As Seen in The Stamford Advocate, January 22, 2002

Dentist takes a bite out of pain By Mary Beth Faller

More than 45 million American suffer from chronic headaches. But few of them probably seek help from their dentist. Jerry M. Simon, a Stamford dentist, is trying to change that.

“I always ask my patients if they get headaches, and they will say no,” he says. “They aren't trying to deceive me; they just think they don't have the kind of headache I can fix.” So he persists. “I will ask even a third or fourth time, and they finally say, 'sure I get headaches all the time.'”

And very often, Simon can cure them on the spot.

Simon, a dentist for 30 years, says chronic headaches that don't respond to other treatment are probably caused by a problem with the bite, called temporomandibular joint dysfunction, or TMJ ds.

“There is no medical test for it, blood test. We can't poke you or x-ray you,” Simon says.

So Simon has invented a way to immediately diagnose the disorder with his Best-Bite™ Discluder. The small plastic device is fitted on the front teeth and if the patient's bite is off the Discluder will ease the stress on the jaw, draining the pain and tension away immediately. The Discluder is only worn for a few minutes during the office visit. Once the patient commits to treatment, he or she receives the Discluder to use as a crutch between visits.

Simon writes about TMJ ds, and his invention, in his book Stop Headaches Now: Take the Bite Out of Headaches. (Wellness Institute, $14.95).

Beside immediate relief from the pain and tension, there is emotional relief as well. “They are happy they don't have a brain tumor,” Simon says.

In TMJ ds, there is a conflict between the biting surface of the teeth and the jaw joint. The 28 teeth in an adult's mouth (not including wisdom teeth) have 68 points of contact, and they must fit together like a puzzle. When they don't, the bite is off, the jaw is wrenched out of place and the muscles begin to spasm. TMJ ds is a tooth problem and the jaw is the victim.

This would seem to be a problem only during chewing, but Simon says that isn't the case. “The brain abhors irregularities and the whole body will work toward equilibrium.” So people with TMJ ds will grind their teeth - the brain subconscious attempt to “correct” the bite. “It is like a grain of sand in you bed sheets,” he says.

All that grinding and stress on the jaw (the body's most complicated joint) can lead to headaches - tension, diet hormones - all exacerbate the problem, Simon says. Treatments such as chiropractic and biofeedback ease the pain temporally, but do nothing to solve the problem.

Sometimes, people with TMJ ds don't have headaches, but Simon will see signs of tooth grinding. Or, the patients will have pain in the neck, face, shoulder, jaw or ear, or clicking and popping in the jaw joint. Other symptoms are sensitive, broken, or displaced teeth and gum problems. If he sees tooth damage or the patient's reports pain, Simon will check for jaw soreness. If that is present he'll try the Discluder.

Simon patented the Best-Bite™ Discluder two years ago, and is hoping to market it to other dentists.

Up to a quarter of the population is affected by TMJ ds, and Simon has seen this among his own staff - out of 25 people, he's treated five for the disorder.

One of those staffers was Cheryl Case of Nanuet, N.Y. When she first started working with Simon, she didn't want to admit that she had facial pain, which she attributes to sinusitis. “I took antihistamines every day,” she says “I knew I ground my teeth. I ground right through my night guard.”

After two months she allowed Simon to examine her teeth, and try the Best-Bite™ Discluder. “I started crying,” she says. “It was very emotional. It was the first time the pain had gone. It was the first time anyone said to me “you're right.” “Afterward my finance said to me, “You face looks really good,” “I was so relaxed.”

If Simon determines that a patient has TMJ ds, there are a few options to correct the bite:

• Tooth reshaping: This is the only long term solution from most patients. Simon does this by polishing down the teeth until the bite is correct. This needs to be done over about six visits. “Think of a door that doesn't close right,” Simon says. “You can take sand paper and smooth down the rough spot.”
• Bite splint: The hard plastic device is fitted into the mouth to create an even biting surface. A bite splint provides a longer term, though not permanent, solution. In his book, Simon compares a bite splint to fixing a wobbly table by putting a match book under the leg - it work temporarily. Some people choose this option before the more permanent tooth reshaping or drastic treatment. It must be worn all the time except when eating. It must be particularly at work.
• Occasionally, more elaborate help is needed if the bite is very far off, such as orthodontia, jaw surgery, or tooth capping. Those cases are not common.

Not every headache sufferer has TMJ ds. Simon says his success rate is very high because chronic headache suffers have already tried everything else, so by the time they try his approach all other probables are ruled out.

Most dentists don't ask about headaches or pursue TMJ ds symptoms because they are extensively trained in it; it's considered postgraduate work, Simon says. The treatment of TMJ ds is not a recognized specialty.

“But any dentist can use a Discluder, even without training,” he says.