March Newsletter

One Step Closer to Specialty

Ronald C. Auvenshine, DDS, PhD

Dr. Ronald Auvenshine
Dr. Ronald Auvenshine

I would like to share with you some very exciting news regarding specialty status of Orofacial Pain. In January, a court case was settled in the State of Texas. The case involved a complaint of violation of the First Amendment (freedom of speech) involving five dental subspecialties. The court case began several years ago but took on a more serious nature in January of 2015. The American Academy of Orofacial Pain is one of the five organizations who brought the suit against the State of Texas. I testified before the State Attorney General in January 2015 on behalf of the American Academy of Orofacial Pain

The complaint of the five organizations is really against the American Dental Association. Even though I am a strong supporter of organized dentistry and of the American Dental Association, I feel that the process of awarding specialty status to other fields of dentistry has become extremely politicized over the years. Since 1994, the American Academy of Orofacial Pain has been trying to obtain specialty status from the ADA. We have spent close to $1 million, to date, on attempts which now have become numerous.

In 1997, we formed the American Board of Orofacial Pain. In fact, I was a member of the founding Board of Orofacial Pain. This is an exam similar to the Princeton Review. Those of us who were founding members actually took the same board that medical doctors take for Pain Medicine. Once we had passed that board we now became certified through Princeton Review to write the Board of Orofacial Pain that a dentist would take for specialty status. The board was one of the “keystone” requirements for ADA specialty status. With the board in place, we made application to the American Dental Association and were immediately turned down because we had not “fulfilled all of the ADA requirements.” We attempted to file again and were again told that we had not fulfilled all of the ADA requirements. Each time that we have presented an application we have received virtually the same the response from the ADA.

Out of frustration, the 5 organizations considered forming an American Board of Dental Specialties which would mimic the American Board of Medical Specialties which is the body within medicine that confers specialty status. This is a long and tedious process and one which will require a concerted effort on the part of all parties involved.

In the meantime, we, as a group, felt that it was restrictive on the part of the State of Texas to not allow those of us with the Board certification to be able to tell the public that we had specialty training beyond the traditional dental school education and had passed a board of certification. That was the nature of the lawsuit. It was filed in state court under the protection of the First Amendment, freedom of speech. The judge heard the case and ruled in favor of the five groups. We still are in the appeal stage, so I’m not certain how this is going to play out. However, I am most encouraged that in the near future Dr. Pettit and I will be able to actually notify the public on our website that we are specialists in Orofacial Pain. This will also include our letterhead as well as business cards.

I know that there will be a lot of negative press regarding this lawsuit. Already, there have been attacks from the American Dental Association. However I do see some positive things which are coming through the ADA, so it may be easier for us to obtain specialty status without having to form the American Board of Dental Specialties.

As you can see Dr. Pettit and I are constantly trying to keep you up-to-date on important issues. We want your experience with us to be the very best in every way. Your care is our greatest concern.

Ronald C. Auvenshine, DDS, PhD
Diplomate, American Board of Orofacial Pain

Dr. Pettit’s Tip for Healthy Living : Grapefruit Powerhouse

Nathan J. Pettit, DMD, MSD

Dr. Nathan Pettit
Dr. Nathan Pettit

Texas has fantastic grapefruit! And lately we’ve had a lot of delicious grapefruit available at our markets. Dr. Auvenshine and I have been eating a grapefruit every day for the past few weeks. I thought I’d take some time to highlight the benefits of this tasty fruit in this month’s newsletter.

A core benefit of grapefruit is the level of Vitamin C, with one fruit providing 122%  of your RDA. In addition, it is set apart from other citrus fruits in its high content of Vitamin A (92% RDA) and lycopene. Lycopene is an important antioxidant for skin, eye, and heart health. The redder the flesh of your grapefruit, the more lycopene content there will be. The more red the flesh, the sweeter your grapefruit will taste as well.

Grapefruit is very hydrating, with 90% of it being water. It is high in fiber as well and can help curb your appetite. If you’re aiming for weight-loss, eating half a grapefruit before each meal may be helpful. Several studies also show eating a red grapefruit a day can help lower your triglycerides and LDL cholesterol.

One caution with grapefruit is the interaction it can have with the metabolism of certain drugs. Certain antidepressants, antihistamines (for allergies and colds), and statin drugs (for lowering cholesterol) can become either less potent or toxic because of this interaction. Medication package inserts should tell you if grapefruit is likely to interfere with the medication you are taking. You can also check with your pharmacist.

How do you pick a grapefruit? To avoid picking a dried out fruit, look for a grapefruit with weight and a little bounce in the skin. You can store grapefruit for about a week at room temperature. I prefer to eat my grapefruit refrigerated, which can make them last for up to three weeks. Cut your grapefruit into small bites to protect yourself from wide opening and heavy chewing.

