mrc myobrace beginner course 2014 part 4
DESCRIPTION
Myofunctional Research Company presents Myobrace Beginner Course by Dr. Barry Raphael at the Raphael Center for Integrative Education, Clifton, New Jersey, January 2014: Part 4TRANSCRIPT
The Myobrace System-A hammer for a house-
Sat-Sun, January 18-19, 2014
dr. barry raphaelthe raphael center for integrative education
Day 2 PMSunday, January 19, 14
6. Starting your first case
1.Introduce the concept2.Case selection checklist3.Materials check list4.Health history forms5.Patient flow check list6.Fees7.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 oldChief 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. scoliosisBody Function:
Facial Form: Indicator line less than 10mm excessFacial Function: (That’s why you’re here!)
Intraoral Form: Avoid extreme crowding or overjetIntraoral Function: Frenectomy? MFT back up.
Sunday, January 19, 14
Patient List
Name Age Date of Exam Result
Sunday, January 19, 14
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 you2.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 Historyof
Myofunctional Orthodontics
Sunday, January 19, 14
Egil Harvold
A History of Myofunctional Orthodontics
George Catlin
1880 1890 1900 1910 1920 1930 1940 1950 1960 1970 1980 1990 2000 2010 2020
Norman Kingsley
Julius Wolff
J. Sim Wallace
Edward H. Angle
Andresen and Haupl
Alfred P. Rogers
Chris Farrell, John FlutterRoger Price
You
Allan G. Brodie
Westin Price
Bimler, Balters, Frankel
Tom Graber
Melvin Moss
Donald Enlow
Charlie Tweed
Daniel Garliner
Robert Little
John Mew
Sunday, January 19, 14
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
•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.
1873-1959
Sunday, January 19, 14
“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…”
Alfred P. Rogers, 1918 to the A.S.OAlfred P. Rogers, 1918 to the A.S.O
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 Masseter-Temporal 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
This tooth-focused battle rages on even today.....Must take muscles into account...
1917-2007
Sunday, January 19, 14
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 function” crucial in treatment
•Homeostasis, postural rest position, the effect of function on the teeth and bones.
1917-2007
Sunday, January 19, 14
Walter StraubDaniel Garliner
Bernie FogelWalter 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
1880 1890 1900 1910 1920 1930 1940 1950 1960 1970 1980 1990 2000 2010 2020
Norman Kingsley
Julius Wolff
J. Sim Wallace
Edward H. Angle
Andresen and Haupl
Alfred P. Rogers
Westin Price
Bimler, Balters, Frankel
Tom Graber
Melvin Moss
Daniel Garliner
Donald Enlow
John Mew
Chris Farrell, John
Flutter
You
Sunday, January 19, 14
Published Studies: Keywords: “Muscle” and “Orthodontics”
N=110
Meta-analyses or Theories Clinical TrialsSunday, January 19, 14
The Futureof
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
• 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
Kevin Boyd
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
•Wrote: Your Jaws, Your Life•Relates dental health, jaw development and airway
•www.smilepage.com
David Page
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
AAGOAmerican 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
• “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
Esther Gokhale
Poor posture and back pain is another industrial disease
Sunday, January 19, 14
•Chirodontics• Merges
•Chiropractic•Cranial mechanics•TMJ mechanics•Dental Orthopedics•Nutrition
•exceptionaldentalcourses.com/
Robert Walker
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
Different Solutions
Take half of 8 and you have...
4--
Different Ways of Looking at the Same
Thing
Sunday, January 19, 14
Lesson #3Don’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 personand work your way in.
Sunday, January 19, 14
Lesson #4:The Missing Link...
It’s not justGrowth and Development
It’sGrowth, Development and
AdaptationSunday, 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-CentricVs.
