September 2017 Newsletter

Ronald C. Auvenshine, DDS, PhD

Dr. Ronald Auvenshine
Dr. Ronald Auvenshine
Dr. Pettit
Dr. Nathan Pettit

I have some really great news for you this month! About two weeks ago, I received notification through the Texas Dental Association Newsletter that the State of Texas will now allow those of us who are board certified in our respective specialties to advertise to the public as specialists. Even though TMD and Orofacial Pain is not a certified specialty by the American dental Association, this is a major victory for those of use who limited our practice to this treatment.  I never actually thought that I would see this happen in my lifetime but because of hard, diligent work by many people, we have succeeded in the first step toward specialty recognition.

As many of you know, and as I have written in previous newsletters, the American Academy of Orofacial Pain has, for the last 25 years, petitioned the American Dental Association on several different occasions for specialty recognition. The Academy has spent close to $½ million on fulfilling all of the requirements of the ADA. On four different occasions we have presented our application for specialty recognition and have been denied each time because of some “technicality.” It has become a political issue within the American Dental Association and, because of that, there is a very active and powerful opposition to our petition.

The last time the AAOP presented our application for specialty status, we did so along with four other specialty groups. Those groups included Dental Implantology, Dental Anesthesiology, Dental Radiology, and Oral Medicine. Four of the five applications were denied. The only group which was able to achieve specialty status with the ADA was Dental Radiology.

After several years of discussion within each of the groups, it was determined that we would sue each State of the USA for the right to advertise to the public stating that our practice was not a General Practice but one that was a specialty. We did this through the First Amendment right of the Freedom of Speech. Our attorney was absolutely brilliant and the person to whom I credit with the success of our lawsuit. We began the process with the State of Texas.

In essence, the ruling of the Texas State Attorney General and District Court stated that if a dentist is Board Certified and is a member in good standing within one of the four groups named in the lawsuit, then that dentist has the right to inform the public as to the nature of their practice. Before this ruling I was not allowed to call myself a specialist because Orofacial Pain and TMD is not a recognized specialty of the American Dental Association. I had to advertise to the public that I was a General Dentist even though my practice does not include general dentistry in my daily activities. It was against state law for me to say that my practice was limited only to TMD and Orofacial Pain. Now that has changed and I, along with Dr. Pettit, have the right to inform the public that we are Diplomates of the American Board of Orofacial Pain and that our practice is one which specializes in the treatment of TMD and Orofacial Pain.

The AAOP will continue to work closely with the American Dental Association and will try again to obtain certification for specialty status along with Oral Surgery, Orthodontics, Periodontics, Endodontics, Prosthodontics, etc. It is my hope that we will be able to achieve this status.

What will this status mean to you, the patient? Well it is very frustrating for me that insurance does not cover our fees. Insurance companies say it is because we have no standards in this field. They consider the treatment to be experimental and without a standard of care. Having a specialty will establish a standard of care, because now the residency programs devoted to Orofacial Pain will be recognized as the “standard of care.” It will also make it easier for you to know the doctors who are board certified in Orofacial Pain, rather than someone who has just taken a weekend course and is now incorporating TMD treatment into their general practice. There are several things which will make it much easier for you, as the patient, to discern: what is evidence-based treatment and who is the practitioner trained to deliver that type of care. I feel that this will eventually become a win-win for everyone.

This newsletter will end a major era of my life and my practice. For the past 30 years, I have been writing this newsletter each month. I did this to inform you as to the issues that face the field of Orofacial Pain and TMD as well as to give you insight into the activities that I pursue in order to prepare myself to deliver the care that you receive. However, all things must come to an end. I have chosen this month to turn the task of continuing the newsletter over to Dr. Pettit. Of course, I will be writing guest editorials from time to time, but I will not have the chief responsibility of writing each monthly newsletter.

It has been an extreme honor to be not only your caregiver but your spokesperson within the profession for TMD and Orofacial Pain. You are my greatest asset. Your care and your loyalty means everything to me and as long as I have breath, I will continue to work diligently to provide you with the type of care that can only be found here at MedCenter TMJ.

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

Dr. Pettit’s Tips for Healthy Living

Nathan J. Pettit, DMD, MSD

In visiting with many of you during your visits to MedCenter TMJ, I have been impressed with the light many of you carry with you, despite your hardship and pain. I make particular note of those who amid personal challenges and pain, still find a way to smile and enjoy life, counting the blessings they receive and focusing on the positive.

Why should we be grateful? Believe it or not, scientist have investigated the health benefits of being grateful for quite some time. Some of these benefits are the natural result of having a positive attitude. Those who are grateful tend to have better protective health behaviors, such as regular exercise, doctors visits, and a healthy diet. But the attitude of gratitude will also decrease your level of stress.

