MRC Myobrace Beginner Course 2014 Part 4
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MRC Myobrace Beginner Course 2014 Part 4

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Myofunctional Research Company presents Myobrace Beginner Course by Dr. Barry Raphael at the Raphael Center for Integrative Education, Clifton, New Jersey, January 2014: Part 4

Myofunctional Research Company presents Myobrace Beginner Course by Dr. Barry Raphael at the Raphael Center for Integrative Education, Clifton, New Jersey, January 2014: Part 4

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    MRC Myobrace Beginner Course 2014 Part 4 MRC Myobrace Beginner Course 2014 Part 4 Presentation Transcript

    • The Myobrace System -A hammer for a houseSat-Sun, January 18-19, 2014 dr. barry raphael the raphael center for integrative education www.alignmine.com drbarry@alignmine.com Day 2 PM Sunday, January 19, 14
    • 6. Starting your first case 1.Introduce the concept 2.Case selection checklist 3.Materials check list 4.Health history forms 5.Patient flow check list 6.Fees 7.Ordering Myobrace appliances Sunday, January 19, 14
    • Introduce the Concept (Elevator Speech) • Your Elevator Speech •“I notice your child has…” • “Did you know that we can… “ • “There is a way that we can help…” •“If you would like us to do an assessment of his/her problem, we can sit and talk about how it will benefit him/her. Can we make an appointment?” • Myobrace “Soft Tissue Dysfunction” card laminated • Toothberg laminated • Myobrace brochure • Rubber dentoform (www.kilgoreinternational.com, Item I21D-400G, $174.) Sunday, January 19, 14
    • Myobrace STD Card Sunday, January 19, 14
    • Myobrace STD Card Sunday, January 19, 14
    • Myobrace STD Card Sunday, January 19, 14
    • Myobrace STD Card Sunday, January 19, 14
    • Myobrace STD Card Sunday, January 19, 14
    • Myobrace STD Card Sunday, January 19, 14
    • Myobrace STD Card Sunday, January 19, 14
    • Myobrace STD Card Sunday, January 19, 14
    • Case Selection Checklist Good Cases to Start with: Age: a compliant 6-10 year old Chief Concern: Crooked teeth. Wants alternative to braces. Medical History: Mild airway-related dysfunctions. Use caution with a major medical and respiratory history or refer first. Body Form: Avoid extreme postural deformity, eg. scoliosis Body Function: Facial Form: Indicator line less than 10mm excess Facial Function: (That’s why you’re here!) Intraoral Form: Avoid extreme crowding or overjet Intraoral Function: Frenectomy? MFT back up. Sunday, January 19, 14
    • Patient List Name Sunday, January 19, 14 Age Date of Exam Result
    • Informed Consent • Informed Consent • Myobrace is a good first step • May need further treatment • Myofunctional therapy • ENT/Allergy/Pulmonology • Orthodontics • Give options • Have a back up plan... Sunday, January 19, 14
    • Backup Plans 1. BE PATIENT - This is not a quick fix. The body needs time to readjust. Watch for positive signs. Keep dialogue with patient and parent. 2. Find a Myofunctional Therapist. Just like school, some kids need private tutoring. 3. Find an Airway-conscious Orthodontist. Or train one. Or become one. 4. Be an airway-conscious Dentist. The more you identify at the start, the more treatment options you’ll have. Sunday, January 19, 14
    • Myobrace Materials • Cheek retractors • Camera with macro • Hand mirror • Ruler or Boley gauge • Forms • C&B or trimming scissors • Lisko-S Polishing Disc (www.glidewelldirect.com) • Myobrace inventory • Optional: •BWS supplies •Biobloc supplies Sunday, January 19, 14
    • Patient Flow Checklist Introduce parent to concept Appointment for assessment Assessment Consultation Delivery of Myobrace and instructions Comfort call (1week) Comfort check appointment (2 weeks) Myobrace check; review activities Myobrace check; review activities Issue second Myobrace, take progress pictures Myobrace check; review activities Myobrace check; review activities Issue third Myobrace; take progress records Myobrace check; review activities Myobrace check; review activities Final records, plan observation, retention, further treatment Sunday, January 19, 14
