Dr. William Farrar may have had the greatest impact ever on the dental medical community involved with TMJ dysfunction with his pioneering anatomical and clinical studies into how the human jaw joints function. His death on September 17, 1985 was a blow to all who understood and benefited from his contributions. His discovery of how the disk functions in the TMJ made general dentists and many specialists rea1ize, for the first time, that the condyle displaced posteriorly, either by nature or by the practitioner, was probably the worst position possible. At the time, his discovery of how the disk and condyle moved defied the concept of the border position, which positioned the condyle posteriorly and often caused the disk to move into an anterior displaced position. Most gnathological concepts pushed the mandible posteriorly, because the border position was repeatable.
Bill was a pioneer with great courage. His concepts disrupted many articulator mechanical concepts and equilibration techniques. His courage never faltered and his greatness will live in history. His pioneering in diagnostics, treatment methods, and disk displacement classifications was the first correct concepts ever published. Through his insight, Bill helped us understand the phenomenon of disk dysfunction. He totally shared the knowledge he had acquired through his research and study. In the sixth edition of the Normandie News and Notes (Summer 1985), Dr. Farrar stated: “The first goal in examining and managing TMJ patients is diagnosis. The diagnosis will be based on the patient's history, clinical examination, and radiographic and laboratory findings. Our main emphasis (Normandie Study Group) has been to be able to observe and measure the differences among TMJ patients, for we believe the differences are more important than the similarities. The only way to be really sure about observation and concepts is to perform clinical studies of condylar movements, muscle function, radiographs, range-of-movement studies, and auscultation studies, and to do them yourself. When the overview is finally gained and the picture is fully seen, the medical profession, including dentistry, and all of the other health-related sciences are going to be astounded at the enormous impact that the abnormal function of the jaws, the muscles, and the nerves of the face, head, and neck have had on the health of large
segments of our population.” How prescient is that
statement.
Dr. Farrar graduated from Emory University School of Dentistry in 1952. He served at Maxwell Air Force Base, Alabama Hospital Clinic for two years. In 1954, he began a general dentistry private practice in Montgomery, Alabama. In 1958, he initiated studies of normal and abnormal jaw joint function.
Dr. Farrar treated more than 6,500 patients with temporomandibular joint disorders (TMD) and craniofacial pain. His lecturing schedule and seminars were conducted extensively in this country and Europe. Aside from designing many new therapies for TMD patients, he also designed many new surgical techniques with Dr. William L. McCarty, Jr., an oral surgeon from Montgomery, Alabama.
In 1979 Dr. Farrar established the Normandie Study Group for advancement of continuing education in the field of TMJ diagnosis and treatment. He was codirector with Dr. McCarty of the Normandie Study Group.
In December 1980, Bill was diagnosed with idiopathic pulmonary fibrosis with terminal prognosis within a year. Bill Farrar remained active for almost five years due to grit and drive. To all who knew him well, he was an inspiration. He remained vigilant in his search for scientific knowledge. Until the day of his death, he continued his desire to share. Most of all he was a mentor. His students were in constant contact with their prophetic, charismatic mentor.
Although weakened and physically compromised, he entered his office on time every day. With his associates, Dr. Bill McCarty and Dr. Ken Farha, he did patient consults and telephone consultations.
Following his serious prognosis, he continued teaching along with his associates for 49 more courses in severa1 1ocations. He was invited to teach in Europe in Monte Carlo, Switzerland, Germany, the Netherlands, and Sweden and fulfilled those invitations in his weakened condition. In 1983, he was a featured speaker in Munich, Germany at the First International Symposium of TMJ Dysfunction. Over 900 dentists traveled to Montgomery from 16 foreign countries and 46 states to take part in advanced courses taught at the Normandie Institute during the period 1980-1985. He found great satisfaction in teaching in all of the 79 courses held in Montgomery during this time. Bill coauthored, “Clinical Outline of TMJ Diagnosis," with Dr. McCarty in 1982. The book was a major resource for TMJ practioners, and most of the concepts still remain in place today. In addition, Dr. Farrar had numerous scientific articles published in American and European dental journals over a 25-year period.
He told each group that he taught, “My time is short, I will fight and I am not bitter. I have accomplished much of what I wanted to do. It has been exciting. I can now be selective and do things that are of the greatest importance to me.” He told his staff, “No long faces. Let’s get busy. There is so much to be done.” An article in the 1985 Alabama Dental Journal, quoted Bill on a number of subjects. For example, “Criticism on the professional level, is actually beneficial because it stimulates us to re-think and re-test our viewpoints and concepts. We must not accept old ideas not based on scientific fact. We must make scientific observations. We are not in as bad trouble as we think we are if we do not agree with one another.”
