Continuing Dental Education

This course will cover diagnosis and treatment of temporomandibular disorders including arthritis, myogenous pain, and disc displacement disorders. The morning session will primarily consist of PowerPoint lectures as well as live demonstrations and video demonstrations.  The following topics will be covered:

• Anatomy and mechanics of the TMJ
• Diagnostic imaging of the TMJ
• TMD patient history and clinical examination
• TMD Disorders and treatment modalities

The anatomy review will be enhanced by incorporating 3D-CT models of the skull and TMJ demonstrating normal jaw movements. A CD on Diagnostic Imaging Techniques of the TMJ will be reviewed and a CD will be given to each participant. Participants will be instructed on how to take a pain history and a clinical exam will be demonstrated on a volunteer. Case-based learning will be incorporated into the lectures on temporomandibular disorders and diagnostic criteria will be presented for each condition. At the completion of this course, participants should be comfortable taking a history, performing a clinical examination, making a tentative differential diagnosis and a treatment plan. 

The following treatment modalities will be discussed for temporomandibular disorders:

• Pharmacological therapy 
• Splint therapy
• Physical therapy
• Acupuncture

Injections for myofascial pain (trigger point injections) and arthrocentesis and corticosteroid injections into the TMJ will be discussed. In the afternoon session, the physical therapist will discuss and demonstrate therapies for myofascial pain treatment including exercises (stretching and posture), spray and stretch, trigger point release, ultrasound, and electrical stimulation. In addition, he will demonstrate mandibular mobilization for treatment of conditions causing restricted range of mouth opening. An acupuncturist will discuss and demonstrate techniques used for relief of muscle pain, headaches and inflammatory conditions affecting the masticatory muscles and the temporomandibular joints.

At the completion of this course, the participants should:

• Be knowledgeable of the basic anatomy of the TMJ and masticatory muscles
• Be comfortable assessing a patient experiencing TMD by taking a thorough pain history, performing a clinical examination and formulating a differential diagnosis for common TMD disorders
• Be knowledgeable of the techniques for imaging the TMJ including a Panorex, tomograms, 3D-CT, and MRI
• Understand management techniques for myofascial pain including spray and stretch and trigger point injections
• Understand which diagnoses warrant using  intra-articular injections or arthrocentesis
• Be knowledgeable of the various medications commonly used in treatment of temporomandibular disorders
• Understand the different types of splint therapy and the indications for use
• Be knowledgeable of how to request physical therapy and which patients would benefit from receiving physical therapy treatment
• Be familiar with the physical therapy treatment modalities used for TMD conditions
• Understand the principles of acupuncture and which conditions would benefit from this alternative therapy