    • Fees • Screening Exam •Diagnostic Records •Consultation •Treatment Fees • Age-related • Appliance Fee • Monthly Fee • Additional Monthly after year 1 • Set Target Date Sunday, January 19, 14
    • 7. Course Review and Q&A 1.What I told you 2.Questions. Maybe some answers. 3.Your cases Sunday, January 19, 14
    • 8 Lessons I’ve Learned Subtitled: “Plasticity is the capacity of the brain to change with learning” Sunday, January 19, 14
    • Lesson #1: There is Nothing New Under the Sun Sunday, January 19, 14
    • A Not-so-brief History of Myofunctional Orthodontics Sunday, January 19, 14
    • A History of Myofunctional Orthodontics George Edward Catlin H. Angle Westin Price J. Sim Wallace Andresen and Haupl Norman Kingsley 1890 Sunday, January 19, 14 1900 1910 1920 Bimler, Balters, Frankel 1930 1940 1950 Melvin Moss 1960 Chris Farrell, John Flutter Roger Price Egil Harvold Tom Graber Alfred P. Rogers Julius Wolff 1880 Daniel Garliner Charlie Tweed Allan G. Brodie 1970 Robert Little John Mew Donald Enlow 1980 1990 You 2000 2010 2020
    • George Catlin • Lawyer, artist, amateur anthropologist •Documented native populations in North and South America • The health of native tribes deteriorated after introduction to modern ways •Whisky and sugar •1870 •“Shut Your Mouth and Save Your Life” • Book recommended by Edward Angle in 1925 Sunday, January 19, 14
    • George Catlin •The cause of modern man’s maladies is his lack of “a quiet and natural sleep”. •Proper breathing regulates digestion and circulation to every part of the body. •Improper breathing brings imbalance and disease. •The nostrils are intended to measure and temper the air in support of proper breathing. Sunday, January 19, 14
    • George Catlin On mouth breathing at night: “That man knows not the pleasure of sleep; he rises in the morning more fatigued than when he retired to rest - takes pills and remedies through the day, and renews his disease every night.” Sunday, January 19, 14
    • Alfred P. Rogers 1873-1959 Sunday, January 19, 14 •Angle School, 1903 •taught at Harvard •private practice in Boston •past president of the AAO •total-child approach and advocated muscular exercises to improve neck, head, and tongue posture and encourage nasal breathing •treated many so-called “skeletal Class II” cases ONLY with exercise.
    • Alfred P. Rogers, 1918 to the A.S.O Alfred P. Rogers, 1918 to the A.S.O “Our teachers have recognized the importance of muscular pressure in its normal conduct as well as in its abnormal conduct, but here we seem to have stopped, assuming that with the correction of the faulty osseous formation and cusp relation, nature, somehow or other, would establish the correct muscular tone and muscular habits…” Sunday, January 19, 14
    • Early works by Alfred P Rogers “Exercises for the Development of the Muscles of the Face with a View to Increasing Their Functional Activity. Dental Cosmos, October, 1918. “Muscle Training and Its Relation to Orthodontia.” Dental Items of Interest, 1919, xli. “Stimulating Arch Development by the Exercise of the MasseterTemporal Group of Muscles. International Journal of Orthodontia, February, 1922, viii. “Making Facial Muscles Our Allies in Treatment and Retention.” Dental Cosmos, July, 1922. “Coordinating Natural and Artificial Methods of Treatment. ” International Journal of Orthodontia, February, 1924, x. “ Simplifying Orthodontic Treatment. International Journal of Orthodontia, June, 1926, xii.” Sunday, January 19, 14
    • Tom Graber AJO, 1963 “The Three M’s: Muscles, Malformation, and Malocclusion The Two Groups of Disciples: Edward Angle: Edgewise Expansionists Calvin Case: Extractionists 1917-2007 Sunday, January 19, 14 This tooth-focused battle rages on even today..... Must take muscles into account...
