Quote by Joshua Graham, image Michael Fry


Temporomandibular disorders (TMDs) present a challenge for health professionals, due to the great complexity of the condition. This complexity is evident in various aspects, including accurate diagnostic methods, treatment, associated co-morbidities, and the socioeconomic impact they entail. TMD cases are even more complex when the pathology becomes chronic or persistent. I did a little exploring to understand when the first Multidisciplinary approach came to light. 

It appears that by about the mid-1970s, a new care concept was born: the multidisciplinary approach. This approach integrates a group of specialists dedicated jointly to the study, diagnosis, and management of chronic pain conditions. The multidisciplinary approach had its origins at the University of Washington. Professor and Physician, Dr. John J. Bonica. One of the first things Dr. Bonica did at the University of Washington, in collaboration with a nurse, Dorothy Crowley, and a neurosurgeon, Lowell E. White, Jr., was to found a multidisciplinary pain clinic. This group of academic health care providers and researchers met regularly to discuss problem patients with chronic pain and to devise effective treatment strategies.

Dr. Bonica graduated from Marquette University School of Medicine in 1942. Marquette was a medical school?? Granted I was born in 1966, but I have lived in the suburbs around Milwaukee my whole life and I had no idea Marquette used to be a medical school. I have only known it to be an excellent Dental school and of course excellent Physical Therapy School. Dr. John Bonica was the Founder and guiding hand behind the formation of the 

International Association for the Study of Pain. Dr. Bonica, we thank you so very much for your contribution to managing pain.


I had the pleasure of being invited by Dr. Greg Larson DDS, (a wonderful friend and colleague, who is the only triple board-certified TMD and Dental Sleep Medicine Specialist in the bay area), to a weekend-long Provider Retreat, in South Bend, Indiana, Saturday, March 20, 2021. I like to call it the Dr. Daniel Klauer Retreat, the focus was on all things Dental Sleep Medicine, Orthopedic Development, Temporomandibular Disorders, and Craniofacial Pain, with the opportunity to focus on relationship building with providers in a variety of other specialties. We experienced interdisciplinary Mastermind Sessions with experts across the country, and the collaboration was amazing!

 Dr. Daniel Klauer DDS, is Board Certified with the American Board of Dental Sleep Medicine, American Board of Craniofacial Pain, and the American Board of Craniofacial Dental Sleep Medicine. He is Diplomate Eligible with the American Board of Orofacial Pain and he is the only doctor in a 100-mile radius that carries these 3 board credentials. Dr. Klauer, his wife, and Staff were the most amazing and generous hosts!

Here is a list of all the various healthcare disciplines and professionals that attended The Daniel Klauer Retreat; Oral Surgeons, Nurse Practitioners, Dentists, Orthodontists, Pediatricians, Neurologists, Myofunctional Therapists, Oral Surgeons, ENTs and Otolaryngologists, Neurologists, Chiropractors, Physical Therapists, General Physicians, Dental Hygienists and several vendors and sponsors that also play a crucial role in providing the technology and equipment to help our Orofacial Pain and Sleep Disordered Breathing patients, Aerin Medical/VivAer, KaVo Imaging, Independent Dental Solutions, BioResearch (Nate Krey is just a great guy with Bioresearch, check out the link to their upcoming BioResearch 2021 Annual Conference this summer), Inspire Medical Systems, EA Medical/SphenoCath/Dolor Technologies, and Midway Dental.

All of this to say, “It takes a Village” to help our chronic and complicated Temporomandibular and Oral Facial Pain clients get appropriate and successful care and compassion. I am a better practitioner for having attended this retreat. I now have even more contacts around the US to help direct our patients in need. One of my company Tag lines for Freedom Physical Therapy Services used to be, “It is a privilege to be part of the healing process”! It was a privilege and an honor to be invited to this Retreat, and I look forward to fostering, supporting, and growing my multidisciplinary approach and team.

So, whether you suffer from Temporomandibular Disorders, Trigeminal Neuralgia, Craniofacial Pain, Sleep Disordered Breathing, etc. please keep the fire inside you burning brighter, find a TMD specialist that has the training, passion, and compassion to help, along with their multidisciplinary team of professionals to help put out the fire, the pain and work together to improve the quality of your life.

To my family, all my friends, colleagues, and patients that have guided me to this point in my life as a human being and a professional…… THANK YOU.

Enjoy More Freedom!

Mike Karegeannes


Michael Karegeannes
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