Therapeutic Use of Neuromodulators in Dentistry – Full Course Series

May 25-26, 2024:  (Live online only with e-cadaver lab)

Module NMD.DF Anatomy –  Neuromodulator and Dermal Filler Use in Dentistry – Introduction and Applied Head & Neck Anatomy

AND

September 14-15, 2024: (LIVE Online Synchronous & Online Asynchronous Examination)

Module I-A/B DIDACTIC – Management of Bruxism and Myofascial Pain & Parafunction,

Module II-A DIDACTIC – Therapeutic and Esthetic Use of Neuromodulators in the Upper Face 

AND

September 28-29, 2024:   (In-Person, Clinical live patient care)

Module I-A/B CLINICAL – Management of Bruxism and Myofascial Pain & Parafunction,

Module II-A CLINICAL – Therapeutic and Esthetic Use of Neuromodulators in the Upper Face

Introduction

“Botulinum toxin blocks neuromuscular transmission by binding to acceptor sites on motor nerve terminals and inhibiting the release of acetylcholine.  Injectable drugs (neuromodulators) derived from this paralytic agent are listed in Schedule 1 of the Manual for Canada’s National Drug Scheduling System published by the National Association of Pharmacy Regulatory Authorities.” (referenced from the Manitoba Dental Association Bylaw for the Use of Neuromodulators and Dermal Fillers).

Neuromodulators in therapeutic doses produces partial chemical denervation of the muscle resulting in reduction in localized muscle activity and potential muscle atrophy. Neuromodulator therapy has been used both cosmetically and therapeutically to treat both the muscles of facial expression as well as the masticatory muscles in temporomandibular dysfunction and other parafunction. It can also be used as a treatment modality for orofacial pain, including headaches and migraines, and various forms of facial parafunction.  The use of neuromodulators may include treatment for the management of bruxism that includes clenching and grinding as well as treatment and management of myofascial pain that includes headaches and migraines.  Understanding the mechanism of action of neuromodulators will help to educate the provider and patient to understand what the injectables can do, and more importantly, what their limitations are.

Dermal fillers are used “for the treatment of the naso-labial fold, lip augmentation, gingival augmentation and other areas of the face, including but not limited to: malar enhancement, treatment of the nasojugal groove, and the treatment of glabellar, laugh and marionette lines.” (referenced from the Manitoba Dental Association Bylaw for the Use of Neuromodulators and Dermal Fillers).  The techniques involving injectable dermal fillers is used to increase facial volume, enhance lips and reduce deep facial lines and folds.

This three-course series has been developed for the Manitoba dentist and when taken together, will provide certification-level training that includes didactic and hands-on clinical sessions to enable the participant to competently perform patient assessment, diagnosis, treatment planning and administration of neuromodulators for therapeutic treatment of bruxism, myofascial pain and other facial parafunctions, and for esthetic treatments of the upper face. Upon completion, participants will be able to add this treatment modality to their scope of practice and register for Roster IA/IB and IIA of the MDA Bylaw for Neuromodulator and Dermal Filler Use.

Scope of practice is dictated by provincial dental regulatory bodies that determine which professional group can administer neuromodulators for therapeutic and cosmetic uses.  It is the responsibility of the Participant to understand the regulatory requirements for this scope of practice respective to their jurisdiction of practice.    See Flowchart for the course path to roster according to the MDA Bylaw for the Use of Neuromodulators and Dermal Fillers.  Flowchart_NMD.DF_v3

Description

Module NMD.DF Anatomy –  Neuromodulator and Dermal Filler Use in Dentistry – Introduction and Applied Head & Neck Anatomy

Understanding the injectable substance and knowing how to navigate the full facial, head and neck anatomy in hands-on anatomical e-cadaver lab sessions will enable the health provider to administer the injectable with confidence and aid in providing acceptable outcomes and help to prevent complications.

Day 1 will consist of a full day, live online didactic instruction (8-hour) that will cover an introduction of neuromodulators and dermal fillers to include discussion of the pharmacological and physiological considerations of its use.  A comprehensive review of head and neck surface anatomy, muscles of facial expression, muscles of mastication, cervical musculature, relevant vascular anatomy, and neural considerations as well as the temporomandibular joint complex will be thoroughly presented and discussed.  Day 2 will be a half day (4-hour) e-cadaver session delivered live online only via ZOOM platform. Please note that the e-cadaver session may be distributed within the didactic course material to enhance learning.