    • Tom Graber •…they ignored “the balancing effect of contiguous muscle on the role of growth and development” •“…muscle plays a dominant role, affecting our manipulations whether we like it or not”. •“controlling abnormal perio-oral muscle 1917-2007 function” crucial in treatment •Homeostasis, postural rest position, the effect of function on the teeth and bones. Sunday, January 19, 14
    • Walter Straub Daniel Garliner Bernie Fogel Walter J. Straub, orthodontist: Included speech therapists as the best people to do myofuncitonal therpy for orthodontic patients. Daniel Garliner: created training and routine for MFT for orthodontic patients Bernie Fogel: First East Coast private practice of “Tongue Thrust Therapy” in 1960 Sunday, January 19, 14
    • John Flutter •Combines •Posture •Breathing •Tongue •Orthopedics/Orthotropics •Tooth Movement www.orthodonticearlytreatment.com Sunday, January 19, 14
    • A History of Myofunctional Orthodontics Edward H. Angle Andresen and Haupl Norman Kingsley 1890 Sunday, January 19, 14 Tom Graber Alfred P. Rogers Julius Wolff 1880 Daniel Garliner Westin Price J. Sim Wallace 1900 1910 1920 Bimler, Balters, Frankel 1930 1940 Chris Farrell, John Flutter 1950 Melvin Moss 1960 1970 John Mew Donald Enlow 1980 1990 You 2000 2010 2020
    • Published Studies: Keywords: “Muscle” and “Orthodontics” N=110 Meta-analyses or Theories Sunday, January 19, 14 Clinical Trials
    • The Future of Myofunctional Orthodontics Subtitle:You Are Not Alone Sunday, January 19, 14
    • Robert Corruccini •Anthropologist •Southern Illinois U • Studies epidemiology of malocclusion •Native populations all over the Earth •Malocclusion a Modern Disease Sunday, January 19, 14
    • Kevin Boyd • Darwinian Dentistry • Nutritionist, Pedodontist, anthropologist •Indiana U. Northwest •The genetics of our mouths (and bodies) were developed in a very different world than the one we live in now We are leading our genetic potential astray Sunday, January 19, 14
    • James Garry Pedodontist •airway affects the normal formation of the jaws and face •Breast feeding critical •Wrote: •The Role of Dentistry in Sleep Apea •Upper Airway Compromise • Influences on Oro Facial Development •www.tmdataresources.com Breast feeding, airway, and posture are critical factors Sunday, January 19, 14
    • Brian Palmer • Straight teeth begins at birth •Importance of Breast Feeding • Short Frena limit suckling and proper tongue posture • www.brianpalmerdds.com •International Affiliation of Tongue-tie Professionals • www.tongue-tied.net Tight frena limit breast feeding Sunday, January 19, 14
    • David Page •Wrote: Your Jaws, Your Life •Relates dental health, jaw development and airway •www.smilepage.com Airway is a critical component for development Sunday, January 19, 14
    • Gavin James and Dennis Strokon Cranial Strains and Malocclusion •Strains on the cranial sutures create rotations of the bones during growth • The maxilla is at the endpoint of these rotations Cranial and postural factors affect growth Sunday, January 19, 14
    • Barbara Greene, Sandra Coulson and Joy Moeller •Oral Myology •Certifying organization •Exclusive for professionals Oral postural and muscular issues affect growth Sunday, January 19, 14
    • AAGO American Association of Gnathologic Orthopedics •Based on the work of •George Crozat and •Albert Weibrecht • Arch development in harmony with natural growth and muscles •Light wire removable appliances Light intermittent forces can affect skeletal growth Sunday, January 19, 14
    • Esther Gokhale • “8 steps to a Pain Free Back” •Poor posture is a cultural drift away from our natural design •“In the 1920’s, people began to thrust their pelvises and necks forward and hunch or round their shoulders. It became fashionable to slouch” • Egwellness.com Poor posture and back pain is another industrial disease Sunday, January 19, 14
