Sleep & Jaw Joint Problems with Barry Glassman, DMD

Larry (00:00):

I'm Larry Barsh. And you are listening to specifically for seniors on today's show is Dr. Barry Glassman. Hi Barry. How are you?

Barry Glassman (00:10):

Hi. Good to talk to you.

Larry (00:11):

Hey, before we get along too far, let me read, let me introduce you officially. Should I say Dr. Glass maintained the private practice in Allentown, Pennsylvania, which was limited to chronic pain management head and facial pain, temporal mandibular, joint jaw, joint dysfunction, and dental sleep medicine. He's a diplomat of the American of the board of the American academy of Cranio-Facial Pain. Yeah,

Barry Glassman (00:43):

That's changed since you were the president.

Larry (00:46):

I was never the president of Cranio-facial Pain. I was the president of the American Dental Sleep Apnea association.

Barry Glassman (00:52):

Right. Well, that's coming.

Larry (00:54):

Yeah, no, it wasn't on what you gave me. So you're, you're gonna have to tell me about that yourself, a fellow of the, the international college of cranial mandibular, orthopedics, and a diplomat of the American academy of pain management. Barry is also a guest lecturer at Tufts university school of dental medicine. How's that?

Barry Glassman (01:19):

That's good.

Larry (01:20):

And the, American academy of dental sleep medicine,

Barry Glassman (01:25):

That's what I was referring to. So for those that don't know, Dr. Barsh and you may not know that as well, but Dr. Barsh was among, was either the first or second president of the society for sleep disorders, which was the precursor beginning of what is, our premier organization in sleep, the American academy of dental sleep medicine.

Larry (01:51):

Okay. Let, let me change positions here on our screen. So we know whose talking and who is interviewing

Barry Glassman (01:57):

Well, I think people should know that you are, I mean, I, you are and were a, a true, pioneer, in dentistry and, most, especially in sleep medicine, dental, sleep medicine,

Larry (02:12):

Pioneer, how old do you think I am? Anyway,

Barry Glassman (02:15):

Most pioneers are dead. So, therefore it fits.

Larry (02:23):

You gave a seminar in last weekend. What was it about,

Barry Glassman (02:28):

dental sleep medicine, the basics of principles of basic principles of dental sleep. It was an introduction course for dentist.

Larry (02:37):

We were talking before you said there's some new things in sleep.

Barry Glassman (02:41):

Oh my.

Larry (02:41):

Rather than just sleep apnea and snoring.

Barry Glassman (02:46):

So I certainly, we, you know, sleep is a, one of the things about sleep, Larry, you know, as well as I, it's a relatively young science. And that's why to be honest with you. And I, I don't mean this in, in any, you know, patronizing way, your introduction, your, the work that you did in, in, in, in that organization, was so far ahead of its time, because even at that point, so little was known about sleep. And when we look at, at sleep as a science, it wasn't, until 1923, that we knew that, that sleep involved in awake brain and, and not a resting brain and that it was worth, and the things were happening during sleep, that were critically important. We didn't, we didn't know anything about sleep hygiene. We didn know how long people needed to sleep.

Barry Glassman (03:41):

We need, we didn't know what happened when people were sleep deprived and physicians to this day. Unfortunately, aren't taught very much about that. but what, now we know a lot about growth and development, and we know a lot about kids. So a lot of our growth, a lot of our changes, a lot of what we've learned about is not only what happens to older people, when they don't sleep and, and how important it is, and the connection with sleep, we're aware, well, the connection of sleep with cardiovascular disease, but now we're aware of the, of sleep with Alzheimer's. And we're aware of, the, the, the role of the lymphatics or the drainage of sleep that happens in with quality sleep that we don't get and how we can, there may be a, a, a, a, actually a multiple sclerosis connection and, definite connection with diabetes.

