Course summary:
The most significant parts of the human spine are the TMJ and upper cervical
area. There is moderately strong research evidence indicating a susceptibility of
patients with extensor neck muscular hypertonicity and global/upper neck
vertebral hypomobility to develop TMD. The muscles with “lower endurance”
indicate that they are not functioning as efficiently as intended. As a result, they
fatigue more quickly, leading to head and neck issues such as neck discomfort,
shoulder pain, headaches, and migraines.
With TMD, it may not be merely a problem of “malocclusion” or “stress,” but
can include postural distortions, weak or inhibited muscles, faulty biomechanics
and neurologic proprioceptive alterations associated with chronic misalignment
patterns. When the structural integrity of this area is disrupted, it is crucial for all
chiropractors to grasp the local or global repercussions of how and why they may
arise.
A significant number of the population suffer from some version of TMD and could inadvertently develop instability
and chronicity. Many undergraduate chiropractic programs provide only a basic understanding of the approaches
and assessments to effectively manage TMJ issues. One outcome of these webinar/seminars is to provide a greater
degree of confidence on how to examine and assess TMJ conditions, either in isolation or best, in conjunction with
other health disciplines.
The introductory seminar will will be a review of anatomy, biomechanics, examination procedures (observation and postural inspection), differentiating TMJ conditions, mobilisations, adjustments, and recommended home care and/or co-management with dentists. As a result of attending this seminar, you will be more confident in assessing and working with several types of
TMD presentations.
Course Breakdown
1. TMJ Introduction
2. TMJ Symptoms
Identifying the regions that can be involved with the various
types of symptoms originating from each location.
3. TMJ Relevant Anatomy Review (brief)
a. osseous
b. ligamentous
c. disc
d. muscles
e. nervous innervation
4. Biomechanics
Two positions – intercuspal and mandibular rest position
5. Normal Opening and Closing cycle
6. Examination Procedure
a. history and questionnaire
b. inspection – normal dentition alignment with deflection and
deviation
c. postural inspection
d. mandibular motion
e. static palpation
f. range of motion
g. measurement of opening
7. Loading the TMJ
a. compression
b. distraction
c. clenching
d. bite contacts
8. TMJ Disorders and Diagnosis of Malocclusion or Mechanical
Dysfunction
a. synovitis
b. capsulitis
c. myofascial
d. acute anterior disc dislocation
e. osteoarthritic degeneration
9. TMJ Disc Pathology
a. discal movement versus discal lock
10. Mobilization
a. goal of management
b. mild mobilization – with intraoral distraction; active mandibular
self-stretch; device
c. moderate mobilization -reflex relaxation opening and closing.
d. active resisted exercises
e. TMJ trigger points
11. Adjustments
a. distraction
b. translatory
12. Conservative Treatment Approach
a. phases and types of modalities
b. home care and dietary changes
c. lists of ways to manage each of the mechanical dysfunctions listed
in #8
13. Clicking Jaw and Discal Lock differentiation
14. Non-Chiropractic Approaches
a. initial care
b. dental appliances and splints – (Bionator, Twin Block, Herbst and
anterior point stop or flat plane/full arch
c. the role dentists and chiropractors can play in obstructive sleep
apnea and thereby reducing the need for CPAP machines and overall
compliance.
15. Chirodontics Overview and, for those interested, additional
development possibilities.
Your lecturer:
Dr David Hannah graduated from the University of British Columbia in 1977 with a B.Sc. in Biochemistry and Microbiology.
After his Undergraduate degree, he studied chiropractic and graduated from the Canadian Memorial Chiropractic College in Toronto,
Ontario with a D.C. in May 1983. He completed the Clinical Teaching Residency at Palmer in October 1995 and was hired as a full-time faculty in the Palmer Clinics October 1995 to October 2008, achieving the rank of Associate Professor. After leaving Palmer College, he taught as a Senior Lecturer in chiropractic program units in Malaysia at the International Medical University in Kuala
Lumpur (2012-2015), Central Queensland University in Mackay, Queensland (2015-2020), and Australia Chiropractic College in Adelaide SA (2020 – 2023). He completed the B.C.A.O. in 1997 (Upper Cervical
certificate in Atlas Orthogonal work). He completed the Diplomat in Academy of Chiropractic Orthopedics (D.A.C.O.) in
2005 after completing the studies from 1996-1999. He had also travelled and helped develop the Brazilian Chiropractic school from
1999 to 2003 in Rio Grande Do Sol, Novo Hamburgo, Brazil where he taught technique and provided clinical supervision. David had participated as senior clinician in the International Clinic abroad program and had completed 20 health missions at various places around the world. In this capacity, he was able to bring ‘true/raw’ chiropractic to thousands
of individuals and saw the amazing impact at how this can change lives.