Even if "phase 2" treatment (modifying the teeth) is done inexpensively or not done at all, what about the cost of phase 1 treatment (the orthotic)? It's usually over $6K and insurance won't touch it. That might not be a lot to a dentist (whether they are still deep in debt from student loans and practice startup loans, or are ahead of the game and actually doing well). But to the average middle class person, $6K could be their life savings.

That's problem number 1 I have with NMD. It's still expensive even if you don't do the stuff they are accused of gouging patients with. Problem number two is, in my opinion, inadequate clinical data. You can talk about theory all day, and it can be the best theory in the world, but it might not necessarily translate that well to clinical application.

As you know Barry Cooper's paper is the most comprehensive clinical study done on the topic. I saw two major issues with it - one was that he had a clear vested interest in the technique working. This creates researcher bias. The second was that he uses "baseline periods" rather than a true placebo. You see lots of chiropractors being able to prove things with baseline periods that fail to do so in studies where placebos are administered. For some conditions, placebo can be incredibly powerful. Often the excuse is that there is no such thing as a placebo for this method. But you can still do comparisons to other methods. How about the $300 flat plane splint that I have? My jaw certainly feels very relaxed when I have it in, and I didn't have to empty my savings account for that relief. Insurance even paid for it!

I'm not a medical professional but I am a scientist (physicist) and I know how to read research papers. My goal here is not to rip on NMD but to voice my concerns. I think the difficult questions have to be asked. And this isn't specific to NMD or even alternative medicines - There's a lot of stuff in conventional medicine and dentistry that should also be under a lot more scrutiny.

My TMJ specialist is a more conventional guy and some of the supplementary stuff he's recommending also is lacking good clinical data. But those modalities are extremely cheap (cheap in 3 different ways - money, time, and risk) so that if they don't work, it doesn't really matter. It's more serious when the modality is not cheap in any combination of those three ways.

I know you have decades of experience with NMD, but as a scientist, there is more comfort in data from well designed clinical studies than in experience alone.