Barry Glassman (04:29):

a, a, a lot of, changes, understanding of the changes as we get older. Why, when I texted you, when I called you this morning, or emailed morning at six o'clock, and we were both up, why is that? And, and, why is it that our, our, our, our was changing or what changes it, in our, in our system as we get older and how to, how to resolve that. So, one of the bigger issues as we get older is the, this P gland that produces melatonin. And oftentimes that calcifies so as, as we get older, we, we lose that. And, the thought being that melatonin, really should be considered as a supplement for, for a lot of our older population. So a lot of those things, what temperature should we be sleeping in was a long before we realized that, very low temperatures are, are far better for us to sleep.

Barry Glassman (05:27):

and, we're talking in terms of 65 degrees, as opposed to the, the 71 72, that, that are that's common and why that's so important and the release of heat through our extremities, and the lower core temperature, for the, those people that have trouble falling asleep. There's a, a lot of techniques that we've learned, taking a warm bath, 20 minutes, 20 minute, bath or shower, or 15 minute shower, but not getting your hair wet, critically important in, in, in helping to, to alter your body temperature as it changes when you, when you, when you fall asleep. And, and that, that alone can be a big help instead of the medications that so many people were taking, whether they be, antidepressants or SSRIs, a whole series of medications that really have some negative side effects, simp, a simple, low level amine, and a histamine, a Benadryl can be much safer and much more effective helping, us as elderly fall asleep. So there's just so much progress, when we're looking at sleep and it, yes, sleep apnea is a big thing and, and 90% remain undiagnosed and all that's critically important. And you, yes, we're better at treating it and diagnosing it, but there's just so much more to sleep than this disease called sleep apnea.

Barry Glassman (06:47):

I know, are we done?

Larry (06:50):

And what's the connection to dentists? What, what can dentists do? I know both of us a dentists in case I didn't tell anybody that.

Barry Glassman (06:59):

Right. Right. so

Larry (07:03):

What role do we play in getting people to recognize

Barry Glassman (07:09):

That

Larry (07:09):

They have sleep Apnea

Barry Glassman (07:10):

That's great and, and or, or that they have a sleep problem in general. And, and, and the reality is, is many, many years ago, it became, it became a part of the, the, the better dentist regimen to start testing patients for hypertension, they would take blood pressures in their office. And if the, the blood elevated blood pressure, they, they at least inform their patient that they should be treated, or they should be, they should have that looked into, finding out whether or not someone has sleep apnea. The very best way is interestingly enough is with a validated questionnaire that consists of five or six questions. And so we're trying to get dentists because more people go to their dentist than go to their physician on a regular basis. maybe not in Florida, but around the rest of the world where the average age is, you know, know, two, two decimals instead of three, the, the, the, the, the, the, the, the, reality is, is that, getting people to, to getting dentists, to ask the right questions and, and at least advise people that they may have a, a, a breathing problem and get them started.

Barry Glassman (08:18):

And, and now even more so, more and more dentists are actually involved, helping distribute and give out the testing that's involved to help people determine whether or not they've got a, the sleeping issue that was validated was suspected in that validated screener.

Larry (08:34):

And this is a valid role for dentists.

Barry Glassman (08:36):

Oh my

Larry (08:37):

Goodness. So a dentist doing it, isn't somehow out on the free inch.

Barry Glassman (08:41):

You know, that, that is like a great question. I, no, I'm serious. That's a great question because unfortunately, a lot of dentists feel just that way, that, well, if I ask these questions of my patient, they're going to feel as though I'm not in my, why are you asking, why are you bothering? Why are you doing? I came here to get my teeth cleaned, shut up, clean my teeth, let me go home. And, and, and, it's unfortunate. It's unfortunate because we really should be the number one portal of move, moving patients into sleep medicine, because now we, more and more dentists are trained in, in, in recognizing. And even that more and more dentists are being taught, how to scrape,

Larry (09:26):

interesting. You started as a dentist dentist. Yeah. With a regular dental practice. How did you transition, sleep into pain management?

