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16 COMMUNIQU FALL 2015 Office of Continuing Medical Education Jaw-dropping approaches to temporomandibular joint disorders by Pat Grauer When Gary DiStefano and Lisa DeStefano planned their rst day-long course on temporomandibular joint disorders in January 2015 they expected 10 to 12 orthodontists. Instead they had to cut enrollment off at 141 120 of whom were dentists and 20 of whom were physicians. The topic is hot. Gary DiStefano a community dentist and clinical assistant professor of osteopathic manipulative medicine was among the very rst to recognize the importance of the joint nearly three decades ago when face head and neck pain of unknown origin was often dismissed as psychogenic. Today the biomechanics are much better understood and TMJ disorders wide- reaching effects are recognized ear jaw neck and thoracic pain Eustachian tube problems and headaches. Seventy percent of Western civilization has the jaw relationship a Class II deep bite which can lead to a hyperextension injury of the TMJ he said. Its a facial skeletal growth and development issue allowing the jaw to go back. There are broad implications of overextension of the mandible when one closes the mouth said Lisa DeStefano an osteopathic physician and chairperson of the Department of Osteopathic Manipulative Medicine. Biting creates 500 to 1000 pounds per square inch of force into the joint and the only thing that stops the mandible from going into the temporal bone is the teeth. It can even destabilize the cervical spine relative to the thoracic spine causing postural instability. Both agree that collaboration between a dentist and an osteopathic physician with expertise in manipulation provides the best diagnoses and treatments for TMJ disorder patients. The initial session focused on principles dening the issue clinical assessment and using OMM as a diagnostic tool to communicate to the dentist recommendations for prescribing an orthopedic device. Basic Principles of TMJ Diagnosis and Treatment Modalities will carry these principles into practice including the history of TMJ disorders basic orthopedics of joint function and dysfunction principles of treatment and surgery on the rare occasion it is required. The course will be held in two parts Part I on Feb. 26 2016 at MSUs Breslin Center and Part II on Feb. 27 at Fee Hall. Each part is approved for eight Category 1-A credits. Upcoming CME Programs CRANIOSACRAL TECHNIQUES PART II October 9 - 13 2015 MSUCOM East Fee Hall East Lansing Michigan 35 credits of Category 1-A DIRECT ACTION THRUST MOBILIZATION WITH IMPULSE October 23 - 26 2015 MSUCOM East Fee Hall East Lansing Michigan 27 credits of Category 1-A OMM FOR THE PREGNANT NEWBORN PATIENT November 6 2015 MSUCOM East Fee Hall East Lansing Michigan 7 credits of Category 1-A MANUAL MEDICINE RELATED TO SPORTS OCCUPATIONAL INJURIES TO THE EXTREMITIES November 7 - 8 2015 MSUCOM East Fee Hall East Lansing Michigan 15 credits of Category 1-A BOTSFORD SYMPOSIUM FOR PRIMARY CARE November 20 - 21 2015 Suburban Collection Showplace Novi Michigan 17 credits of Category 1-A Ph 248 471-8350 PRINCIPLES OF MANUAL MEDICINE December 4 - 7 2015 MSUCOM East Fee Hall East Lansing Michigan 28 credits of Category 1-A ALSO AVAILABLE CME ONLINE Up to 56 1-B Credits For details and additional programs COM.MSU.EDUCME Dentist Gary DiStefano was among the rst to recognize the clinical signicance of TMJ. CME