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There are many ways to measure the quality of a doctor. Dr. Mark A. Piper started by getting the best training available- Harvard College, Harvard Dental School, and Vanderbilt Medical School. Dr. Piper not only attended these prestigious institutions, he excelled- BA and DMD with honors and a Harvard Gold Medal Awardee for graduating first in his dental school class. Beyond the formal education of a doctor is the actual clinical experience. Dr. Piper did everything he could to prepare for his dental and medical practice- three years of residency as an oral and maxillofacial surgeon and two years of training as a general surgeon. In addition he worked for a time as an emergency room physician in rural Tennessee. With this background the real work began when Dr. Piper opened the Piper Clinic in the early 1980's. Since then over 10,000 patients from all over the world with bite, joint, and pain disorders have been treated at the Piper Clinic. In 2005 alone Dr. Piper was recognized for three prestigious honors- Top Physicians in the United States by his medical colleagues, Top Dentists in the United States by his dental colleagues, and Top Educator in Dentistry by the Dentistry Today magazine. In spite of all the honors, there is but one reality and one promise that we hold dearest.
The measure of a "best doctor" is in the eyes of the patient, and Dr. Piper promises to never stop aiming for this honor from every patient in his practice.

Dr. Piper has been teaching, researching, and publishing his entire career. However, he waited twenty years before opening his formal training programs at the Piper Education and Research Center (PERC). He wanted to prepare himself before embarking on the responsibility of training other doctors. Now the staff of PERC is focused upon one thing- offering the best training available for the occlusion, for the temporomandibular joint, and for facial pain. The bottom line is that the concepts that we teach others simply mirror the way that we practice at the Piper Clinic.
We promise to train PERC doctors to deliver the best diagnosis and treatment of the 21st century.

If you have never experienced a TMJ problem then you may not appreciate the value of having a doctor who knows about the temporomandibular joint. But what you may not realize is that you are even less likely to develop a TMJ disorder if your doctor knows how to practice preventive dentistry by fixing your bite in a way that the joint is not injured. In general, the more complicated your bite, the more likely that you can acquire a TMJ problem if you are not fixed appropriately.
We promise to teach PERC doctors how to prevent injury to the TMJ by establishing a functional bite that does not stress the joint.

Some TMJ disorders are asymptomatic or painless. Therefore many patients are not aware that they may have a potential problem. This is particularly true in the child patient. When a doctor can pick up an early abnormality, more serious damage can be avoided. Serious damage to the joint can occur with or without pain. Little is gained if you make a big investment in your mouth only to have your bite change and your chin recede. Most dentists never examine the TMJ.
We promise to teach PERC doctors to recognize when a joint has an early problem that projects to become more serious. We teach how to do non invasive screening for abnormal joints. Furthermore, once PERC doctors diagnose a problem they know how to advise you about your treatment alternatives.

A smaller segment of the population has a serious joint condition or pain. This may be a child whose jaw has failed to grow normally, a teenager who is starting to have headaches, or an adult who is breaking or losing their teeth. Many TMJ patients develop life threatening sleep apnea. When a patient experiences a serious problem or severe TMJ pain, then they will do almost anything to get well. Unfortunately most of these patients are mismanaged because their joints are never imaged, testing is ignored, or treatment is empirical.
At PERC we promise to teach doctors how to understand the condition of the joint in every patient. For more serious problems we teach them how to order and interpret tests and how to prescribe directed treatment. Most dentists have never seen a scan of an injured TMJ. PERC graduates have seen hundreds of such scans, and they know what to do when they find an abnormality.

You may be one of the most unfortunate of TMJ patients suffering from failed previous therapy. Pain patterns may become increasingly worse and non responsive to narcotics. Bite alignment may be distorted and crippled, and the teeth damaged or lost. Appearances sometimes change so dramatically that patients become unrecognizable.
At PERC we promise to teach doctors how to recognize the complications of failed management. In particular PERC doctors have been trained to look at three aspects of every patient. The first is the pain patterning of the patient for layering of pain or serious nerve damage. The second is the condition and the stability of the joint, and for very complex patients this means that the doctor must know what TMJ images to obtain and how to interpret them. The third aspect that PERC students learn about TMJ patients is how the bite and the face are changed by a poorly developed or degenerated joint.


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