Tooth-Centric
Sunday, January 19, 14
Lesson #5:The Context Changes
1. Level and Align the Teeth2. Correct the Bite3. Match the Jaw Size or Position4. Improve the Profile5. Refer for Tongue Thrust Therapy6. Relieve Joint Dysfunction7. Permanent Retention
Tooth-Centric Tx Goals
Sunday, January 19, 14
Lesson #5:The Context Changes
1. Breathing through the nose2. Lips together at rest3. Correct tongue position4. No mentalis activity on swallowing5. Optimal facial development6. Class I occlusion7. Straight teeth8. No retainers required
Muscle-Centric Tx Goals
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
•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
Big-Picture Issuesrelated to
(Mal)Occlusion
Sunday, January 19, 14
Orthodontics in the 21st Century
EstheticOrthodontics
AirwayOrthodontics
GeneticTooth-Focused
Dental: PerfectionEsthetics Primary
Treating SymptomsAirway Ignorant
AdaptationMuscle-FocusedMedical: Better
Esthetics SecondaryTreating Causes
Airway ConsciousSunday, 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
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.
“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.”
Lesson #6:I have a mission
Alfred P. Rogers, 1918. Sunday, January 19, 14
Lesson #1:There is Nothing New
Under the Sun
Alfred P. Rogers, 1918.
“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.”
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 on4. Prize: Mystery gift sent to your practice.
2.Learn about more about Myobrace and other modalities3.Wire-bending primer4.Online study club (ask Barry)5.Myobrace advanced course
1.Bending and using BWS2.Using removable expanders3.Case presentations and discussion4.Building systems that motivate5.Improving your facility6.Becoming an MRC Provider
Sunday, January 19, 14
GETTING STARTED STEPS
EDUCATION, MOTIVATION and COMPLIANCE leads to SUCCESS
1 SPACE 2 LAYOUT 3 STAFF TRAINING 4 IMPLEMENTATION 5 PATIENT SELECTION6 PATIENT FEES
Basic clinic layout
The system is easy to implement but requires good planning and well defined goals to succeed.
Sunday, January 19, 14
MYOBRACE CERTIFIED PROVIDER PROGRAM
Sunday, January 19, 14
MYOBRACE CERTIFIED PROVIDER PROGRAM
What is the Myobrace CertifiedProvider 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 USAMRC USA officeSouthern CALIFORNIA
Next Seminar Dates
Sunday, January 19, 14
GETTING STARTED STEPS
EDUCATION, MOTIVATION and COMPLIANCE leads to SUCCESS
1 SPACE 2 LAYOUT 3 STAFF TRAINING 4 IMPLEMENTATION 5 PATIENT SELECTION6 PATIENT FEES
Basic clinic layout
The system is easy to implement but requires good planning and well defined goals to succeed.
Sunday, January 19, 14
MYOBRACE CERTIFIED PROVIDER PROGRAM
What is the Myobrace CertifiedProvider 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 EducationResearch
Study Clubs
The TriState Myofunctional Study Club
Sunday, January 19, 14
Picture of mt sinai
MFO in Education
Sunday, January 19, 14
Mt. SinaiCurriculum
• Lectures• Labs• Guests
• Introduction to Preventive Orthodontics
• History of Myofunctional orthodontics
• The Etiology of Malocclusion
• 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
• Myofunctional Treatment: Exercises
MFO in Education
Sunday, January 19, 14
“...allowing for a healthy dialogue to take place between orthodontists, ENTs, physicians, dentists, physical therapists, and oromyologists. The focus of the study club is the airway with impact on Potential, Performance, and Protection in children and adults.
American Academy of Physiological Medicine and DentistryMichael Gelb and Howard Hindin
More ways to get involved...
http://w
ww.AAPMD.org
Sunday, January 19, 14
the raphael center for integrative education
www.learnairwayortho.com
•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
Coming in 2014...
Sunday, January 19, 14
Join the Evolution!
www.myoresearch.com
www.slideshare.net/drbarry
Sunday, January 19, 14