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Foreword

It is a great challenge for any teacher to write a book with the aim of presenting the theory and practice of a particular dental clinical specialty. To accomplish this task successfully requires extensive clinical experience and excellent knowledge of the scientific principles underlying the specialty. Writers engaging in such an endeavor—like the authors of this book—usually have a clear goal in mind: to improve dental health care, which means making innovations in diagnostics and treatment accessible to dental practitioners.

Achieving this goal is a particular challenge given the subject of this book. Therapy for painful craniomandibular dysfunction (CMD) is a field of dentistry that undoubtedly differs greatly from traditional subjects in dental medicine, such as periodontics, restorative dentistry, or oral surgery. In these subject areas, innovation essentially means adapting clinical procedures to new technologies, such as the use of digital resources. The objective of adaptive processes has hardly changed in the past 100 years: to enhance the mechanical perfection of treatment methods while simultaneously increasing the efficiency and safety of the working materials being used. Generations of dentists in education, research, and practice have pursued this objective—in some cases with great success. This was accompanied by a concentration on the results of mechanical working procedures. Every step toward perfection was regarded as clinical progress. Michael Heners coined the term “technomorphic model of dentistry” for this orientation of dental medicine. Based on this model, the mechanically defined actions of the clinician determine the quality of the dental therapy provided. Accordingly, better dental care can only be achieved by optimizing the dental intervention in terms of technique.

In the past 20 years, the technomorphic model has been greatly modified in all areas of dentistry because research and practice have increasingly focused on the biologic principles of dental activity. Nevertheless, many dentists continue to equate better care with better technique.

The authors of this book confront these attitudes from the outset. Better basic treatment of CMD cases cannot be achieved simply by better technique but by a new way of thinking that places patients, their suffering, and what they tell their dentists center stage. Readers will only succeed in adopting a new and different way of thinking if they can free themselves from conventional, outmoded patterns of activity. This book invites them to do so. It offers those with a professional interest a clear guide to help them address the issue of CMD in theory and practice and provide their CMD patients with the best possible treatment. Great emphasis is placed on the importance of history taking. Recognizing this and drawing the necessary conclusions about diagnosis and treatment are key to the new way of thinking, which makes appropriate clinical decisions possible in CMD cases.

The book is divided into two parts. The first part presents a practical guide to the basic treatment of CMD patients, while the second builds on that basic knowledge by exploring scientific and theoretical principles in more depth. The two parts complement each other to form a “rounded” and complete picture of the present state of the art. This is why readers are strongly encouraged to study both parts. The second part examines scientific perspectives that not only reveal other courses of action but help interested practitioners to critically evaluate their own experiences.

It is possible to improve the treatment of patients with CMD. This book documents the clinical paths that will lead to a targeted and evidence-based therapeutic approach. It is up to all of us—as members of the dental profession—to seize this initiative and pursue the paths that are laid out for us.

Prof Dr Winfried Walther

Director

Dental Academy for Continuing Professional Development

Karlsruhe, Germany