TMD / TMJ Orofacial Pain and Dental Sleep Medicine

Total: 80 HOURS ONLINE TRAINING/DIDACTIC (13 EIGHT HOUR CE SESSIONS )

Part 1: 56 HOURS ONLINE TRAINING/DIDACTIC

• 7 EIGHT HOUR CE SESSIONS
• TOPICS PER SESSION
  
  I. ONLINE SESSION ONE
  Anatomy: Gross neuroanatomy, Head and neck structures, TMJ anatomy
  Neuron: Anatomy and Physiology
  
  II. ONLINE SESSION TWO
  TMJ: Function, Biomechanics, Histology, and Imaging
  Pain terminology; Neurophysiology of pain
  
  III. ONLINE SESSION THREE
  Dental Sleep Medicine: Stages of sleep; Neurophysiology of sleep; Sleep disorders; Sleep related bruxism; Snoring and obstructive sleep apnea; Sleep and pain
  
  IV. ONLINE SESSION FOUR
  Non odontogenic Pain
  Musculoskeletal Pain: Myalgia; Myofascial pain; TMJ arthritides; Fibromyalgia
  
  V. ONLINE SESSION FIVE
  Neuropathic Pain: Neuralgias; Neuropathies; Nerve injuries; Traumatic neuroma
  
  VI. ONLINE SESSION SIX
  Headaches: Primary; secondary; Neurovascular orofacial pain
  
  VII. ONLINE SESSION SEVEN
  Pharmacology for OFP
  Imaging for OFP
  
  
• QUIZ (IN MULTIPLE CHOICE FORMAT) UPON COMPLETION OF EACH SESSION

During Module 1, Part 1 those candidates who intend to take up an OSA case for evaluation (before Module 2) should get patients at this time. This will ensure timely referral for OSA evaluation by sleep physician, thereby enabling us to schedule the patient for possible impressions during Module 2. In addition, we will be arranging for the required George gauge for bite registration during Module 2.

Part 2: 24 HOURS ONLINE/VISUAL/CONTACT (4 Hours/ day for 6 Days)

I. DAY ONE
OFP case work up: Case history; comprehensive evaluation; differential diagnosis; diagnostic tests

II. DAY TWO
Pain pneumonic for history taking; art of effective history taking

III. DAY THREE
OFP clinical examination part 1

IV. DAY FOUR
OFP clinical examination part 2

V. DAY FIVE
Evaluation in dental sleep medicine

VI. DAY SIX
Case discussions, Question answer sessions QUIZ (IN MULTIPLE CHOICE FORMAT) UPON COMPLETION

• Required Material: Class notes
• Recommended Textbooks:
  Bell’s Oral and Facial Pain, Seventh Edition by Jeffrey Okeson
  
  Oral and Facial pain and Headache, second edition by Yair Sharav, Raphael Benoliel
• Reference Books:
  Management of Temporomandibular Disorders and Occlusion by Jeffrey Okeson
  
  Neuroscience, 2nd edition Editors: Dale Purves, George J Augustine, David Fitzpatrick, Lawrence C Katz, Anthony-Samuel LaMantia, James O McNamara, and S Mark Williams.
  
  Sleep Medicine for dentist by Gilles Lavigne

Total: 20 hours (3 days)
Clinical onsite

• DAY 1:
  This will be the first day the students are being introduced to clinically how to work up an orofacial pain (OFP) case. These three days are “Hands-on”. These sessions are really one on one with personal attention to individual students as they work up and examine a case. The OFP form is an approximately 8-page form, critical to a systematic work up of OFP cases. Each candidate is encouraged to actively participate fully in these clinical sessions. Either actual patients or volunteers acting as patients will be part of these sessions. Once the students are thoroughly familiarized with the OFP form, they will be guided through how to systematically take a history of the pain complaint. Candidates will be actively participating in the history taking and the subsequent “systems review”. Clinical examination will be comprehensive, and would include such pearls of wisdom as observing the patient while he/she walks into the practice/operatory. Students are also strongly encouraged to have a “patient” (a volunteer) to self-practice the systematic examination. This will be followed by thorough discussion and vibrant interactions on diagnostic testing, discussion of imaging and coming to a differential diagnosis.
  
  

  • Review and familiarize with the Orofacial Pain form
  • History taking and systems review
  • Clinical examination of OFP patient
  • Diagnostic testing
  • Imaging discussion
  • Differential diagnosis
• DAY 2:
  Now that the student is familiarized with a comprehensive history and evaluation, we move on to systematic work up of a dental sleep medicine case. This starts with forms such as sleep history form, and the sleep quality screening forms which will all be provided to the participant in advance. These sessions are really one on one with personal attention to individual students as they work up and examine a case. If a candidate does not have a patient, he/she is encouraged to pair up with another student and complete the examination form.
  Please note patients or individuals who are getting impressions done for appliances must be present and registered with the clinical site. The prerequisites for an OSA case should be checked and completed with a faculty prior to scheduling patient for this day.
  
  

  • Adjunctive testing
  • Sleep history form
  • Sleep history form
  • OSA screening
  • Treatment planning for OSA case
  • Possible referral to sleep physician
  • Bring your patient here for MAD appliance impression and bite registration
• DAY 3:
  This day is also clinical, hands on; One on one session. Students are encouraged to bring their cases (patient/records) for possible discussion in this session. These sessions will be valuable in that the students will be exposed to myriad of cases with varying complexities. All case discussions will be strictly based on the given OFP form duly completed. The quiz is of multiple-choice format, and pass score is 80% and every assistance will be provided during the online sessions to equip a student to pass this test.
  Passing the test is a required component.
  
  

  • Case discussions
  • Question answer session
  • Quiz (in multiple choice format) upon completion of each session

Total: 50 hours (Two 3-day sessions)

Part 1 - ONLINE
This part will be a blend of intense didactic and clinical components. The participants are encouraged to pre-check with the course coordinator to appropriately schedule patients for MAD insertion visit. Those students who do not have a patient are encouraged to join your classmates clinically treating these patients.

Pharmacology being a critical component of OFP training, reading material will be given in advance for review before this part.

The systematic clinical work up of OFP/Dental Sleep medicine cases will be reviewed prior to starting Day 2.

Patients already worked up with diagnosis of Myofascial pain should be appropriately scheduled for day 3.

All these sessions will have one on one clinical sessions with ample time for personal interactions with the faculty.

• Day 1
  Didactic: Overall review of topics covered to date; Advances in the same
  Clinical: OSA MAD appliance insertion; post-operative instructions; schedule re-call
• Day 2
  Didactic: Advanced pharmacology; sleep pharmacology
  Clinical: Comprehensive OFP clinical evaluation
• Day 3
  Didactic: Surgical management in TMD; ENT issues in OFP
  Clinical: Trigger point injections; diagnostic blocks; spray and stretch

Part 2 - ONSITE
This module will include didactic and clinical components with hands on training. Participants are strongly recommended to either bring in patients or appropriate records for case evaluations and discussions. In the absence of patient availability faculty will discuss cases from patient archives. This module is intended to enhance the clinical diagnostic and patient management skills and equip the students to apply the principles in their practices.

• Day 1
  Didactic: Occlusal concepts and OFP; full mouth rehabilitation
  Clinical: OFP patient cases
• Day 2
  Didactic: Systemic causes of OFP; movement disorders in OFP
  Clinical: OFP patient cases
  Quiz (in multiple choice format) upon completion
• Day 3
  Didactic: OFP and its relation to other specialties; Practice management principles in OFP and Dental Sleep Medicine; Psychology of OFP Clinical: OFP patient cases