Mike Gow: A Consultation with... Dr Barry Glassma by Mike Gow BDS (Gla) MFDS RCPS (Gla) MSc Hyp (Lon) PGCert (Edin), Editor, DentaltownUK magazine

by Mike Gow BDS (Gla) MFDS RCPS (Gla) MSc Hyp (Lon) PGCert (Edin), Editor, DentaltownUK magazine

Like me, I’m sure you have a few dental lectures and workshops that really tend to stand out in your memory over the years. Sometimes it is the subject matter that makes it stand out, however more often than not it is the presenter. A great presenter engages, educates and entertains. When I first met Dr Barry Glassman at an S4S workshop several years ago, I quickly realised that he was easily going to tick all three boxes.

It was a fabulous training event and I highly recommend anyone who has not yet attended a presentation or workshop with Dr Glassman, to do so. I believe he is returning in 2019! A few weeks ago, during his 2018 S4S UK tour, I had the chance to meet up with him again and interview him for DentaltownUK. I jumped at the chance to do so and when you watch the interview you will understand why.

Glassman qualified from University of Pittsburgh, reluctantly revealing in the interview that this was in 1973. Recently retired, he had built his career focusing on Sleep Medicine and the cross over between medicine and dentistry especially in orofacial pain issues. He describes retiring as ‘the most difficult decision’ of his life.

In the interview I was interested to hear his views that evidence-based dentistry is important but that he feels that not everything we do as clinicians needs to have an ‘evidence base’. He stresses that gaining evidence base in certain aspects of dentistry is virtually impossible and appropriate clinical evaluation and experience are important factors in the risk/benefit decision making in treatment and diagnosis. When dealing with things like chromic pain, he stresses that patient management is the key. Later in the interview he also discusses the importance for dentists to be able to evaluate papers and identify confirmation bias and weak papers.

I particularly enjoyed hearing him describe the fact that in dentistry we stopped saying ‘TMJ’ to refer to the actual problems of the joint, (although many clinicians and patients still do), as TMJ is actually the name of the joint! He compared this to a patient with knee pain being diagnosed by their doctor with ‘knee’! So, he explains how as a profession we changed the ‘J’ to a ‘D’, however he compares this to instead of being diagnosed with ‘knee’ to now being diagnosed with ‘KD’ or ‘Knee Dysfunction’. There are numerous problems that can occur in the knee joint and a diagnosis of ‘KD’ would not help indicate what the problem was or how to manage it. This comparison really does highlight the fact that ‘TMD’ really tells us very little about what the actual issues are and how to help that individual patient.

Glassman feels there are many myths in dentistry. Paraphrasing an old quote by Ronald Regan, (who was describing Democrats rather than dentists), Glassman says ‘the problem with dentists isn’t that they are stupid, it’s just that they know so much that isn’t true!’.

We touch on several of what Glassman believes are ‘myths’ in dentistry, including an interesting discussion about the reported occurrence of Anterior Open Bites when using ‘anterior discluder’ devices. He explains that it is not common but can happen yet perhaps not for the reasons we think it does!

If he could get one message across to the profession regarding ‘myths’ in dentistry he said ‘When you consider the fact that the teeth touch for only 15-20 minutes per day, you will realise that MIP will become a little less important.’

When I asked him what three things he would put into a ‘Dental Room 101’, he simply said ‘Ego, ego and ego’.

Glassman reflects that there seems to be less camaraderie now within the dental profession than there was historically, wondering if that is in part due to the loosening of advertising restrictions. He feels that dentistry has become competitive and the business aspect of dentistry, albeit important, may on occasions make dentists lose sight of their primary goal, to improve the quality of life of their patients.

He talks of the responsibility of taking care of patients while weaving your way through the healthcare distribution system and regulations. He feels that this has led to fewer younger dentists wanting to invest in their own clinics, which feeds into the growth of corporate dentistry.

This brought us on to talk about a book that he is currently writing about ‘what happened to us’ as a profession. He explains that it will look at the suggestion that is ingrained into us as dental students that ‘good dentistry is perfection’. He suggests that nothing hurts us more than the suggestion that if something fails, then it is our fault.

He admits that in a busy practice, things for him didn’t always go the way he wanted. We are trained to expect perfection from ourselves and when you add this pressure to an unsatisfied or complaining patient or an upset staff member etc, and then combine this with the legislation issues and competitive and financial elements, we can begin to understand why we are becoming more stressed.

Do your best but don’t expect more from yourself than is humanly possible.

I don’t know how to tell you this, but you are not perfect.

He then said something that I believe is very true and that I believe is becoming a bigger issue within modern dentistry.

He said, ‘The fear of failure... holds us back’.

This is actually something I personally have been thinking about a lot recently as I am about a third of the way through reading Matthew Syed’s ‘Black Box Thinking’. I’m so impressed by this book that I plan to write my next editorial on some of the insights from it that I feel dentistry should learn from.

I hope that this article gives a small taste of what was a fantastic interview with one of the most engaging dental teachers I have had the pleasure to know. Obviously, there is a huge amount more within the interview itself including discussion about Glassman’s experiences ‘treading the boards’ as an actor!

The full interview is a little over an hour long, and I do hope you take the time to watch it.

Contact S4S to find out about the next opportunity to attend a presentation by Dr Barry Glassman.

Click to watch the video: A Consultation with Dr Barry Glassman.