Barry Glassman (09:40):

That's really interesting. I, we're not taught very much about in dental school about chronic pain, and we're really taught, to, to think rather linearly when it comes to pain, a patient comes to us, they point to their tooth. It says it hurts. And we take this x-ray and we hope that we can see a black spot somewhere. The black spot in the tooth would tell me, it's the K a black spot at, at the root would tell me it needs a root canal. And, and, and if I don't see any of those black spots, I'm concerned because that patient's telling me they have pain. And I don't see, and I don't have any reason why. Well, Laura, Laura came to see me miss Laura. Who's a 35 year old married woman with, three children, came to see me. And she had pain in a, in a bicuspid.

Barry Glassman (10:31):

And we took that x-ray and there was no black spots, and I couldn't find anything wrong. I thought maybe it was a fit only I replaced the filling. It wasn't that, eventually she, was referred out because she was so upset that we couldn't find her pain and wound up in taking, seeing an oral surgeon and having the tooth out the pain didn't get better. In fact, it got worse and we followed this along. And just about that time, I receiving flyers in my office about how TMD temperament joint dysfunction can lead to referred pain patterns. my path Larry was a torturous one because there was a lot of bad information given by well intended dentists about the role of teeth in those kinds pain patterns. And, the good news is eventually I, I found my way through evidence based concepts, learning more about the role that the demandable and the jaw and BRX brightening your teeth and what that, how this, these oral structures can contribute to what we call, try trigeminal signaling, or increased, elevated status of the trigeminal nerve, which is the main, motor and sensor sensory nerve of the head and neck.

Barry Glassman (11:52):

And, the learning curve has it, it was massive, but it, it hasn't stopped. And I've enjoyed the, just putting down the hand piece and concentrating on how we can help people with acute pain, chronic pain and sleep disorders.

Larry (12:11):

And then you transition again into teaching.

Barry Glassman (12:17):

Well, yes, I was, I was working with a company, that was, that had some technical equipment that I, that I was using and learning about. And they had asked me to teach, and I came back to my wife who, you know, my wife, Sharon, who was by the way, just a, the teacher's teacher, just a phenomenal teacher. And I, I said to Sharon and I share, I've just been asked, I wanna start teaching. And she said, who the health said, you have any idea on how to teach? I said, well, I know this, you know, I can teach. It said, just because, you know, something doesn't mean you can teach it. And she was really critical. And I said, well, okay, then you can, you can, you can help me. You can teach me how to teach. She said, I am not going to help you fail.

Barry Glassman (13:05):

Certainly. And I taught for about a year and a half, and she refused to come see me doing, she refused. And, eventually, we were, I was in Las Vegas with her and she came to see me and I was teaching and she actually walked in the room. And Larry, I gotta tell you, I've never been nervous teaching. I'm a wreck as she walks into the room and she sits down and, and, and, and soon I forget, she's there. And I go on with my teaching and I look up and she's gone. Well, we're having dinner that night. And I said, finally, I said to her, cuz she said nothing to me. I said, you were in the room. I know you were in the room. Talk to me. And she says the follow, I don't know. you know, we've been married, we're married.

Larry (13:51):

Okay.

Barry Glassman (13:51):

And we're married. And, I don't know when you mastered all the material you mastered, but it's massive. I'm feeling pretty good right there. Yeah. Said if your purpose was to let everybody in the room know how much you knew you were phenomenal. If your purpose was to teach them, you sucked. And then, then she took me under her wing and she spent time teaching me how to teach, how to look at people in the eyes, how to know whether or not I was getting through how not, how to create a safe environment so that they could learn. it's, it's been a tremendous journey with her, because it, it, it really helped differentiate me. I really feel as though it really helped me take the message of pain management and sleep to my fellow dentist.

Larry (14:48):

I've sat in on a couple of lectures and my friend, you know how to teach.

Barry Glassman (14:54):

Oh, thank you. And, I give Sharon and that's Sharon, Larry that's Sharon. That is

Larry (15:00):

All you don't, you don't know how to stand on a table properly, but you know how to teach.

Barry Glassman (15:05):

I don't, you don't. I must tell you I, so, so what Larry's referring to the order to be seen sometimes in the back, if I'm demonstrating, I would get on a chair and I would stand on a chair. Well, trust me, I don't do that anymore. It's not, I I've considered that. Not safe.

