The
Temporomandibular Joint Disorder
Newsletter
Vol. 1, No. 1
ISSN 1091-7888
June 1997
HAS
HARRY COOPERMAN, D.D.S.,
SOLVED THE PROBLEM OF
TEMPOROMANDIBULAR JOINT DISORDERS?
Albert Schatz, Ph.D.
Author's comment: I have known Dr. Cooperman and have followed his work closely for more than 50 years. When I had a serious, long-term breathing disorder, I experienced relief in half an hour with a plastic splint that he made, Some of his patients have told me how successfully he treated their temporomandibular joint disorders (TMJD) involving serious, long-term pain. Other dentists and doctors had not helped them at all, in some cases over a period of several years. Cooperman was born on October 1, 1910, served as a Lieutenant Colonel in the U.S. Army Dental Corps from 1940 to 1947, and has worked on TMJD since the 1940s. During the 1950s, he did the basic research on what he calls Myodontics, with his own patients in his own office. He had no institutional affiliation and no grant support. Working largely alone, he discovered the cause of temporomandibular joint disorders (TMJD), developed a reliable method of diagnosis, and perfected a safe and effective treatment. His contributions are destined to revolutionize dentistry and medicine.
Myodontics is widely used in Japan
There are more things in heaven and earth, Horatio, than are dreamed of in your philosophy. - Shakespeare
Cooperman's first publication appeared with Samuel B. Willard, M.D., as coauthor in 19561. In 1971, Japanese dentists recognized the importance of Cooperman's work, and invited him to lecture in Japan in 1972. He revisited Japan for seven more lectures. Japanese physicians also recognized the importance of Cooperman's work. The International Academy of Myodontics was formed in Japan in 1972. It is recognized by the American Dental Association as a bona-fide dental organization, and publishes the journal Myodontics. Dr. Noboru Miura is President of the Asian Chapter of the International Academy of Myodontics. His address is 7-6-7 Ohjima, Kohto-Ku, Tokyo, Japan 136.
Cooperman's work on temporomandibular joint disorders (TMJD) has been used in Japan for almost a quarter of a century. Consequently, there is no question about the effectiveness of his approach for which he coined the term Myodontics. The journal Myodontics and two textbooks on Myodontics are published in Japan. Cooperman wrote the Introduction for the book Myodontics* published in 1984, and the Forward for the book Practical Myodontic Splints* published in 1987.
H.N. Cooperman and N. Miura patented the Coop Machine and the Coop Machine Assembly in Japan. These instruments enable dentists to establish Cooperman's hamular-incisive-papilla (HIP) plane from the maxillary cast. The maxillary landmarks forming the HIP plane are the right and left hamular notches and the center of the incisive papilla. These three anatomical points define a plane which is the attritional plane of dental occlusion that Cooperman and Willard discovered in the 1950s.
The HIP plane of occlusion is parallel to the attritional plane and is used in all diagnoses by members of the International Academy of Myodontics. This anatomical information is essential to correctly diagnose and successfully treat TMJD. Cooperman has a lso developed diagnostic procedures (to be published in this newsletter) which enable dentists to diagnose patient casts without the use of sophisticated instruments.
The Cooperman-Miura Syndrome, called the Uvula Tongue Malposture Syndrome in the original publication, is described in the two above-mentioned books on Myodontics published in Japan and in two medical texts published in English - the Dictionary of Medical Syndromes* and the Dictionary of
Syndromes and Eponymic Diseases.*Cooperman has maintained close contact with his Japanese colleagues, and knows more about what Japanese dentists and physicians have been doing that anyone else in the United States.
Nobody is a prophet in his own land.
Despite Cooperman's monumental contribution to our understanding of TMJD and its successful treatment, his important work was not discussed at two recent National Institutes of Health (NIH) conferences concerned with TMJD. The first was the Workshop on Selected Chronic Pain Conditions: Clinical Spectrum, Frequency, & Costs. This workshop, held on December 4-5, 1995, focused on temporomandibular disorders, low back pain, painful neuropathies, and post stroke and central pain.
The second was the Technology Assessment Conference on the Management of Temporomandibular Disorders held on April 29 - May 1,1996. This conference highlighted the need for definitive information about the cause of TMJD, more reliable methods of diagnosis, and effective treatment for severe cases.
Both conferences disregarded more than two decades of success in treating TMJD in Japan based on Cooperman's work, his reports published over a period of 40 years, several of which are available via Medline; and the extensive literature on Myodontics in Japan.
The fact that Cooperman's publications and the Japanese literature were completely overlooked at these two NIH conferences calls to mind Bertrand Russell's comment, Aristotle could have avoided the mistake of thinking that women have fewer teeth than me n by the simple device of asking Mrs. Aristotle to open her mouth.