    • Robert Walker •Chirodontics • Merges •Chiropractic •Cranial mechanics •TMJ mechanics •Dental Orthopedics •Nutrition •exceptionaldentalcourses.com/ The chiropractor can help with postural issues Sunday, January 19, 14
    • Darick Nordstrom •ALF: Alternative wire functional • Works with Sacro Occipital Technique team •Postural balance of whole body affects jaw growth and alignment Light intermittent force affects skeletal growth, too Sunday, January 19, 14
    • G. David Singh • Epigentic Orthodontics • The “DNA Appliance” •Genetics is important in the way genes react to stimuli "Malocclusion is one solution for the complex adaptive orofacial system to be in equilibrium." Sunday, January 19, 14
    • Allen J. Moses •Dentist in Sears Tower • Childhood Sleep Apnea • Reduce obstructions • Reduce collapsability of airway • Behavior re-education • Reduce intermittent hypoxia • www.kidsapnea.com Cause-directed treatment, not Consequence-directed tx Sunday, January 19, 14
    • Konstantin Buteyko (1923-2003) • The Buteyko Breathing Method •Russian Physiologist • Worked with Asthmatics • Mouth breathing LOWERS Carbon dioxide blood levels too far. Oxygen not processed properly. •Reduced breathing relieves symptoms •Variations •Patrick McKeown •Roger Price •Artour Rakhimov Hyperventilation affects everything Sunday, January 19, 14
    • Dr. Steven Park • ENT specializing in Sleep Medicine • Wrote “Sleep Interrupted” •Hosts weekly webcasts •www.doctorstevenpark.com Treating airway is critical Sunday, January 19, 14
    • Michael Gelb • This is not your father’s TMD •TMD is a product of airway distress TMD is an airway issue Sunday, January 19, 14
    • Jeff Rouse •Prosthodontist •Bruxism is relief for airway problems. •Treat biology first, then do mechanics Bruxism and occlusal wear are airway issues Sunday, January 19, 14
    • Jeffery Hindin •Heart-rate Variability • Proportional to health • an indicator of inflammation, • Significance related to sleep apnea, TMD and growth “What we do to the mouth affects the rest of the body” Sunday, January 19, 14
    • Etsuko Kondo •Japanese RO •Recognizes the importance of muscle function in occlusion •Nasal respiration is the key to treatment and stability The Three Goals of MFO 1) Create Adequate Tongue Space 2) Eliminate tongue habits 3) nasal respiration with lip closure Sunday, January 19, 14
    • Bill Hang • American BioBlock •RO • Focuses on Face, Jaws and airway •IAFGG : International Association of Facial Growth Guidance with John Mew You must advance the maxilla AND the mandible Sunday, January 19, 14
    • Ali Attaie • Pedodontist • Dept Chair Mt. Sinai Medical, Pedodontics • Developing first MFO curriculum in post-grad school • Developing innovative teaching methods for MFO There is a future for MFO in the U. S. Sunday, January 19, 14
    • Lesson #2: Keep an Open Mind “The mind is like a parachute: it’s best when it’s open” - Frank Bogdan quoting... Sunday, January 19, 14
    • Take half of 8 and you have... 4 Different Solutions -Different Ways of Looking at the Same Thing Sunday, January 19, 14
    • Lesson #3 Don’t be a Barker Sunday, January 19, 14
    • Lesson #3: Don’t be a Barker Step back from the teeth Start by looking at the person and work your way in. Sunday, January 19, 14
    • Lesson #4: The Missing Link... It’s not just Growth and Development It’s Growth, Development and Adaptation Sunday, January 19, 14
    • Regarding Adaptation: The Maxilla is the key. Sunday, January 19, 14
    • Lesson #5: The Context Changes If the Etiology is centered in the muscles, then the treatment is, too. Muscle-Centric Vs. Tooth-Centric Sunday, January 19, 14
    • Lesson #5: The Context Changes Tooth-Centric Tx Goals 1. 2. 3. 4. 5. 6. 7. Level and Align the Teeth Correct the Bite Match the Jaw Size or Position Improve the Profile Refer for Tongue Thrust Therapy Relieve Joint Dysfunction Permanent Retention Sunday, January 19, 14