Larry (15:22):

just a question. I know when I've got a, when I had a difficult case coming up the next day, thank you about it kept me up at night, thinking through the procedure, reviewing stuff, I didn't know, or wasn't confident knowing What keeps you up at night.

Barry Glassman (15:45):

Wow. That's so one of the things I don't know, I'm gonna be able to make this as clear. I'm gonna really try cuz this is a great, this is a great question. One of the things that, that I've learned is that so much of what we're taught in dentistry, isn't true. There are some myths taught and those myths are often transferred to patients. And while sometimes patients don't get hurt by that, by those myths, sometimes they do. And a lot of the information is passed down empirically, which means there was never really a good study. We, we learned that people grind would grind, cleanse their teeth because of their bite, because of something that exists in their bite. And we, we now know that isn't true, but it's still taught. And there's a whole series of things like that that are taught, recognizing that these Aren are, are true, has been mind boggling and, and, and practice changing and actually simplifying.

Barry Glassman (17:10):

And I firmly believe that if dentistry knew all the myths understood that the evidence that they could help more people more readily along the way, I began to have a national and international influence. And I really believed Larry that I was going to have lead a, a, a movement that would change the way dead, this were taught and would think, and turn them back into the complex thinkers that I know they could be rather than the linear thinkers that we're taught to be in dental school. The, the simple cookbook kind of, I was at one point there's a, a, a major institution here in Florida where that does a lot of teaching for a lots of dentists. And the leader is a big name in dentistry. And the leader was contacting me and wanting me to come teach. And I'm thinking to myself, I could affect so many, so many people and really turned the 25 people a week.

Barry Glassman (18:13):

I was teaching into the 200, 300 people a week, a major, make a major change. Unfortunately, that individual couldn't let go of some of the myths he was teaching and felt there would. And I felt there would be a conflict. And I, I knew ever got to do that. And what keeps me awake is that I know, in the end I will never have had the influence and the positive influence on my profession and on the people who are served by that profession that I really believe one day I would have Sharon gets upset with me. Cause I keep saying, I failed. I have not accomplished my goal. there are some people I have influence. There's no question about that, but it's not, not what I thought would happen.

Larry (19:01):

Well, the one you have influenced are gonna go on and influence others.

Barry Glassman (19:08):

You don't,

Larry (19:09):

You don't get, you don't get run of the mill dentists. I, I shouldn't say that, but

Barry Glassman (19:16):

I know, I know what you're saying. I know exactly what you're saying and

Larry (19:18):

Coming to your courses, they don't put in intensity that it requires,

Barry Glassman (19:22):

And there is a theory that it takes funerals to make scientific progress. Unfortunately, some that particular leader is no longer with us and the people that have taken up the flag are more dogmatic than he was.

Larry (19:40):

Oh yeah. Our profession does attract a lot of dogma.

Barry Glassman (19:47):

Yes.

Larry (19:49):

so Our patient has facial pain. How do they find a dentist that says more than I'm gonna put in a mouth guard and, that'll take care of it.

Barry Glassman (20:04):

Right. So here's the good news. I don't even know if you know, this, the American dental association has just created a new specialty of oral facial pain,

Barry Glassman (20:17):

And in order to become a specialist in oro- facial pain, while there is some grandfathering going on with diplomats of the American academy of oro- facial pain, that's all gonna go away in the next few years. And the only people that will be specialists will be those who attend a two year residency pro just like any specialty, just like endodontics, just like periodontics. It's like orthodontics two years of oral facial pain programs. And they are, they exist in Kentucky with Jeff Focusun in, UCLA and at Tufts, at Rutgers. and there will be more, more and more programs popping up that will be Coda approved. And you will, you will be sent if you're wise, you will go to a specialist, just like a, a if you, you wanted, there are orthodontists that do general dentists to do endodontics, to do root canals.