Cultivating feelings of thankfulness can tremendously improve how you cope with your problems and the stresses of life. Optimism comes with gratitude. Research has shown optimism can actually improve your immune system. Immune cells and healing time improve for those with a positive and grateful attitude. It would be wise for each of us to find time each day to be grateful. We can all find something to be grateful for.

I am grateful for my position at MedCenter TMJ, and to work alongside Dr. Auvenshine. He is a man who truly cares for his patients. We are all so blessed to have his influence in our lives. It is his persistence and hard work that has made MedCenter TMJ possible. So many lives have benefited from his thoughtful care and ingenuity. His treatment philosophy is unique and effective. To have come under his wing has been one of the greatest blessings of my life.

As we close the Summer, and open the Fall, let us focus on the positive. Look for opportunities to be grateful, and share your gratitude with your friends and neighbors. As we lift eachother, we will be lifting ourselves. I thank each of you for the trust you have placed in us. We have the world’s greatest patients.

Nathan J. Pettit, DMD, MSD
Diplomate, American Board of Prosthodontics

The Power of a Daily Gratitude Journal

Gratitude is a powerful mindset to have, especially if you’re dealing with a painful condition like TMD. But when we’re faced with adversity, it can be more difficult to focus on the things that are going right in

Making one simple change to your daily routine can dramatically increase the thankfulness that you feel each day. Research has shown keeping a gratitude journal can be an effective way to increase feelings of appreciation and overall well-being. It’s considered a therapeutic exercise that can help you focus on
positive thoughts rather than the negative. Here’s how gratitude journaling works:

  • Get a notebook or journal that’s solely used for documenting your thoughts of gratitude. Keep it in a place that’s easily accessible and visible so it serves as a daily reminder.
  • Write down one thing you’re grateful for each day. That’s really all it takes to reap the rewards of a gratitude journal.
  • Review your entries at the end of each week. Look for trends that point to the things that make you most grateful and happy.

Consistently making journal entries every day is the key to becoming more grateful. It’s easier to make gratitude journaling a habit if you connect it to an existing routine. For example, break out your journal after brushing your teeth before bed. This will help you remember to make journal entries and put you in a relaxed state of mind when it’s time to sleep.

Quick Tip: Starting a Winter Garden

We’re fortunate in Texas to have mild winters that allow for fruitful gardens all year long. The beginning of September is a great time to start your winter garden even if you only have a limited amount of space to work with.

Gardening is a proven stress reliever that can also encourage healthy eating. That’s a win-win in our book. The trick is to pick the right plants that have the best chance of surviving and thriving in the cold. It starts by knowing which hardiness zone you live in. The USDA has identified 26 hardiness zones based on temperature. It’s best to stick to plants that are suitable for your hardiness zone. If you don’t know which zone you live in, check the maps on the USDA website.

Next, you’ll need to know which produce is considered a winter plant. Most leafy greens and cruciferous vegetables fall into this category. A few other veggies that can be planted in a winter garden include carrots, potatoes, onions and peas. When in doubt, ask a local garden center for advice on what will grow best in your area.


Celebrate the Start of Fall With Winter Squash

The end of September is the official start to the fall season. We can’t think of a better way to celebrate than by cooking a delicious winter squash dish. Squash is a great ingredient because it’s in season, nutritious and easy on the jaw. Plus, there are a variety of winter squashes to choose from.
Butternut squash is a versatile ingredient that can be sweetened or made savory. This Parmesan Butternut Squash Gratin recipe is crispy and has a little crunch without being hard to eat. It’s the perfect way to warm up when it starts to cool down outside.


  • 1 butternut squash approx. 2.5 lbs.
  • 1/4 cup butter or margarine
  • 2 large garlic cloves finely chopped
  • 1/4 cup panko bread crumbs
  • 1/3 cup grated Parmesan cheese
  • 1/4 teaspoon salt
  • 1/8 teaspoon pepper
  • 1/4 cup fresh parsley chopped


Step 1. Pre-heat the oven to 375°F and spray a 13×9-inch (3-quart) glass baking dish with cooking spray.

Step 2. Peel, halve (lengthwise), and seed the squash.

Step 3. Cut the peeled squash into 1/2-inch thick slices. Arrange the slices so that they overlap slightly in bottom of baking dish.

Step 4. Melt the butter over medium heat in a 2-quart saucepan. Reduce the heat and add the garlic. Cook 2-3 minutes, stirring frequently, until the garlic is soft. Don’t let the butter brown.

Step 5. In a small bowl, mix together the breadcrumbs, cheese and one tablespoon of the butter-garlic mixture.

Step 6. Brush the squash slices with the remaining butter-garlic mixture.

Step 7. Sprinkle the squash slices with salt, pepper and the breadcrumb mixture.

Step 8. Bake uncovered 30-40 minutes or until squash is tender when pierced with a fork. Then bump the oven temperature up to 425°F and bake an additional 5-10 minutes to lightly brown the tops.

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