Successful completion of a formal written evaluation and full attendance of lecture and e-cadaver sessions are required to receive a Certificate of Completion and is intended to be compliant with Section I, 1.a.i, Section II, 1.a.i and Section III, 1.b.i of the Manitoba Dental Association Bylaw for the Use of Neuromodulators and Dermal Fillers.  Note:  This course is the first of a 3-course series to become eligible to roster according to the MDA Bylaw.

Learning Objectives

• Understand the full facial, head and neck anatomy to include musculature, vascular and neural considerations with focus on the upper facial, mid-facial, lower facial and neck region, as well as the temporomandibular joint in addition to the pharmacology and physiology relevant to neuromodulator and dermal filler use
• Anatomic comprehension of where the injections are aimed and what structures to avoid utilizing  e-cadaver lab sessions
• Understand the therapeutic and cosmetic uses of neuromodulators
• Understand the cosmetic use of dermal fillers
• Know the risks and complications of injecting neuromodulators and dermal fillers
• Understand the benefits and limitations of neuromodulators and dermal fillers
• Understand record keeping and documentation principles for neuromodulator and dermal filler use

Full attendance of the course, Bylaw Module I-A/B Anatomy (Neuromodulator and Dermal Filler Use in Dentistry – Introduction and Applied Head & Neck Anatomy) course by CPD Dentistry and Dental Hygiene, Dr. Gerald Niznick College of Dentistry, University of Manitoba and successful completion of the formal assessment examination, or an equivalent course recognized by the respective dental regulatory authority is required to move forward with subsequent courses in this series and for accessing future courses associated with this subject area.

Module I-A/B DIDACTIC – Management of Bruxism and Myofascial Pain & Parafunction,

Module II-A DIDACTIC – Therapeutic and Esthetic Use of Neuromodulators in the Upper Face 

Successful completion of a formal written evaluation and full attendance of the two-day lecture series are required to receive a Certificate of Completion and is intended to be compliant with the Manitoba Dental Association Bylaw for the Use of Neuromodulators and Dermal Fillers.  Note:  This course is the second of a 3-course series to become eligible to roster according to the MDA Bylaw.

Full attendance of the second course session, Module I-A/B Didactic (Bruxism and Myofascial Pain & Parafunction) and Module IIA Didactic (Upper Face) by CPD Dentistry & Dental Hygiene, Dr. Gerald Niznick College of Dentistry, University of Manitoba, and successful completion of a formal assessment following the course, will be required to proceed to the clinical component of the course.

Module I-A/B CLINICAL – Management of Bruxism and Myofascial Pain & Parafunction,

Module II-A CLINICAL – Therapeutic and Esthetic Use of Neuromodulators in the Upper Face

Full attendance of the third and last course session, Module I-A/B Clinical (Bruxism and Myofascial Pain & Parafunction) and Module IIA Clinical (Upper Face) are intended to enable the successful participant learner to fulfill clinical requirements to be eligible for Roster IA and Roster IB and Roster IIA of the Manitoba Dental Association’s Bylaw for the Use of Neuromodulators and Dermal Fillers.

Each registered participant will bring three (3) of their own patients from private practice to administer botox injections, under the clinical supervision of certified instructor(s), as relevant and specified in the MDA Bylaw for the Use of Neuromodulators and Dermal Fillers. All patients will have read and completed applicable documentation that include medical history, informed consent, course protocols, clinic protocols, and UM protocols. Each registered participant will have screened, assessed and evaluated each of their own patients for suitability as patients prior to attendance for the clinical component of this course and will be responsible for continued maintenance and care after completion of the course.

Taken together (didactic and clinical), the remaining portion of the three-course series will provide certification-level training that includes didactic and hands-on clinical sessions to enable the participant to competently perform patient assessment, diagnosis, treatment planning and administration of therapeutic doses of neuromodulators in treating bruxism, myofascial pain and other facial parafunctions, and for therapeutic and esthetic upper face treatments with neuromodulators.

A Certificate of Completion intended to be compliant with the Manitoba Dental Association Bylaw for the Use of Neuromodulators and Dermal Fillers will be provided upon successful completion of this portion of the course.

