Universitat Internacional de Catalunya
Orofacial Pain and Dental Sleep Medicine
Other languages of instruction: Catalan, English,
Teaching staff
Make an appointment with the teachers by email:
Dra. Natalia FELIPE SPADA – nfelipe@uic.es
Dr. Jordi TOMÀS ALIBERAS – jtomas@uic.es
Introduction
Pain and craniomandibular dysfunction have a very significant prevalence in the general population. It is very common to consult patients with dysfunctional symptoms in the different areas of dentistry and other medical specialties, hence the need to be able to diagnose the signs and symptoms quickly as dentists to be able to guide our patients on which therapeutic measures carry out
Dysfunction of the masticatory system is a broad subject, in which students must gradually acquire a set of theoretical concepts, a sufficient practical skill and experience to be able to diagnose and treat.
Many of these patients have disturbances during sleep. Due to the presence of snoring, or Obstructive Sleep Apnea (AOS). It is a pathology that is difficult to manage and has a great impact on the patient's quality of life. There are different diagnostic tools to establish a correct treatment plan, but optimal knowledge of human anatomy and physiology is required to take an accurate clinical history. Among the treatment options being considered are self-care, teaching sleep hygiene, the use of mandibular advancement devices, orthodontic treatments, surgical treatments (orthognathic surgery), based on the otorhinolaryngology approach, etc. But always from a multidisciplinary approach.
Currently, the concept of dysfunction of the masticatory system and sleep disturbances, in the knowledge area of Dentistry, is integrated within the general context of the patient as a functional unit, which requires a comprehensive approach and treatment.
Pre-course requirements
No prerequisite required
Objectives
1. To train undergraduate students to acquire advanced, theoretical and practical knowledge, in relation to the diagnosis of dysfunctional pathology of the masticatory system and orofacial pain.
2. To obtain sufficient knowledge for the different types of multidisciplinary treatment.
3. To enable students to acquire the basic, theoretical and practical knowledge, in relation to the diagnosis of disorders associated with sleep (snoring disorders, OSA).
4. To obtain sufficient knowledge for the different types of treatment (physiotherapy, oral orthoses, self-care, pharmacology, infiltrations, laser).
5. To know the relationship between sleep disorders and the emotional component of the patient. Knowing how to handle the axis 2 or psychological component of the patient.
6. To dentify the bruxism component of sleep and wakefulness.
7. To Know how to digitally design and make oral orthoses and neurodeprogramming devices.
8. To Know how to link sports dentistry in daily clinical practice.
Competences/Learning outcomes of the degree programme
- 03 - Knowing how to identify the concerns and expectations of patients, as well as how to communicate effectively and clearly, both orally and in writing, with patients, family members, the media and other professionals.
- 04 - Understanding and recognising the social and psychological aspects that are relevant in terms of treating patients.
- 05 - Knowing how to apply the correct principles to control anxiety and stress in oneself, in patients and in other memebers of the dentistry team.
- 06 - Understanding the importance of achieving a professional practice that respects the independence, beliefs and culture of all patients.
- 07 - Promoting new knowledge and techniques being acquired through autonomous learning, as well as the motivation to achieve quality.
- 15 - Being familiar with the general pathological characteristics of the illnesses and disorders that affect organic systems, specifically those which have dental repercussions.
- 20 - Obtaining and creating a medical record containing all the relevant information.
- 23 - Establishing a diagnosis, prognosis and suitable treatment planning for all the different clinical areas of Dentistry, being competent in terms of the diagnosis, prognosis and writing up the dental care plan for patients who require special care, including medically compromised patients (such as diabetics, those with hypertension, a depressed immune system or are anticoagulated, etc) and patients with disabilities.
- 33 - Knowing the morphology and function of the stomatognathic apparatus, including material on embriology, anatomy, histology and specific physiology
- 34 - Knowing about scientific methods and having the critical ability to evaluate established knowledge and new information
- 38 - Being aware of clinical and laboratory-based procedures and diagnostic tests, knowing their reliability and diagnostic viability and being competent in interpreting the results
- 60 - Knowing about general and clinical pharmacology for dental practice
- 65 - Diagnosing, planning and undertaking, at a general level, multidisciplinary, sequential and integrated treatment of limited complexity for patients of all ages and conditions and patients with special needs (diabetes, hypertension, oncological diseases, transplants, immune-depression, anti-clotting, etc.) or disabilities. Specifically the dentist should be competent in establishing a diagnosis, a prognosis and developing a suitable treatment plan, particularly in terms of orofacial pain, temporo-mandibular disorders, bruxism and other parafunctions; dental and periapical pathology; oral and dental trauma; periodontal and peri-implanted tissue pathologies; pathology of the mandibular bone, of soft oral tissue and annex glands; states of partial or total edentation and planning rehabilitation treatment via dento-muco supported prostheses, or dental impants, dental malpositions or malocculusions and other anatomical or functional alterations of the face or the stomatognathic system and their potential orthodontic, orthopaedic or surgical corrections
- 70 - Evaluating motor and sensory oral, mandibular and annex function
- 73 - Applying loco-regional anaesthetic techniques
- 88 - To undertake non-surgical treatment for temporo-mandibular disorders and oro-facial pain
- 90 - To identify and correct oral habits that are susceptible to causing or exacerbating malocclusions
Learning outcomes of the subject
- 1.07 - Know the structure and function of support and movement systems; skeletal and muscular system, different bones and muscle groups that form the axial and appendicular skeleton.
