The “evolution” of the psychosocial (anti-instrumentation, American Academy of Orofacial Pain group) therapies present no studies supporting the veracity of their own treatment!! Often, their treatment consists of providing no treatment while waiting for a supposed self-limiting disorder to resolve or their recommendation of ameliorative home self-care, psychological/psychiatric, and/or pharmacological management of a chronic pain state.

If there is going to be a meaningful debate, they need to produce studies that cite their treatment protocol and more importantly the statistical success of their treatment on large patient populations.  NMD has these studies and we need to turn the table and ask for theirs!

The Global Reach of an Anti-Instrumentation Framework

“AAOP and its international affiliates are threatened by the global appeal of NMD and the increasing number of studies that substantiate the efficacy of NM occlusion.  They have long denied the etiological role of occlusion in TMD and the clinical success of occlusal therapies.  So it is not surprising that we see their proponents lecturing in Italy, Germany and as far as the Philippines.  It is our responsibility to be aware of the significant volume of scientific literature supporting our science and be able to present it.  Resources to access such studies are posted in Myotronics web site under “index of articles” and the ICCMO web site.” – Fray Adib, CEO of Myotronics-Noromed, Inc.

What the AAOP Application Actually Said

The AAOP’s anti-instrumentation perspective is not just an informal disagreement. It was put on the institutional record in their 2019 application to the National Commission on Recognition of Dental Specialties and Certifying Boards. The application states twice — on page 22 and again on page 91 — that surface EMG and jaw tracking are “untested diagnostic tests that have no evidence of reliability and validity for TMD and orofacial pain conditions” and that their use “has been promoted to increase revenue for the provider.”

That language was approved by the ADA on March 31, 2020, when Orofacial Pain was recognized as the twelfth dental specialty. The anti-instrumentation framework is no longer one perspective among several. It is now the framework that holds the specialty designation.

The structural and historical analysis of how this happened, with reference to the AAOP’s own application document, is examined in Dentistry Without Occlusion: A Profession Redefining Itself Out of Its Foundation →.

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Frequently Asked Questions

What is the anti-instrumentation perspective in dentistry?

The anti-instrumentation perspective rejects the use of objective neuromuscular instrumentation — surface EMG, jaw tracking, electrosonography, and J5 Dental TENS — in the diagnosis and treatment of TMD. The framework is associated with the American Academy of Orofacial Pain (AAOP) and was codified institutionally when the AAOP’s specialty application was approved by the ADA on March 31, 2020. Clinicians working from this framework do not measure mandibular position, muscle activity, or joint function with electronic diagnostic instrumentation as part of standard practice.

What does the anti-instrumentation framework actually treat patients with?

According to the AAOP’s own treatment table in their 2019 specialty application, treatment is dominated by pharmacology (NSAIDs, tricyclics, muscle relaxants, sleep medications, neuropathic medications, migraine medications), behavioral interventions (cognitive behavioral therapy, mindfulness, biofeedback, hypnosis, habit reversal), injection-based therapies (Botox, steroids, dry needling, trigger point injections), splint therapy with explicit limits, and physical therapy. Only one category is dental — “occlusal equilibration” — and the application explicitly admits this category lacks systematic review evidence.

Where are the studies supporting the anti-instrumentation treatment protocol?

This is the question the page asks. The AAOP framework produces no large-scale studies demonstrating clinical success of its own protocol. By contrast, the bio-physiologic neuromuscular tradition has decades of published research documenting structural findings in TMD patients (Cooper and Kleinberg, Haskin, Emshoff, Tasaki, Katzberg) and clinical outcomes from neuromuscular orthosis treatment. The burden of evidence rests on the framework that claims authority — and the AAOP’s own application admits its primary dental treatment category lacks systematic review evidence.

Why does the AAOP attack EMG and jaw tracking?

The AAOP’s 2019 specialty application states twice — on page 22 and again on page 91 — that surface EMG and jaw tracking are untested diagnostic tests with no evidence of reliability and validity for TMD. This is the AAOP’s institutional position. The technologies they attack are FDA-cleared and have held the ADA Seal of Recognition and Seal of Acceptance. There is exactly one clinical framework in dentistry that uses these instruments as core diagnostics, and the AAOP’s framework is built around their exclusion.

How does the anti-instrumentation framework affect TMD patients?

A patient whose TMD originates in mandibular malposition — which research suggests is the great majority of cases — is routed into pharmacological and behavioral management of symptoms rather than structural diagnosis and correction of the cause. The mandibular position remains unmeasured. The occlusal interferences remain unidentified. The pain is treated as a chronic pain syndrome to be managed indefinitely rather than as a structural problem with a structural solution. This is the somatopsychic patient routed into psychosomatic care. The framework cannot see what it has trained itself not to look at.

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🔹 The Framework Distinction

• What is TMJ? →
• Prevalent Philosophies of Treating TMJ →
• Psychosocial vs. Physiologic: Clarifying the Diagnostic Divide in Orofacial Pain →
• Psycho-social Intervention for Chronic Orofacial Pain: Weak Supportive Evidence →
• Pain: The Psychological Effect On the Patient — by Loren Pilling, M.D. →
• Dentistry Without Occlusion: A Profession Redefining Itself Out of Its Foundation →

🔹 The Original Science Behind GNM

• Why OC is Different — The Original Science Behind GNM Dentistry →
• SCIENTIFIC TRUTHS: Bio-Physiology & Objective Measurements →
• The Science Behind GNM — Evidence, Research & Objective Measurement →
• Gneuromuscular vs. Neuromuscular Dentistry →
• GNM is Not the Same as NM →
• What Does the K7 Technology Measure? →

🔹 Treatment & Clinical Application

• TREATMENT →
• TMD Treatment Approach: NM or GNM? →
• Why GNM Dentists Use Lower Orthotics →
• GNM Case Studies →
• Headaches and Relief Following Gold Standard for Assessment →

🔹 The Difference Between GNM and NM

• The Difference Between GNM Dentistry and NM Dentistry →
• Defining Occlusion →
• Chan Optimized Bite Training →
• Optimized Bite and the Chan Optimized Bite™ Education and Training — Leader in Bite Optimization →
• GNM Optimized →
• Optimized Bite History →

🔹 Standard of Care and Evidence

• What is the “Standard of Care”? →
• What is the Standard of Care? – Part 2 →

🔹 Finding a GNM Trained Dentist Near You

• Choosing a Dentist that Practices GNM Dentistry →
• Finding a Gneuromuscular (GNM) Dentist Near You →

🔹 Ready to Train

• OC Masterclass Training — Course Schedule and Registration →

Last Updated: May 7, 2026

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Written by Clayton A. Chan, D.D.S. — Founder and Director, Occlusion Connections | Las Vegas, Nevada

 6170 W. Desert Inn Road, Las Vegas, Nevada 89146 | Telephone: (702) 271-2950

www.occlusionconnections.com

Leader in Gneuromuscular Dentistry