    • Lesson #5: The Context Changes Muscle-Centric Tx Goals 1. 2. 3. 4. 5. 6. 7. 8. Breathing through the nose Lips together at rest Correct tongue position No mentalis activity on swallowing Optimal facial development Class I occlusion Straight teeth No retainers required Sunday, January 19, 14
    • Lesson #6: Dentistry is Medicine •The separation is political (for good reason) but may be coming to an end •The dentist as oral physician •Broaden your view..... Sunday, January 19, 14
    • Dentistry is Medicine Big-Picture Issues related to (Mal)Occlusion •Early Feeding, Nutrition and muscular development •Tight Frena and Early Nutrition •Posture, musculo-skeletal-cranial stress and facial growth •Breathing, Airway and Apnea •Soft Tissue Dysfunctions, Habits and malocclusion Sunday, January 19, 14
    • Orthodontics in the 21st Century Esthetic Orthodontics Airway Orthodontics Genetic Tooth-Focused Dental: Perfection Esthetics Primary Treating Symptoms Airway Ignorant Adaptation Muscle-Focused Medical: Better Esthetics Secondary Treating Causes Airway Conscious Sunday, January 19, 14
    • Lesson #7: It’s NOT about the Trainer Sunday, January 19, 14
    • It’s not about the Trainer… It’s about the Training Sunday, January 19, 14
    • Lesson #7A: It’s not about YOU •11/5/10 Feedback from my office manager on MRC “You’ve been getting a little tough on kids. I hear you losing your temper especially with the MRC kids. I know you’re passionate about this technique, but it’s not sitting well with the kids or their mothers especially. You said “You have to wear it because it’s going to make you more beautiful and the mother said but she’s already beautiful”” Problem > Cooperation is a major factor in the success of the case. Solution > Encourage cooperation in a positive, upbeat way without offending the kids or Mom’s. It’s good to set expectations for cooperation from the beginning. Have ways of evaluating cooperation without the judgementalness. Sunday, January 19, 14
    • Lesson #8: I have a mission Our care of children is not complete until we, as dentists, gain a broader view of facial growth and help them achieve not only straight teeth, but also beautiful faces, which they have a right to enjoy. Sunday, January 19, 14
    • Lesson #6: I have a mission “Our guardianship of little children is not complete until we, as orthodontists, gain a broad conception Our scope of our science, and minister until of thecare of children is not completeto the we, as dentists, gain a broader view of young under our care until their faces represent not only the ideal from the them achieve not facial growth and help standpoint of the function of mastication, butalso beautiful faces, only straight teeth, but also the ideal of perfection in contour and strength which it is their which they have a right to enjoy. right to enjoy.” Alfred P. Rogers, 1918. Sunday, January 19, 14
    • Lesson #1: There is Nothing New Under the Sun “Our guardianship of little children is not complete until we, as orthodontists, gain a broad conception of the scope of our science, and minister to the young under our care until their faces represent not only the ideal from the standpoint of the function of mastication, but also the ideal of perfection in contour and strength which it is their right to enjoy.” Alfred P. Rogers, 1918. Sunday, January 19, 14
    • 8. What comes next? 1. Our Contest: First to assess 10 cases… 1. Patient List (gender, age) 2.Diagnosis and treatment recommended (in brief) 3.Picture of patient with Myobrace on 4. Prize: Mystery gift sent to your practice. 2.Learn about more about Myobrace and other modalities 3.Wire-bending primer 4.Online study club (ask Barry) 5.Myobrace advanced course 1.Bending and using BWS 2.Using removable expanders 3.Case presentations and discussion 4.Building systems that motivate 5.Improving your facility 6.Becoming an MRC Provider Sunday, January 19, 14