- 1.08 - Identify and describe the morphological and functional characteristics of the different joints of the human body
- 1.15 - Know the structure and function of support and movement of the head and neck systems. Bones of the skull and face. Head Musculature: muscles of facial expression, masticatory, supra and infrahyoid. Neck muscles
- 1.16 - Know the structure and function of the temporomandibular joint
- 1.17 - Know the distribution of vascularization of the head and neck
- 1.18 - Know the distribution of cranial nerves and clinical examination
- 1.37 - Will value as necessary the knowledge throughout life
- 2.01 - Know the basic structure of the human personality and the elements that contribute to their training. Distinguish between normal and abnormal psychological traits
- 2.05 - Apply the principles of controlling oneself anxiety and stress, over patients and other members of the dental team
- 2.06 - Develop appropriate research questions
- 2.45 - Make a protector for sport
- 3.01 - Identify the most important characteristics of the different groups of medicines: pharmacological activity, mechanism of action, indications, dosage, contraindications and adverse effects.
- 3.07 - Obtain and develop a medical history that includes all relevant information
- 3.09 - Control of anamnesis and basic general physical examination
- 3.10 - Ask and interpret the results of the general complementary explorations ( laboratory-image- functional)
- 3.16 - Master the techniques of loco-regional anesthesia in the oral and maxillofacial region
- 3.17 - Know the treatment of complications of loco regional anesthesia
- 3.18 - Learn the techniques of anxiety control
- 3.19 - Know the pharmacological treatment of pain
- 3.21 - Know how to explore at physical oro-maxillo-facial level and interpret laboratory complementary examinations and image
- 4.031 - Differentiate pain according to location
- 4.032 - Differentiate pain according to origin
- 4.033 - Differentiate pain according to duration
- 4.034 - Differentiate pain according to the characteristic of the pain
- 4.117 - Know how to make a proper patient history
- 4.118 - Know how to make a proper oral and practical examination of the patient
- 4.119 - Know how to make a correct facial examination of the patient
- 4.120 - Have the ability to diagnose the patient facial typology
- 4.141 - Get the right occlusive fit for each patient and each type of dental prosthesis.
- 4.142 - Apply, when indicated, the technique of selective grinding in the patient
- 5.11 - Develop the skills of oral and written communication
- 5.12 - Develop the capabilities of information management and teamwork
Syllabus
Topic 1. 1st Visit for the evaluation of Orofacial Pain and Craniomandibular Dysfunction
Topic 2. 1st Sleep Dental Medicine Visit.
Topic 3: Sleep and awake bruxism
Topic 4: Interpretation of complementary tests
Topic 5: Treatment of muscular and articular pain
Topic 6: Children's dental sleep medicine Topic 7: Treatment of neuropathic pain: Laser, pharmacology.
Topic 8: Digital design of occlusal unloading splints
Topic 9: Digital design of neuroclusal devices
Topic 10 Pharmacology workshop in the patient with orofacial pain (neurovascular, neuropathic and temporomandibular).
Topic 11. Analyzes of electromyographic, polysomnographic and respiratory polygraph records
Topic 12: Records for the treatment of Obstructive Sleep Apnea (OSA).
Topic 13: Sports dentistry. Making mouth guards.
Topic 14. Topic 14. Surgical and ORL treatment of dental sleep medicine.
Topic 15. Discussion of clinical cases
Teaching and learning activities
In person
Fully face-to-face in the classroom
The subject is taught through theoretical sessions and practical sessions. The content of the theoretical classes will consist of the development of the main topics and concepts of the subject detailed in the syllabus, through a master class based on current literature.
As for the practical classes, they will be based on practical seminars and workshops. Use of the digital design classroom for the making of oral orthoses, and the physiotherapy gym for the muscle and joint treatment.
Evaluation systems and criteria
In person
Fully face-to-face in the classroom
a. Continuous evaluation of seminars: 10%
b. Practical exam: 20%
c. Final exam: 70%.
To calculate the final grade for the subject, it is essential to have passed the final exam.
Continuous assessment:
The grade obtained will be 10% of the final grade, taking into account punctuality, exercises done in class, active participation and attitude.
Practice test:
There will be a short written question and answer practical exam based on clinical situations, diagnosis and treatment of each case. It will account for 20% of the final grade.
Theorical test:
In the evaluation, all the theoretical concepts taught during the entire semester of the subject will be considered. It will consist of 50 multiple-choice questions. Each correct answer will add one point. Incorrect answers will subtract 0.20 points from the final score. To pass the test a minimum score of 25 points must be obtained. The theoretical test will represent 70% of the total grade of the subject.
It will be necessary to obtain a total score (continuous assessment + theoretical test + practical test) of 5 / 10 to pass the subject. Likewise, you will need to pass the two exams (practical and theoretical) individually to pass the subject and the continuous assessment.
Copying, falsification or fraud in individual or team written work, in attendance at classes, in written or oral exams is a serious offense that leads to the immediate suspension of the subject. In case of repetition, a disciplinary file will be opened against the author or authors.
See: STUDENT DISCIPLINARY REGIME REGULATIONS INTERNATIONAL UNIVERSITY OF CATALONIA. CHAPTER I. Disciplinary offences. Article 2.
Bibliography and resources
Okeson JP. Treatment of occlusion and temporomandibular disorders. 7th Ed. Elsevier, 2013.
Headache classification committee of the International Headache Society (IHS). The International Classification of Headache Disorders, 3rd edition (beta version). Cephalalgia. 2013; 33: 629-808.
De Leeuw R, Klasser GD. ed. Orofacial Pain Guidelines for Assessment, Diagnosis and Management of the American Academy of orofacial Pain. 5th Ed. Quintessence, 2013.
Lavigne G. Sleep medicine for dentists. 1st ed. Quintessence books, 2009
Rodriguez Flores JM. Oral sleep medicine in children and adults. 1st ed. Quintessence, 2014
Chokroverty S. Medicine for sleep disorders. 3rd ed. Elsevier, 2011
Reading and analysis of current and classic literature