The conferences also disregarded advice in the title of a lecture given by Professor Godfrey Rose in October, 1990, at the London School of Hygiene and Tropical Medicine."2 The title of that lecture is You cannot exclude the explanation you have not considered.
Double. Double. Toil and trouble. Fire burn and caldron bubble. / Shakespeare, Macbeth
The 1996 Conference was, among other things, concerned with the harm done by dental surgeons which have resulted in lawsuits. The following two cases reveal how serious the situation is.
One patient reported that she "has had both jaws replaced and, after 10 surgeries, is worse off than when she started."
Another "patient who came to the [conference] hoping to find solutions, said her problems started at the age of 12 when a dental surgeon dislocated her jaw while extracting wisdom teeth. She hasn't been able to work her jaws normally since. When she was 2 8, an oral surgeon convinced her that a total jaw joint replacement would 'mean there would never again be a problem.' But three months later, the plastic-like material used in the artificial jaw shattered. The patient has had four more surgeries and her problem is still far from corrected. She lives now on a feeding tube, has not had solid food since 1988, and can talk only with great difficulty to a patient listener."
More reports about the horrors of TMJD and the inability to obtain satisfactory treatment were presented at the Second Annual TMJ Meeting in April, 1996. At this meeting, "Many cried as they were reminded of their own experiences with TMJ, and with compassion for those who spoke."
"Many patients shared the opinion that the dental profession has proved itself to be inadequate in researching and treating TMJ disease, one with many symptoms which typically would fall into the medical ... arena,. Presently however, the medical professionals balk at treating TMJ because they don't learn anything about it in medical school which inevitably leads them to tell patients 'You should see your dentist.'"
These and other case histories, presented at the 1996 Conference, led to the conclusion that, "The probability of relief from pain decreases with each successive surgery." Although a variety of surgical procedures have been used, doing nothing was medically the most successful medical treatment. One
individual "left the ... Conference with the statement, 'There is no science to current TMJ treatment modalities.""In 1987," ... the treatment of TMJ ... was described by Enid Neidle, ADA's former Director of Scientific Affairs, as 'dentistry's hot-test area of unorthodox and out-and-out quackery." She [said] it is 'a field where untested and unproven therapies abound.'"
In 1991, "Many professionals utilize[d] treatments which [were] based on what they perceive[d] the cause to be, resulting in '50% of patients presenting.. iatrogenic disturbance because of inappropriate surgery, unnecessary coronoplasty [equilibration], unwarranted restorations, orthodontics, and most
frequently, incorrect splint therapy.'"Caveat emptor.
Let the buyer bewareIn 1996, "The problems of TMJ patients [in the United States] are still out there and, in effect, worsening."5 The lack of progress in treating TMJD in the United States is in sharp contrast to the significant progress in Japan, based on Myodontics.
To protect the public from cruel and unusual punishment due to iatrogenic TMJD surgery and other harmful treatments, the Surgeon-General should issue a warning that TMJD surgery and some other interventive treatments may be dangerous to your health.
Many people might have avoided surgery and its iatrogenic results if they had been treated with Cooperman's biomedical engineering procedure which Japanese dentists and physicians have been using with good results. Cooperman's treatment eliminates surgery and relieves pain even in some people who have been unsuccessfully treated by surgery and other means.
The NIH conferences, which ignored Cooperman's work, call to mind the story about an individual named Nasrudin who "while on his hands and knees, peering on the street for a lost key was approached by a friend. 'You lost your key here?' his friend inquired. 'No,' said Nasrudin, 'I lost it in my house.' 'Then why are you looking here?' asked his friend. 'Because.' said Nasrudin, 'the light is better here.'"
The light may be better in Bethesda, MD than in Doylestown, PA, but the key to reliably diagnose and successfully treat TMJD is in Doylestown where Cooperman lives.
Congress can help
Congress is responsible for motivating NIH's interest in alternative health care. It should now motivate NIH to seriously consider Cooperman's Myodontics if for no other reasons that Myodontics is a safer and less expensive way to treat many cases of TMJD.
Approximately ten million people in the United States are suffering from TMJD, and are spending an estimated one billion dollars for relief. A significant amount of this money has been paid for surgery that was unnecessary and iatrogenic. In many cases, it created problems that were far more serious than the original problems. As has already been noted, Cooperman's treatment eliminates surgery and relieves pain even in some people who have been unsuccessfully treated by surgery and other means.
"Each year since the budget hearing of 1994, Congress has sent a message to the National Institute of Dental Research (NIDR) that temporomandibular joint disease is not to be ignored." What has been ignored in temporomandibular disease is Cooperman's work and what Japanese dentists and physicians have been doing, based on his work, for almost a quarter of a century.