Your health is important to us. If your medication list allows, enjoy some fresh grapefruit this year!

isolated ripe grapefruit and slice

Nathan J. Pettit, DMD, MSD

*U.S. Department of Health and Human Services and U.S. Department of Agriculture. 2015 – 2020 Dietary Guidelines for Americans. 8th Edition. December 2015. Available at

Hit Every Food Group Each Meal During National Nutrition Month

Food for heart.

Spring is a great time to put focus on your plate because so much wonderful produce is in season. With all the fresh fruits and veggies it’s no surprise that March is National Nutrition Month.

Too often we don’t hit all of the food groups in our daily diets. While most people understand how that can affect their waistline, they don’t realize how much it impacts health in other ways. Our bodies need essential nutrients like fiber, protein and vitamins – some of which we can only get through food. Without them our bodies can’t function at their full potential.

TMD patients are all too aware that no one diet is a perfect fit for every person. However, hitting every food group in each meal is a great goal for anyone. Here’s a quick reminder of the latest food group guidelines based on nutritional needs.

1,600 Calorie Diet
(young children, women, some older individuals)

2 Servings of Fruits
3 Servings of Vegetables
2-3 Servings of Diary
2 Servings/5oz. Total of Protein
6 Servings of Grains

2,200 Calorie Diet
(older children, female teens, active women, men)

3 Servings of Fruits
4 Servings of Vegetables
2-3 Servings of Diary
2 Servings/6oz. Total of Protein
9 Servings of Grains

2,800 Calorie Diet
(male teens, active men)

4 Servings of Fruits
5 Servings of Vegetables
2-3 Servings of Diary
3 Servings/7oz. Total of Protein
11 Servings of Grains

For a healthy diet, limit fat to 30% of your caloric intake or less. When you eat nutritional, healthy foods that are low in fat and sugar you’ll also reduce stress hormones and use more of what you eat as fuel.

What to Watch Out for With Frozen Food

Grocery Store Cooler

Ironically, as fresh produce gets plucked from farms this March it’s also when people celebrate Frozen Food Month. Frozen foods and treats pose a unique situation for people with TMJ disorders. When prepared, most frozen foods are perfectly fine to eat but if something isn’t thawed it can fast-track TMD symptoms.

Another misconception is that frozen diet meals and produce are automatically healthy options. While they can be healthier than some alternatives, there are things you have to watch out for when you’re buying frozen food.

High Levels of Sodium – Just because food is in the freezer section doesn’t mean it has a low sodium count. In fact, some frozen diet foods pack in sodium to improve the taste.

Fatty Sauces – Veggie mixes that come with a sauce can quickly take a side from healthy to junkie. Even though the vegetables are good for you, the sauce can contain GMOs, unhealthy oils, butter, salt and sugar.

Added Sugars – Frozen fruits and veggies can actually have more nutrients than fresh options, but if ingredients are added they can become unhealthy. One of the most common issues is sugar or juice from concentrate that’s added to sweeten fruit.

One thing to look for in the frozen aisle – whole grain breads. Bread products can contain a lot of additives to increase their shelf life. Freezing food acts as a natural preservative so artificial ingredients aren’t needed.


Grapefruit, Salmon and Avocado Salad Recipe

Grapefruit, Salmon and Avocado Salad Recipe

There are a lot of ways to incorporate healthy grapefruit into your daily diet. One of the easiest and most delicious options is to include it in a salad. The grapefruit will give greens a delightful zest and the taste is robust enough to mix with flavorful ingredients without getting lost.

This well-balanced grapefruit salad recipe comes from Martha Stewart herself. Despite how much nutrition is in the salad, it’s quick and easy to make.


2 eight-ounce skinless salmon fillets
2 cups sunflower shoots, watercress leaves or a combination of the two
1 Ruby Red grapefruit peeled, segmented and pith removed
1 ripe avocado pitted, peeled and sliced
3 tablespoons of extra-virgin olive oil
2 scallions trimmed and sliced (optional)
1 tablespoon fresh lime juice
Coarse salt
Freshly ground black pepper


  • Preheat your oven to 375 degrees.
  • Season the salmon with salt and pepper to taste, and place it in a 9-inch baking dish.
  • Drizzle a tablespoon of oil over the fish and sprinkle with half the scallions.
  • Bake 10 to 12 minutes until salmon is partially opaque in center.
  • While the salmon is cooking prepare the grapefruit, avocado and greens.
  • Prepare the dressing by whisking 2 tablespoons of oil with the lime juice and salt.
  • Once the salmon is done cooking transfer the fish to a dish and let cool. After it’s had time to cool break the salmon into large pieces and divide among four serving dishes.
  • Top the salmon with grapefruit, avocado, greens and the remaining scallions.
  • Season with salt and pepper.
  • Drizzle dressing over each salad.

Add a little mozzarella cheese to incorporate dairy and a side of whole grains for a delicious meal that hits every food group.

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