that are more onerous and draconian than those in Ontario. No general dentist would be able to treat a patient with more than a flat plane splint and palliative care. If symptoms persisted, a referral to a specialist (oral medicine, prosthodontist, orthodontist, periodontist or oral surgeon) would be required. These guidelines would essentially stop all treatment of TMD by general dentists in Saskatchewan. The six references cited all include Dr. Greene or the AADR/IADR positions. No dissenting voices were allowed! The timing is suspicious and reeks of duplicity and organized action.
In 2011 the Council on Peer Review of the California Dental Association attempted to “update” the TMD Guidelines. The proposed guidelines were taken virtually verbatim from Greene’s ADA article proposing the AADR/IADR position which would have ruled out the use of NMD. Only an 11th hour push by representatives of the IAPA contacting all the CDA Trustees got the measure returned to the Council for retooling.
Greene influences CADTH (Canadian Agency for Drugs and Technologies in Health) & ODQ (Ordre Des Dentistes Du Quebec). CADTH conclusions against NMD is based on Greene’s references He now has influenced a Governmental agency (Canadian) saying that NMD is NOT effective, literature review does not support its usage and puts in doubt the entire NM philosophy.
IAPA – The Voice of Physiologic Based Dentistry – What Have They Done For You?
We who practice Physiologic Based Dentistry cannot expect a small group of leaders to continue to stand alone against these attacks. Only through the power of a united voice crying out on behalf of our patients and ourselves, can we expect to continue to be free to practice as our science and our consciences dictate. We must have a strong and powerful voice. That voice is the IAPA and the more members it has, the more powerful the voice.
2005 – The IAPA was formed due to Physiologic Based Dentistry not being allowed to speak at other dental meetings and to become THE VOICE OF PHYSIOLOGIC BASED DENTISTRY.
2006 – Dr’s. Gary Klasser and Jeffrey Okeson article published in JADA against surface EMG use for diagnosing TMD. IAPA officers and members had letters to editor published in opposition to their conclusions.
2010 – Dr. Charles S. Greene article published article in JADA, OOOOE, JCDA, and in Japan announcing a “New Gold standard in TMD treatment” which was the same thing he was proposing in the 1990’s. The IAPA suggested and supported a write in campaign to JADA and JCDA in opposition. Normally JADA receives 100 letters to the editor a year for all of their articles. A new JADA record was set with over 300 letters in opposition to this one article. JADA editor later stated that if he would have known the article would have caused such a problem he would have not published it. The negative response to Greene’s article by the IAPA led to the ADA removing some of the authority of the JADA Editor.
2011 – The IAPA requested ten minutes to discuss the Greene article with one of the ADA officers. The IAPA was granted one hour to meet with the ADA President, President-elect, Vice-President of Scientific Affairs, Chair of the Dental Practice committee, Executive Director, and the ADA Publisher. All but the last two attended the meeting which lasted almost two hours. At this meeting, an invitation was extended to the IAPA to participate in a “discussion” about TMD at the ADA Annual Session that year in Las Vegas.
2011 – The IAPA was represented in a TMD debate regarding the use of NM equipment in TMD diagnosis. The debate was in an open area of the exhibit hall so attendees in the exhibit hall could also listen. There were about five hundred attendees. The ADA Editor and VP of Scientific Affairs hosted the program and stated they felt that the IAPA defended the NM position well.
2011 – The California Dental Association Executive Committee approved a change in TMD treatment guidelines. Through IAPA connections with the IAPA it was discovered that the changes involved Bio-Psycho-Social philosophies but was not being disseminated to the membership until after voting by their Board of Trustees. However, IAPA officers and members were able to contact the Trustees and inform them of what it was about. When the meeting started this new guideline was immediately removed and sent back to the committee as it was all the Trustees wanted to talk about. This may come up again and will require diligence to assure it is not sent through again with stealth.
2011,Nov – Journal of Oral Rehabilitation publishes Dr. Danielle Manfredini’s study claiming SEMG’s and Kinesiographs should not be used for TMD diagnosis. IAPA and its members sent letters to editor in opposition of Dr. Manfredini’s conclusions.
2012, April – JADA publishes article by Dr. Mohammad Al-Saleh, (JADA 2012;143:351-362) of U. Alberta who concluded that SEMG’s are not diagnostic for TMD. IAPA wrote an official letter to JADA Editor protesting this and it was published in the Oct. edition.
2012 – Dr. Danielle Manfredini in Italy, long a NMD opponent and friend to Dr. Greene, published in the OOOO Journal that the K6 Kinesiograph he used, (which was 12 years old and non-calibrated), was not accurate compared to using the “Gold standard” of an MRI. IAPA wrote a letter to the editor of the OOOO Journal but this was not published.
2012, Dec – In Quebec, Canada, after Dr. Charles S. Greene’s visit to the province, the ODQ, Dr. Barry Dolman, (President of their dental board), wrote a letter to all of the dentists stating they should not use NMD or occlusal devices for TMD treatment and specifically stated, “treatment should be based on the biopsychosocial model.”
2013, Jan – Through the IAPA’s membership in the American Alliance of TMD Organizations, a letter opposing the ODQ’s letter was sent to Dr. Barry Dolman. Though the Alliance had not sent a letter to any organization before, the IAPA insisted that a letter be sent and was the primary writer of the letter – it was approved by all member organizations.
2013, Jan – The IAPA representative to the American Alliance of TMD Organizations became Chair of the organization.
2013, Jan – CADTH (Canadian Agency for Drugs and Technologies in Health), a private corporation that provides scientific opinions for the Canadian Government, released a requested report stating that NM dentistry should not be used for TMD treatment. Again, the IAPA was instrumental in having the TMD Alliance send an official letter of opposition to their findings.
2013, Mar – JCDA published the CADTH report on their online blog. IAPA and its members wrote letters of opposition to the Editor of JCDA.
2013, Apr – JADA published Dr. Manfredini’s study which concluded that pain and bruxism are not associated with occlusion and that the K6 they used did not detect pain. IAPA has again sent a letter to the Editor in opposition to the study.
2013, May – Journal of Oral Rehabilitation publishes an article by Dr. Greene where he states it is unethical to treat TMD through occlusal therapies. The IAPA has responded to his unethical claims.
2013 – There has been no response from CADTH or Dr. Barry Dolman regarding their positions regarding NMD. With both Dr. Greene and Manfredini having more papers published they are having more exposure to their BPS philosophy but more importantly, they are having more exposure to their anti-Physiologic message! Physiologic studies are needed to counter their studies and articles. The IAPA is working on ways to help members conduct and write papers on Physiologic Based research.
2013 – The IAPA has been asked to participate in and oversee a special TMJ issue of the California Dental Association. Authors from other TMD philosophies will also participate. Dr. Greene refused to participate.
2013, Aug 1, 2, 3 – IAPA will host a special presentation on the critical issues facing NMD in Calgary, Canada.
Can you imagine what would happen if there were no IAPA?
2014- April 30- May 3 – Dr. Bill Dickerson appeared on an Occlusion Panel during the 2014 AACD Meeting in Orlando, Florida.
If you value your freedom to provide the best care possible for your patients, support and join the IAPA! For almost the price of the lab fee for one crown ($365), you can help protect your own future. Every Physiologic Based dentist needs to support this organization.
And come to the 2020 IAPA Conference at the LVI Campus in Las Vegas to hear and learn what we need to do individually and as a group. And best of all, to become an agent of change …learn how to help us maintain our professional freedoms from those who would take them away.