In contrast to large, well-funded research projects, Cooperman did the basic research on Myodontics (which elucidates the cause of TMJD and provides a reliable diagnosis and an effective treatment) working alone, with his patients in his office, without any institutional affiliation, and without any grant support.
Before Congress allocates more money for more research on TMJD, it should urge researchers to familiarize themselves with Cooperman's work and what has been going on in Japan. NIH does not have to set up a pilot study to ascertain whether Cooperman's work is valid because Myodontics has been successfully used as a treatment for TMJD in Japan for some twenty years.
The old order changeth, yielding place to new. - Alfred Lord Tennyson
In 1952, Thomas H. Forde, a dentist and an engineer, developed a method for balancing the bite; and was excommunicated from dentistry because he ground teeth which many dentists now do. Cooperman's Myodontics, based on the plane of occlusion, is very different from Forde's bite-balancing.
Cooperman pioneered the first interdisciplinary biomedical engineering in dentistry. His work, for the first time, put the treatment of TMJD and many other dental and medical problems on a firm scientific base. The anatomical landmarks and the occlusion plane, which he discovered, eliminate guesswork and wishful thinking for jaw alignment.
Cooperman's interdisciplinary work bridges and integrates medicine and dentistry. His revolutionary work introduced a new paradigm which is interdisciplinary and integrates both areas. It is far more important for human health and the quality of life than many of the contributions reported by Thomas S . Kuhn in his book The Structure of Scientific Revolutions.
The greatest of all pleasures is the pleasure of learning. - Aristotle
Medicine is presently incorporating alternative health care as complementary medicine. Alternative health care is now taught in medical schools. Doctors are now taking seminars and courses in alternative health care even though it is based largely on test imonials and lacks scientific evidence.
However, dentistry in the United States has for several decades ignored Cooperman's Myodontics which is an alternative to conventional TMJD treatments, including surgery, and rests on a solid scientific basis. Myodontics is also an effective alternative treatment for many other serious health problems, for which there are no satisfactory conventional treatments.
Finally, Cooperman's Myodontics has given good results in Japan for twenty or more years. NIH should facilitate the introduction of courses in Myodontics in dental and medical schools, and sponsor workshops on Myodontics for dentists and doctors.
Those who familiarize themselves with Cooperman's contribution will be surprised at the diversity of medical problems for which Myodontics provides relief, and will realize that it is destined to become the major treatment for some very serious problems i n dentistry and medicine.
Conclusion
Cooperman's Myodontics avoids surgery and suffering associated with TMJD, and reduces the cost of treating TMJD. The effectiveness of Myodontics has been demonstrated in Japan where it has been used for 20 or more years. When will Myodontics be seriously considered in the United States?
Plato's cave
Plato's famous parable of the cave describes a group of people who are chained inside a cave in such a way that they can see only the shadows on the wall of the cave. These shadows are the only world that these people know. One day one of them escapes into the world outside the cave. At first he is blinded by the sunlight, but when he recovers, he realizes that this is the real world, and what he previously considered to be the real world was, in fact, only the projection of the real world onto the wall of the cave. Unfortunately, when he returned to the people who were still chained inside the cave, they thought he was mad. -Zukav10
References
*References to these books are in Cooperman's Curriculum Vitae which is included in this issue of Myodontics.
1. Cooperman, H.N., and Willard, S.B. A new approach to the diagnosis and treatment of head and neck syndromes. Dental Digest. 62:248, 1956.
2. Datta, M. You cannot exclude the explanation you have not considered. The Lancet. 342:345-347, 1993.
3. Racer, P. A panel urges caution on surgery to relieve jaw joint pain. Philadelphia Inquirer. May 2,1996.
4. The TMJ Report. Summer, 1996. A newsletter of The TMJ Association, Ltd. 6418 W. Washington Blvd. Milwaukee, WI. 53213.
5. The TMJ Report. Winter, 1997. (See reference 4 above)
6. TemporoMandibular Joint Disorders. 1993. (A brochure published by The TMJ Association, Ltd.)
7. TemporoMandibular Joint Disorders. Causes. 1994. (A brochure published by The TMJ Association, Ltd.)
8. Dossey, L. Space, Time & Medicine. New Science Library. Shambhala. Boston. 1982.
9. Forde, T.H. The Principles and Practice of Oral Dynamics. Exposition Press. New York. 1964.
10. Zukav, G. The Dancing Wu Li Masters. Banting Books. New York. 1979.
Copyright © 1997
Albert Schatz Ph.D.
6907 Sherman Street
Philadelphia Pennsylvania 19119
This report may be reproduced and distributed in whole or in part provided the original source is stated on what is reproduced and distributed as well as this URL address.
Harry Cooperman DDS
777 Ferry Road / P-6
Doylestown Pennsylvania 18901
215-345-1149
myodont@comcat.com