Dr. Farrar received many awards during his career. In 1984, in Washington, D.C. at the Society of Occlusal Studies (SOS) annual meeting, Dr. Weldon Bell of Dallas, Texas named Dr. Farrar, TMJ Man of the 1970s decade for his contribution to understanding TMJ internal derangements and condylar disk function. The European Academy of Craniomandibular Disorders elected Dr. Farrar an honorary member at their first scientific meeting in Huckelhoven, West Germany in June 1985 in appreciation for his outstanding contribution to the field of craniomandibular disorders.
He was a founder, fellow, and director of the American Academy of Craniomandibular Disorders. He was a member of the editorial board of CRANIO and the American Journal of Orthodontics.
He received many awards and did ground work for so many scientific groups that space does not allow me to list all of them.
Many doctors came to Montgomery to study under the country dentist as Bill described himself. All of Bill's relatives felt a great loss when he died. We are all deeply conscious of how much we have gained from his life’s work. He wished for one of his children to become a dentist. Dr. Marie B. Farrar, an orthodontist and one of Bill's four chi1dren, is in private practice today in Chattanooga, Tennessee. Upon my request, she gave me a list of quotations from dentists throughout the country and around the world. While reading the remarks from these doctors, my eyes teared up. He touched the lives and perhaps the souls of so many doctors. Bill had an outstanding memory and, on occasion, would recite almost full chapters of the Bible when he was touched by various circumstances.
Bill and I went to dinner one year while attending the AES meeting. We walked several blocks to Hy's of Canada restaurant. We stopped at store windows when his breath became too short. He was laboring and at each stop, he would tell me anecdotal tales about his life while he recovered his breath. The following is one of my favorite stories during that walk: He said, “One day last week I was looking for Ed in the office, but I could not find him. I knew that Ed was in the office, and I went room to room looking for him. Finally, I looked over the swinging doors, and there was Ed and the patient down on their knees praying. I hollered, “Get yourself out here.” I said, “Ed we got to be credible not incredible."
When an Alabama physician, Dr Elias Kieser died, he left all his medical books to the Baptist Medical School Library in Montgomery. He left his entire orthopedic collection, as well as books on rheumatology, radiology, and other subjects. In 1966, Bill started visiting the medical library. He practically memorized the text of the orthopedic books. His interest in studying the body’s joints and comparing the larger joints to the TMJ led the dental medical world to a first time understanding of the most complex joint in the human body.
Bill spent time around the farm and he noticed that when a horse’s ligament got stretched, the horse became crippled, but if you could make the ligament tighten, the horse could function. The tendon was fired on the horse, and the tendon and ligament would scar in. So Bill rigged up a machine to fire the ligaments of the TMJ in his office, where he tried it and inserted the cannula in the joint. When he turned the machine on, it blew up! No harm done, but that was certainly the forerunner of radio frequency therapy. His technique for manual manipulation was the first manipulation procedure to recover the anteriorly displaced disk that most pratitioners had ever seen. He modified it over the years. An orthotic to recapture the anteriorly displaced placed disk was another of Bill's inventions. Once he discovered how the disk-condyle moves, he rea1ized that a flat surface orthotic was probably not going to recapture the disk, so he came up with an orthotic that he called an anterior repositioning orthotic. He also used an X-ray machine in his office to take radiographs of the TMJ. To Bill, necessity really was the mother of invention.
One day spent in his office changed my professional life forever, and I often think of the countless other dentists who were dramatically changed by his discoveries.
In January 1986 in CRANIO: The Journal of Craniomandibular Practice, there is a letter to the editor written by Barbara Allgood Killian, the education coordinator for the Normandie Study Group. She writes, “In the final months of his life, the phone calls came from people whom he respected and differed with had become more and more numerous. The essence of their comments was: Thank you for your courage to stand firm on your findings–you were right. The words came easily from some people and with more difficulty from others, but they came. Dr. Farrar considered his patients his primary teachers. His clinical findings encouraged him, even drove him, to scientific contributions. He possessed a mind that did not allow intermissions and a heart that reached out to his patients.”
In his final days, Bill was heard to say, “Medical science has not yet been able to attach a prognosis of doom on man’s spirit nor to predict the physical strength it can harness. I ask only to contribute to life as long as I live it.” This prayer was heard and granted. In his last years, Bill renewed his faith with the Lord. All of us who knew him have been richly blessed.
I leave you with this quote that I think is appropriate: “When you part from your friend, you grieve not, for that which you love most in him may be clearer in his absence, as the mountain to the climber is clearer from the plain.” Kahlil Gibran
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