Before attending my first PRI course several years ago, I often felt as if my patients were stuck in a revolving door – we often “fixed” one problem only to have them return with a new injury or a different body part hurting. The Interdisciplinary Integration and Cervical-Cranio-Mandibular Restoration courses provided invaluable insight into when and why our patients need another discipline to accomplish their goals. The proverbial light bulb switched on. I began working with a local dentist who has expertise in splint fabrication, and through him was introduced to Herb Blumenthal, DDS, an expert in non-surgical evaluation and treatment of TMD. Dr. Blumenthal has utilized an interdisciplinary approach in his practice for many years. He enlists the support of chiropractors, massage therapists, and cranio-sacral therapists in his treatment of complex patients with stomatognathic dysfunction. Notice that he did not include Physical Therapists in that list. As he explained to me, he often did not accomplish good outcomes with PTs, as they do not understand the relationships between muscular activity in polyarticular chains and occlusal patterns. He was so impressed with how PRI evaluation and treatment coordinates with and compliments his dental intervention that he invited me to join him in Arizona, presenting to a group of dentists. It was a wonderful experience; the dentists made immediate connections between common postural adaptations as described by PRI, and what they see daily in their clinics. They recognized that a PRI trained therapist can be invaluable in helping them accomplish optimal results with their patients’ splint therapy, and with their own issues of pain and dysfunction. After all, those in the dental profession have jobs with “attitude” involving strong patterns of sustained and repetitive neuro-motor activity. Surprisingly, only 1 dentist had referred to a PT. The rest had no idea how to find and make contact with a qualified therapist. I highly encourage each PRI trained therapist to seek out and promote working relationships with dentists that specialize in TMD. These individuals have experience with splints in addition to the flat plane splints most commonly made by general dentists, and will be open to how splinting can be used in the treatment of not only TMD, but other types of head and neck pain. I am grateful that my PRI training has enabled me to change that revolving door into an open door of cooperation with others as we strive to attain the best possible therapeutic outcomes for our patients. – Kathy Johnson