Learning Objectives

• • Understand the etiology of, diagnosis of, treatment options, complications and management for bruxism with specific focus on neuromodulator therapy
  • Understand the etiology of, diagnosis of, treatment options, complications and management for myofascial pain and other facial parafunctions with specific focus on neuromodulator therapy
  • Understand the etiology of, diagnosis of, treatment options, complications and therapeutic and esthetic management for upper face
  • Acquire foundational knowledge and understanding of therapeutic neuromodulator uses in dentistry as it relates to application, risks/benefits, complications, and its management
  • Perform patient assessment and evaluations to determine an appropriate differential diagnosis and application of neuromodulator therapy for optimal therapeutic outcomes
  • Complete and maintain documentation that includes informed consent, medical history, patient information, assessment and evaluation documentation and continued maintenance/follow up care
  • Properly handle and prepare injectables for treatment applications
  • Understand and perform injectable techniques specific to target muscles including mapping of anatomical muscle sites and facial landmarks
  • Perform administration of neuromodulator injectables in direct patient care during clinical sessions under instructor supervision
  • Lead and guide dental team in providing neuromodulator therapy as a treatment modalities

Instructor(s)

Dr. Sherif Elsaraj  B.Sc., M.Sc., D.M.D, Ph.D

Dr. Elsaraj was raised in Ottawa where he attended JS Wordsworth Secondary School followed by a B.Sc. Honours in Biochemistry from Carleton University (2004). He then completed his M.Sc. in Oral Biology (2006) and Doctor of Medicine in Dentistry (2010), both at the University of Manitoba, and a Ph.D. in Craniofacial Pain and Health Sciences from McGill University (2022).

Dr Elsaraj is an active member of the Canadian Dental Association (CDA), Manitoba Dental Association (MDA), Ontario Dental Association (ODA), and the Order des Dentists du Quebec. Dr. Elsaraj is a Faculty Lecturer with the University of Ottawa (Faculty of Medicine), McGill University (Department of Dentistry at the Jewish General Hospital) where he lectures and supervises graduate residents of the General Residency Program of Orofacial Pain (OFP) & Temporomandibular disorders (TMD) & Clinic. He is the current Chair of Continuing Education committee of the Ottawa Dental Society (ODS), Executive Treasurer (ODS), Executive Council (ODS & ODA), and Economics Committee Advisor (ODA). He is also an active member of the American Academy of Dental Sleep Medicine, Political Contact dentist- Nepean West (ODS), Dental Emergency Service (ODS), Long Term Planning Committee (ODS), a TMD consultant for the Oral Health Group and Hull Hospital, a Dental Advisor for the Canadian Academy of Clinical Sleep Disorders Disciplines (CACSDD), and a Certified Botox Provider.

Dr. Elsaraj engages in research at McGill University Jewish General Hospital Campus and the Centre de recherche en médecine psychosociale du CISSS de l’Outaouais. His focus includes identifying biomarkers for early detection of sleep apnea, exploring risk factors linked to the transition from acute to chronic pain, and evaluating the effectiveness of new bite techniques in MAD therapy to mitigate the severity of sleep apnea.

Registration Fee:

Dentist/Health Practitioner:    $6500.00

Refund Policy

Registrants may receive a refund provided they give written notice to withdraw a minimum of thirty (45) days prior to start date of the event. An administration fee will be retained to cover staff costs of processing refunds and other costs associated with cancellations.

The University of Manitoba reserves the right to cancel or postpone any educational program due to an insufficient number of registrations. The decision to cancel will normally be made at least fourteen (14) days prior to the program date. Each registrant will be notified by email and provided with a full refund of all registration costs. The University of Manitoba is not liable for any loss, damages or other expenses that such cancellations may cause, including, but not limited to, non-refundable airline fares, hotel penalties or lost income.

Study Credits

This course provides up to 44 hours of Continuing Dental Education (CDE) Credits.

Dr. Gerald Niznick College of Dentistry, University of Manitoba Nationally Approved PACE Program Provider for FAGD/MAGD credit. Approval does not imply acceptance by any regulatory authority or AGD endorsement. The current term of approval extends from July 1, 2022 to June 30, 2026. Provider ID# 214210. Subject Code 012, 200.