    • GETTING STARTED STEPS Basic clinic layout 1 SPACE 2 LAYOUT 3 STAFF TRAINING 4 IMPLEMENTATION 5 PATIENT SELECTION 6 PATIENT FEES The system is easy to implement but requires good planning and well defined goals to succeed. EDUCATION, MOTIVATION and COMPLIANCE leads to SUCCESS Sunday, January 19, 14
    • MYOBRACE CERTIFIED PROVIDER PROGRAM Sunday, January 19, 14
    • MYOBRACE CERTIFIED PROVIDER PROGRAM What is the Myobrace Certified Provider Program? An exclusive network of Dentists or Orthodontists who provide myofunctional orthodontic treatment using Myobrace®. A provider can be certified at varying levels - Bronze, Silver, Gold and Platinum. Sunday, January 19, 14
    • Sunday, January 19, 14
    • MYOBRACE CERTIFIED PROVIDER PROGRAM What to do next? Step 1. Request an information pack from a Myofunctional Research Co. (MRC) representative. The information pack will outline the eligibility, levels, inclusions and terms of the certification. Step 2. Complete the application form and return to your MRC representative. Step 3. Your application will be processed and you will then be contacted by MRC in regards to the next steps you need to take to become a Myobrace Certified Provider. Contact MRC today for access to these materials, and for further training. Visit www.myoresearch.com for more information. Sunday, January 19, 14
    • MRC MEGA CLINICS COOMERA Sunday, January 19, 14
    • MRC USA MRC USA office Southern CALIFORNIA Next Seminar Dates Sunday, January 19, 14
    • GETTING STARTED STEPS Basic clinic layout 1 SPACE 2 LAYOUT 3 STAFF TRAINING 4 IMPLEMENTATION 5 PATIENT SELECTION 6 PATIENT FEES The system is easy to implement but requires good planning and well defined goals to succeed. EDUCATION, MOTIVATION and COMPLIANCE leads to SUCCESS Sunday, January 19, 14
    • MYOBRACE CERTIFIED PROVIDER PROGRAM What is the Myobrace Certified Provider Program? An exclusive network of Dentists or Orthodontists who provide myofunctional orthodontic treatment using Myobrace®. A provider can be certified at varying levels - Bronze, Silver, Gold and Platinum. Sunday, January 19, 14
    • More ways to get involved... MFO in Education Research Study Clubs The TriState Myofunctional Study Club TMFSC@googlegroups.com Sunday, January 19, 14
    • MFO in Education Picture of mt sinai Sunday, January 19, 14
    • MFO in Education • • The Mouth as part of the body • Soft Tissue Dysfunction defined • STDys: Lingual Frenum • Examination and Diagnosis • Prevention and treatment in the Primary Dentition • Planas Direct Tracks • Lab: making Planas Tracks (2 hours) The Importance of Nasal Breathing Lightwire Expansion • Myofunctional Treatment: Trainer • Myofunctional Treatment: Clinical management • Sunday, January 19, 14 • • Lectures Labs Guests The Etiology of Malocclusion • • • • History of Myofunctional orthodontics • Mt. Sinai Curriculum Introduction to Preventive Orthodontics Myofunctional Treatment: Exercises
    • More ways to get involved... American Academy of Physiological Medicine and Dentistry g or Michael Gelb and Howard Hindin D. PM A .A “...allowing for a healthy dialogue to take place between w w orthodontists, ENTs, physicians, dentists, physical therapists, and oromyologists. The focus of //w p: Performance, and tt the study club is the airway with impact on Potential, h Protection in children and adults. Sunday, January 19, 14
    • the raphael center for integrative education www.learnairwayortho.com Coming in 2014... •Myobrace Advanced Course: BWS and Biobloc •LTS (Less than 6years or 6 perm teeth) with Kevin Boyd •Airway Dentistry Mini-residency with Mark Cruz •Myofunctional Therapy Level 2 with Sandra Coulson •Ortho-Postural Training for Trainers with Roger Price •Airway Orthodontics with Barry Raphael Sunday, January 19, 14
    • Join the Evolution! www.myoresearch.com www.slideshare.net/drbarry drbarry.rcie@gmail.com Sunday, January 19, 14