Short Wave

Americans Are Not Going To The Dentist Enough

December 5, 2025

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  • A significant portion of the U.S. population (estimated 5-10%) suffers from Temporomandibular Joint (TMJ) disorders (TMD), which are often related to the improper positioning of the cartilage pad in the jaw joint. 
  • The teeth serve a crucial architectural support system for the jaw joint, and missing teeth can lead to compensatory jaw movements that strain the joint and surrounding structures. 
  • Diagnosis of TMD relies heavily on detailed patient history and clinical examination, often confirmed by imaging like MRI to assess the cartilage and bone health, with treatment ranging from simple occlusal appliances to minimally invasive procedures, reserving open joint surgery for severe cases. 

Segments

Intro and NPR Funding
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(00:00:18)
  • Key Takeaway: NPR is celebrating Giving Tuesday while facing the challenge of operating without federal funding for the first time in 50 years.
  • Summary: The episode begins with sponsor messages followed by an announcement regarding Giving Tuesday. NPR is marking this global day of generosity while navigating a significant financial shift, as it is the first time in 50 years the organization is operating without federal funding. Listeners are encouraged to support the science coverage provided by Short Wave through NPR Plus.
Dentist Absence and Oral Cancer
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(00:01:45)
  • Key Takeaway: Despite the importance of routine care, this episode marks the first time Short Wave has featured a dentist, highlighting a national trend of insufficient dental visits.
  • Summary: Host Emily Kwong confesses that this is the first time a dentist has been featured on the show, noting that Americans are generally not visiting the dentist enough. Guest Justin Richer suggests this lack of routine care has contributed to delays in the detection of oral cancer across the U.S. Routine dental hygiene and care are stressed as important, even if the experience is unpleasant for many.
TMJ Disorder Causes
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(00:02:56)
  • Key Takeaway: The majority of TMJ issues stem from the displacement of the cartilage pad situated atop the jaw joint bone.
  • Summary: TMJ disorders (TMD) affect an estimated 5-10% of the U.S. population and involve the temporomandibular joint connecting the jaw to the skull. The overwhelming majority of these issues involve the cartilage pad not being in the proper position, leading to popping, clicking, or locking of the jaw. Lack of posterior teeth can create an unsupported jaw joint, straining the ligaments that support this critical cartilage pad.
Teeth as Architectural Support
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(00:06:18)
  • Key Takeaway: Teeth function as the primary support system for the jaw joint, similar to how leg length affects pelvic alignment and subsequent hip/back pain.
  • Summary: The teeth provide essential structural support for the jaw joint, which is located near the ear canal. If one side of the mouth lacks teeth, a person develops functional habits by shifting the jaw to chew on the supported side. This uneven movement can weaken the overall structure, analogous to how a shorter leg causes pelvic misalignment and pain elsewhere in the body.
Diagnosing TMD
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(00:08:05)
  • Key Takeaway: Diagnosing TMD requires a detailed clinical exam focusing on jaw movement abnormalities, often confirmed by MRI to visualize cartilage displacement and bone health.
  • Summary: A TMJ exam is extensive, requiring the provider to listen carefully for symptoms like locking or deflection of the jaw during movement. Assessment includes checking for bone changes via X-ray and using MRIs, similar to those used for knee injuries, to confirm the exact position of the cartilage pad. If the cartilage is misplaced, the joint’s capacity to heal is diminished due to improper synovial fluid distribution, leading to visible bone changes over time.
TMJ Treatment Options
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(00:10:12)
  • Key Takeaway: Treatment for TMD spans from non-invasive appliances to minimally invasive injections like PRP, with open joint surgery reserved for complex structural issues.
  • Summary: Treatments start simply with occlusal appliances, which function like a knee brace to relieve joint pressure. More advanced, minimally invasive options include arthrocentesis (injecting water to flush the joint) or injecting Platelet-Rich Plasma (PRP) to promote healing. Open joint surgery, which can involve repositioning or removing cartilage, is generally considered only when necessary, as most TMD cases do not require it.
Actionable Advice and Future Education
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(00:11:54)
  • Key Takeaway: Patients experiencing jaw pain must start with their dentist, and self-treating with internet-purchased appliances can cause more harm than good.
  • Summary: The primary care provider for the mouth, the dentist, should always be the first point of contact for jaw pain concerns. Listeners are warned against purchasing at-home occlusal appliances online, as these often create more problems than they solve and keep specialists in business. The future of TMD care depends on standardizing TMJ education across all dental schools to ensure consistent foundational knowledge for all practitioners.