Therapeutic Use of Neuromodulators in Dentistry – Bruxism and Myofascial Pain & Parafunction

October 14-15, 2023:  Module I-A/B DIDACTIC – Bruxism and Myofascial Pain & Parafunction):  (Online Synchronous & Online Asynchronous)

AND

December 3, 2023: Module I-A/B CLINICAL – Bruxism and Myofascial Pain & Parafunction):  (In-Person, Hands-On)

Description

“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.

This two-course series must be taken together, and 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.

PRE-REQUISITE: Full attendance of the course, Bylaw Module I-A/B Anatomy (Neuromodulator 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.

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 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 second of a 3-course series to become eligible to roster according to the MDA Bylaw.

Full attendance of the course, Module I-A/B Didactic (Bruxism and Myofascial Pain & Parafunction) 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.

The third and last module is intended to enable the successful participant learner to fulfill clinical requirements to be eligible for Roster IA and Roster IB of the Manitoba Dental (Association’s Bylaw for the Use of Neuromodulators and Dermal Fillers (Bylaw)).

Each registered participant will bring five (5) of their own patients from private practice to administer botox injections, under the clinical supervision of certified instructors, as relevant and specified in the MDA Bylaw Section I.a.iii and I.b.iii to fulfill Roster IA and/or Roster IB respectively. 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 been 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.

A Certificate of Completion 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 will be provided upon successful completion of this portion of the course. Note:  This course is the third and final course of a 3-course series to become eligible to roster according to the MDA Bylaw.

Full attendance and successful completion of the final clinical component of the course, Module I-A/B Clinical -Bruxism and Myofascial Pain & Parafunction, will provide eligibility to roster in compliance of the Manitoba Dental Association’s Bylaw for the Use of Neuromodulators and Dermal Fillers, Roster IA and Roster IB pertaining to the therapeutic use of neuromodulators as an expanded scope of practice for the dental practitioner.

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 

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
  • 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 modality

Instructor(s)

Murray L. Fain, D.M.D., F.R.C.D.(C)

University of Manitoba was Dr. Fain’s alma mater for degrees in Dentistry and Oral and Maxillofacial Surgery. He is a fellow of the Royal College of Dentists of Canada and is American Board Certified in Oral and Maxillofacial Surgery. Dr. Fain’s interest in cosmetic surgery arose when studying for his American boards.  It was a requirement to have knowledge on the subject, so he attended a number of courses in the US, and fortunately, has been able to practice that scope in British Columbia. Dr. Fain’s Botox training was actually with the Carruthers, who pioneered the use of Botox for cosmetic use. He has been 28 years in private practice in White Rock, BC, focusing on orthognathic surgery and implantology.  His scope includes facial cosmetic and reconstructive surgery, as well as trauma and all aspects of minor oral surgery. He has taught in both undergraduate and postgraduate programs at University of Manitoba as well as the undergraduate program and general practice residency program at University of British Columbia.  Dr. Fain served as chief of surgery at his main hospital for 5 years and has an excellent association with fellow colleagues in Plastics and ENT, which has allowed collaboration in a number of cosmetic surgical cases. He is married with two daughters and two dogs.  In his free time, they love to travel, often scuba diving as a family; a hobby first learned in Manitoba at West Hawk Lake along with  archery and fishing.

Tareq Aldajani  DDS, MSc, MOMS RCSEd, ABHSOMFS, MSc, FRCD(C)
Oral Medicine Specialist

Dr. Tareq Aldajani is a highly qualified and experienced oral medicine specialist, offering a wide range of comprehensive services to his patients. His expertise includes the diagnosis and management of oral pathologies, treatment and management of oral manifestations of systemic diseases, therapeutic injection of neuromodulators, such as Botox©, for bruxism, TMD, and neuropathic pain, as well as cosmetic Botox© injections. Dr. Aldajani is also skilled in the management of orofacial pain, fabrication of oral appliances for TMD and bruxism, and pharmacologic management of neuropathic, muscular, and jaw joint pain disorders. In addition, he collaborates with patients’ physicians to provide oral orthopedic appliances for mild to moderate obstructive sleep apnea.

Dr. Aldajani received his dentistry degree from Misr University for Science and Technology in Egypt in 2004. He then completed an internship program with the Ministry of Health in Jordan and worked in various clinics and hospitals across the country, treating complex and medically compromised cases in both urban and rural settings. After his clinical training, he earned a Master of Science in Oral and Maxillofacial Surgery from Jordan University of Science and Technology in 2008 and completed advanced training in Oral and Maxillofacial Surgery in Saudi Arabia in 2015. He passed the Diploma in Oral and Maxillofacial Surgery examination with the Royal College of Surgeons of Edinburgh (UK) in 2015 and the Arab Board of Health Specializations Diploma in Oral and Maxillofacial Surgery in 2017.

In 2017, Dr. Aldajani and his family moved to Canada, where he completed a postgraduate residency and a Master of Science in Oral Medicine at the University of Alberta in 2022. He underwent extensive graduate training in oral medicine and pathology, orofacial pain and TMD, OSA and sleep appliances.

Apart from his professional life, Dr. Aldajani is a devoted family man. He moved to Canada with his wife Rand, and they have two sons aged seven and three. He enjoys spending quality time with his family, swimming, playing soccer, and basketball. During his free time, he also enjoys hiking, and indulging in his love of music. Dr. Aldajani’s passion for his profession and personal life makes him a caring and compassionate oral medicine specialist who strives to deliver the highest level of care to his patients.

Israa Elgazzar  B.Sc. Dent, DMD

Dr. Israa Elgazzar is a general dentist whose dental practice spans both Manitoba and British Columbia. Dr. Elgazzar completed her undergraduate studies and received both a DMD and BSc (Dent) at the University of Manitoba. Upon graduating, she moved to British Columbia where she became a partner at a dental practice in downtown Vancouver. While in Vancouver, Dr. Elgazzar received Botox training and began treating patients with Botox. She now resides in Winnipeg and continues to work as an associate in the city while maintaining her practice in Vancouver. Dr. Elgazzar has special interests in prosthodontics and oral surgery and teaches at the Dr. Gerald Niznick College of Dentistry at the University of Manitoba. Outside of dentistry, Dr. Israa Elgazzar has a passion for everything fitness and nutrition and loves to educate patients, family, and friends about these topics.

Registration Fee:

Dentist/Health Practitioner:    $3500.00

Refund Policy

Registrants may receive a refund provided they give written notice to withdraw a minimum of thirty (30) 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 24 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 200.