SDS Occlusion Blog

Dr. Barry Glassman, internationally acknowledged as a leading authority on TMD, migraine and dental related sleep breathing dysfunction, will open the 2nd Bruxism Awareness Week with a lecture at the Royal College of Physicians in London on October 24th 2011.

It turns out that Dr Glassman’s interest in the field was first encouraged by attending a Niles Guichet course, just like the majority of lecturers for SDS Occlusion! Interviewed at his specialist clinic in Pennsylvania, Dr. Glassman described how his interest was first aroused in this specific aspect of dentistry.

“Quite early in my career I had an adult female patient suffering upper right bicuspid pain with no obvious odontogenic cause, and which did not respond to orthodox dental procedures, which included endodontic therapy. At about that time I was advised of a course to be taken by Dr. Niles Guichet explaining how occlusal interferences can provoke excessive muscular activity. Our knowledge has moved on since then, but Dr. Guichet’s course confirmed my desire to learn more about the causes and treatment of craniofacial pain, joint dysfunction, chronic pain, headaches, and sleep disordered breathing.”

Despite the increasing understanding within the dental profession of bruxism, sleep apnoea and migraines there is still much to learn, and Dr. Glassman is concerned that these topics are not being adequately covered in dental training. “Although more practitioners are making the connection between bruxism, migraine and joint dysfunction, the mechanics are not understood and nocturnal and diurnal parafunction are often not diagnosed. I feel that dentistry should be the accepted initial gateway for patients with sleep abnormalities, but the current limitations in dental training, allied to the unresolved controversies surrounding occlusion and joint position, as well as a persistent adherence to dogma, are precluding this. Only by investigating new areas will dogma be defeated.”

Dr. Glassman has published many clinical and academic articles, hosts courses and seminars for dentists and has recently won the AACP’s coveted Haden-Stack Award, which is presented annually to the member who is deemed to have made the most significant contribution to advancing the understanding of TMD while promoting the AACP. In demand as a speaker worldwide, Dr. Glassman is not afraid to court controversy by challenging accepted attitudes and treatment practices. “ It is,” he states, “self-evident that many hundreds of patients have improved following considered, conservative dental therapy when other forms of medicine have failed. It is vital to find practitioners with the appropriate skills, not merely the right qualifications. We must also find ways of coordinating care between the healthcare professions in the best interests of the patient, to avoid the present scenario when rivalry between the disciplines, as a consequence of attitudes established during training, leads to a competitive arena with the patient being offered contrasting therapies or opinions.”

“We need to consider and evaluate therapy guidelines for conditions such as TMD and bruxism with an open mind, and not be hidebound by dogma or emotional adherence to a fixed ‘belief system.’ While this is not an exact science, and hard evidence for conclusions is sometimes lacking, we must always depend on science to underpin the therapies we adopt. To successfully treat chronic pain and dysfunction a more flexible model is required. Both we as clinicians, and our patients, expect successful outcomes from dental treatment based wholly on science, but success in this area is less certain. We need to acknowledge our failures as well as our successes, and always accept that whatever we do we cannot improve on or second guess the science involved.”

As one of dentistry’s latter day pioneers, Dr. Glassman’s October lecture will undoubtedly “muddy the waters of truth with the stick of enquiry,” and some attendees are likely to find themselves re-evaluating long established habits of mind. Dr. Glassman himself is keenly anticipating the event. He concluded the interview by stressing the importance of progress and of “facing the truth about occlusion and bruxism and the role of dentistry in sleep medicine.” He complimented S4S for so radically raising the awareness of bruxism and sleep medicine among dentists. “I’m proud to have been invited to launch Bruxism Awareness Week, and London is my favourite city in the world!”

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