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Science means different things to different individuals. The universal question seems to be, “What causes things to happen?” Throughout history there has been a great deal of argument about cause. Science is neither an accumulation of facts nor the discovery of facts. Factual discovery is important, but the basis of science is the integration of the implications of any discovery into the lives of human beings.
TMD has been lumped together as as a single disease entity virtually in all epidemiological studies to date. The concept of TMD is multi factorial and widely accepted and includes occlusal disorders. In fact, TMDs refer to a group of diseases in the same context as digest disorders. The multiple concomitant TMDs can coexist is also not in dispute in the literature.
It is a well-known that a group of academic dental researchers have taken several stated positions contrary to the clinical reality of most dentists involved in the diagnosis and treatment of temporomandibular disorders. These arguments over the relationship of occlusion and TMDs, whether TMDs are self-limiting, the suitability of epidemiology as a methodology for TMDs, the value of objective electronic measurement for treatment evaluation and uses of the psychosocial model for TMDs are discussed and documented extensively in various writings and publications.
Clinicians must critically exam the allegations by asking the right questions like:
- Are the objections based on hypotheses that are implausible as a result of faulty logic, faulty premise, mistaken belief, or failure to have a valid scientific paradigm as a basis for studies?
- Are the assumptions and data sufficient to support the conclusions?
- Are the conclusions based on original research or subjective literature searches?
- Can subjective standards be as accurate as objective measurements?
- Are the evaluation criteria based on evidence or inference?
- Is the science hard or soft?
- Are the suppositions and premises warranted and scientifically valid?
- Is the psychosocial model as valid as the Selye Stress Model for study of TMD?
- Is the scientific methodology being used appropriate to TMDs or one of convenience?
- Are the definitions, semantics and linguistics generally agreed upon?
- Is the disease definition consistent with clinical reality?
– Excerpts from the writings of Allen J. Moses, D.D.S. (Controversy in temporomandibular Disorders: Clinician’s Guide to Critical Thinking. Chapter 1 Philosophy of Science: Cause and Effect and Explanation, pp 5-9).
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