Guest Book Review: Diagnosing Patients’ Headache Pain With Best-Bite Martin B. Goldstein, DMD

At first glance, Dr. Jerry Simon’s book, Stop Headaches Now (SHN), would seem more likely found on the “well-being” shelves of Barnes & Noble. It looks like one of many books promising to provide clues about why consumers might get headaches and what they might do about them. Were I to formulate a required-reading list for dentists, I would place SHN near the top. While it portends to be written for the lay reader, SHN ties the confusing subject of occlusal dysfunction into such a neat package, even the well-schooled practitioners may never look at their patients’ dentitions the same way again.

Dr. Simon makes an emphatic point that not all headaches are due to TMJ dysfunction, but also notes how many headaches of “unknown origin” have a TMJ etiology and are simply not diagnosed as such. There are numerous and varied case studies of patients Dr. Simon treated over the years, painting portraits for headache patients to recognize as similar (or dissimilar) to their own.

In the process of explaining the varied signs and symptoms of TMJ dysfunction, dentists are reacquainted with such issues as occlusal disharmony, coronal breakdown including abfraction, muscle and nerve groups often affected by parafunctional occlusal habits, tooth form as it relates to function and of course the varied methods dentists might use to assist patients in diagnosing the cause of and relieving their pain.

It has been said education is often nothing more than reminding us of what we already know. Profoundly, for the “reader-dentist”, Dr. Simon ties together the bits and pieces dentists already know about occlusion, and thereby constructs a lattice upon which dentists can “reorganize” their concepts of occlusal dysfunction as it affects all of our patients. Dentists who carefully read Dr. Simon’s case histories will discover, upon reexamining their own patients’ dentitions, all too many patients exhibiting the same signs of occlusal breakdown.

Interestingly, the concept of sub-conscious erasure patterns as the patient responds to occlusal disharmony is called upon to explain excessive parafuntion. Simply put, Dr. Simon attributes the majority of occlusally related myo-facial pain to the patient’s unconscious attempts to “erase” such disharmonies via chronic bruxism or clenching habits that become for the patient, undetectable “background” much like breathing and swallowing.

Near the book’s conclusion, the dentist (and patient) is introduced to Dr. Simon’s invention, the Best-Bite discluder. It is described as a means of differentiating headache pain resultant of muscular dysfunction from pain due to another cause. It also is described as a device that enables the dentist-user to more accurately record a physiologic jaw position likely to promote muscular harmony, thus enabling the dentist to provide a pain-relieving occlusal splint when the need arises. Dr. Simon is quick to disclose to patient and dentist that splint fabrication, while remaining an important palliative service, should be viewed as an early “short cut” to occlusal harmony that is optimally followed with definitive therapy.

Since reading Stop Headaches Now and employing Dr. Simon’s method in my practice, a greater understanding of the goals of such therapy has been realized.

Dr. Goldstein, a graduate of the University of Connecticut School of Dental Medicine, practices general dentistry in a group setting in Wolcott, Conn. He contributes regularly to multiple dental periodicals and can be contacted at martyg924@cox.net.