Neuromuscular Dentistry is about Clouds

The field the cranial mandibular cervical disorders has undergone tremendous growth in the recent years. As software improves and research continues to deliver new information we are constantly pressured to implement this new knowledge into clinical practice. Medical graphics often provide stunning visualizations of complex processes. Intoxicating as these images are, practicing healthcare providers need to reserve judgment and not to draw conclusions quickly from over simplification of more complex and deeper structures.

As we delve into a deeper meaning of physiological and anatomical processes; technological equipment such as bio-instrumentation, cone being volumetric tomography, electronic acupuncture, digital occlusal force devices, and infrared cameras; we have a conundrum. On the one hand, we have data that leads us to conclusions to provide diagnosis and treatment. On the other hand we have data that is so rich in new content and at such large volume that we do not have time to process and confirm its global application and accuracy within a given bio-system.

Clinicians are becoming increasingly bombarded with information from a variety of sources both in the commercial world and the academic world. In evaluations of this knowledge we lack randomized controlled trials and lack strong statistics that indicate improved patient outcomes and cost effectiveness. New knowledge is often difficult to generalize and do not provide the scope of detail necessarily to provide informed decision-making.

An example of this is the modern imaging technology screening healthy people for signs of incipient disease. Such noninvasive diagnostic capabilities may be as much a curse as a blessing. Patient’s like clinician’s often get excited about the prospect of early diagnosis of life-threatening conditions. However, medical researchers and organizations are beginning to understand the potential downside of screening- false positive test results and treatment are either ineffective or not necessary. The approach of early screening provides also a large new database that with more and more imaging, will find more disease. Some patients may benefit from early detection, but a lot may not. Studies on these early findings of potential disease have yet to be quantified and analyzed for actual productivity and benefits to society and then the individual. Disease often is poorly understood in early stages and no database currently exists as we did not have the technology. Early detection screenings may provide us with a great deal of data but will take years of research to understand the actual meaning of the data and how to apply it to treatment and integrate with other diagnostic tools.

This issue of gathering data without context proves to be a similar problem in such areas as functional MRIs , understanding the Cosmos, the human genome project, and bio instrumentation that is currently used to try to understand cranial mandibular cervical disorders.

Karl Popper was a British scholar and professor at the London school of economics and is widely regarded as one of the greatest scholars of the 20th Century. He argued that scientific theories are abstract in nature and can be tested only indirectly, by reference to their implications. He held that scientific theory and generally human knowledge is irreducibly  conjectural or hypothetical, and is generated by the creative imagination in order to solve problems that have arisen in specific historico-cultural settings. Essentially logically, no number of positive outcomes at the level of experimental testing can confirm a scientific theory, but a single counterexample is logically decisive: it shows the theory, from which the implication is derived to be false. His writings  “All life his problem-solving”, Popper sought to explain the apparent progress as scientific knowledge that is our understanding of our world seems to improve over time. In 1934 proper wrote of the search for truth is “one of the strongest motives for scientific discovery.” Indeed Popper once divided the world into two categories: clocks and clouds. Clocks are neat, orderly systems that can be solved through reduction; clouds are at a epistemic mass “highly irregular, disorderly, and more or less unpredictable.” Modern science and indeed neuromuscular dentistries mistake is to accept everything as a clock, which is why we get seduced again and again by the false promises of brain scanner, image generators,  gene sequence and bi- scans. We want to believe that if we find the right widget we will understand nature but this approach is doomed to failure. We live in a world to be understood as clouds and not as clocks.

Neuromuscular dentistry understands the concept that is all connected. The anatomical and physiological processes are by definition interconnected and inter-related and must support each other for function, durability, and comfort. However our understanding via instrumentation scans is both shallow and relatively new. Though antidotal reports of success are plentiful and research that is somewhat related is available, there remains much to be done from confirming research.

It is not a sense of hopelessness that we should take from understanding that the world is more like a cloud than a clock. Instead, it should give us strength in knowing that our search for truth is a path with many turns and forks. Our understanding does grow through the discoveries of new information, the disproving of old theories, and our fundamental need to understand the truth.