Barry Glassman (21:13):

Some of the root canals can be done very well by your general dentist. Most general dentists take the more difficult cases and refer them to an endodontist. When there is a more difficult facial pain issue, whether it be a neuropathic issue or a neurovascular issue, whatever, whatever it is. And that can include things like trigeminal neuralgia, migraine headache, cluster headache, hemicranialcontinuance, one sided headache. it could be facial pain, of, of various sorts, oftentimes traumatically induced, whatever it is, there will be these specialists that will be using interestingly enough, some oral appliances when, when indicated, but will also be experts in pharmacotherapy experts in supportive therapy, and experts in cognitive behavior therapy, et cetera. And so there will be places to go,

Larry (22:10):

Okay, now I've seen you teach, your teaching is as much a performance as it is, getting information across. And I know that you and Sharon were very active in the civic theater in Allentown. I remember seeing you perform several times. Was this a natural transition from teaching, or did you get into teaching because you were acting or is it a hobby or is it a passion?

Barry Glassman (22:48):

So, so I started acting when I met Sharon, on our first date, I was acting, no, I started acting Sharon was involved in theater. She was, she was already teaching, theater at, at, at her at that point, her junior high school, and then eventually her high school. And the one way I could get to spend time with her was come to her rehearsals and pretend I was interested.

Larry (23:16):

So

Barry Glassman (23:17):

It was, I know it was a lot better than going shopping, just saying

Barry Glassman (23:21):

So, so, I got an in, when we, we went to the army, I, after I graduated, was graduated from Pit from dental school. we went to Fort Bragg, North Carolina, and they had a theater. I said, you know, we both went and auditioned and got very, very active in the theater. And that's where my first acting took place. And, and we came down town and got very active there. So the acting came as a result of my meeting, Sharon and her interest. And, and actually I began to absolutely love the concept of performing. I must say that there's no question that once I started teaching the comfort of being in front of a room, the confidence I had, the ability to project, the knowledge of what it took to communicate, added to now learning about how to communicate eye to eye, who were visual learners and who was not a visual learner, who, how to rephrase things to make things work, how to take the blame and not, but all that for, for a lack of, clarity, rather than blame the stupidity of the audience, trust me, you and I both have, have been instructors to do that on a regular basis.

Barry Glassman (24:42):

All, all that came from came from sharing from, you know, learning how to teach, but the, the performance side of it, the changing my voice, changing my volume, changing my speed, giving people moments, not being afraid to have quiet moments, to allow things to sink in. a lot of people are afraid of quiet. I think why it's when we learned the most, not being afraid of that. That's all from acting that's all from my experience. Facting so, yes. it, it certainly, it certainly helped when Sharon went to help me teach, certainly having that those skills already inherent was, was helpful.

Larry (25:26):

This is a quiet moment. I learn. I learn,

Barry Glassman (25:32):

You know, I, I, so I wonder with the people that you meet in Florida, the people who know Larry Barsh, I am betting knowing Larry Barsh. They don't know exactly just like many people here. Don't because I'm new to Florida. I'm only been here about a year. It's it's, it's a, the people here have no idea, just like many people, many people, you know, you, you, you meet here, but you don't know their history only until you can sit down and talk with them and spend time. So for you who maybe spend some time on this podcast and, and, and have heard Larry ask questions, I wanna tell you how absolutely what an incredible human being ison the other side of those questions, the, the, the, he, the pioneering dentistry, the, the incredible photographer, the, the, one of the brightest minds that I've ever, ever, ever dealt with.

Larry (26:46):

Enough. Enough. Thank you enough on a personal note. Yes, my wife, Arline, and I saw you portray Morey Schwartz in the play Tuesdays with Morey based on Mitch Albom's book. Arline and I had some personal contact with Morey. And you asked Arline for some of Morey's mannerisms. Now I should explain to people listening that Moreywas an elderly, frail, thin gentleman. Barry is not, a gentleman, no frail and thin, you know what? Six, two, a hundred and something pounds

Barry Glassman (27:35):

Me.

Larry (27:36):

Yeah,

Barry Glassman (27:37):

No, I'm five nine, and weigh way more than I should.

Larry (27:43):

You know, that's a interesting, because I picture you as a much bigger person. Anyhow, you took on Morey's mannerisms in a manner that was almost scary. You became Moreyand you look nothing like he, did you talk nothing like he did, and yet you were, he, you were him in that show.

Barry Glassman (28:17):

Thank you. there's there are very few compliments that, that could be any were near, what that means to me. the, one of the things that, I mean, going through ALS and learning about ALS is, is, is, was difficult. there were times I went home, literally in tears. There was a there, the moment that I don't know that I've ever discussed with you, Larry, first of all, Arline really helped me. we spent some time on the phone talking about Moreyi and I went back with the director and, and let him know that what, the things that I was taught and that then he would then lead me towards to make sure that I, I followed through three nights before we opened. They brought in two couples, both in both cases, it was a male with, ALS one more advance than the other. And while I knew this was personal, and I knew obviously how disastrous, how destructive this disease was. I never thought about how it would affect the people in the audience do on a show,

Barry Glassman (29:52):

So there I am. Sorry. No problem. So there I am doing the show and we, we were asking them to look and see if there's any look at the way I walked, look at the way I dragged my foot when, as I got worse, look at the, just watch my deterioration and, and, and see if, if they could, they could identify with it. And at one point during the show, I don't remember exactly where it was, but at one point, both of them gasped, and I recognized that this was their life. This was, this was a show for me, but this was their life for them and whatever, whatever we had done to that point. And at that point hit home. And it was so internally, I was sad for me. I mean, so, so to realize that that that's what this could possibly mean. That, and for me, that's, that's theater, that's, it's learning to live learning, to experience the human experience that, that others on this earth are experiencing. That we, we may never experience hopefully. And, and to share that and to feel that, and I felt, I felt as affected then as I am, as I was today. When you said, how me, how, how in your mind, how much captured his physicality, who was very special to me?

Larry (31:38):

There's not much else to talk about after that, Barry.

Barry Glassman (31:41):

Well, the show, you know what, yeah, there is one thing, and here you go, why is this show not done? So there's a show that is, I of all places it's not done in Florida. I mean, I've done. I just finished doing, on golden pond and played the lead in the, on golden pond. Wonderful show, done all the time, done all the time in Florida tracks. Lots of people, no question. Yes, because we're all getting a older and, and, and it's a meaningful, wonderful piece. It's, it's a wonderful piece. It doesn't, it doesn't touch the, the, it doesn't touch the reality of, of, of this beautiful show by Mitch. It doesn't touch it and nobody does it. I don't understand

Larry (32:36):

What can I

Barry Glassman (32:37):

Say? Yeah, well, you don't have to, I don't, you don't have to, you know, I, I, I, I will tell you this. I'm in, I'm in Melbourne, Florida in the Atlantic, absolutely little east of, on, on the, a one, a side of Melbourne on the, off the Causeway. And, we've had a few experiences where I, I went to see, audition or be involved in local shows. And, I would not call the, the local theater welcoming. Uh it's there's, there seems to be no place. It's sort of sad. Right? they, they, they've got their hometown favor and, I would love to with my time now, I, I am teaching, but I would love to perform. So if there's anything down in, in, where you are, just gimme a call and, we can, we can together,

Larry (33:32):

we can work out 10% Fee.

Barry Glassman (33:40):

Hundred percent of nothing is what

Larry (33:43):

It's about, what I'm making from doing podcasts.

Barry Glassman (33:46):

It's all good. It's all good.

Larry (33:48):

It's been great talking to you.

Barry Glassman (33:50):

It's it? It's I, so I I'm, I, I, this is you are, and I've always been one of my favorite people and I it's so great touching base with you.

Larry (34:02):

Thanks for coming on.

Barry Glassman (34:04):

Thank you.

Larry (34:06):

If you enjoyed this podcast, click on the follow or subscribe button on your podcast, device. And I'll let you know when there are more podcasts being broadcast. Next time. This is Larry Barsh, and you've been listening to specifically for seniors.