Hands on Course

Course description: Identifying Invisible Influencers (3i)

This course will allow the participant to be able to understand the principles and identification of restrictions to function that are not easily identified by traditional clinical observations. The 3i Course (Identifying Invisible Influencers) will be valuable to the provider who is interested in supporting improved patient care by becoming familiar with restrictions that are neurological, fascial and metabolic  The 3i course is designed to help providers identify restrictions to patient responses that are metabolic, functional and neurologic in origin including:

• Oral myofunctional concerns with swallow and rest posture
• Retained primitive reflexes
• Fascial restrictions
• Cranial nerve dysfunction and imbalances
• Trigeminal reflex assessment
• Cranial strains
• Bite force imbalances
• Nutritional and metabolic deficiencies affecting sleep and growth

Invisible Influencers Course Agenda

1. Introduction to Concepts

   a. Neurology “Rules” as the primary determining factor of sleep physiology

   b. Hierarchy of needs – Cerebral perfusion

   c. Osteopathy as a concept and application

      i. Cranial vault mobility

      ii. Cranial vault symmetry and strains

   d. The Fascia Factor

2. Retained primitive reflexes: The Trump Card

   a. FPR

   b. Moro

   c. Overview of others and relevance to oral environment

3. Clinical applications of influences to the Locus Coeruleus

   a. Cranial base reflexes

   b. Bite response reflexes

4. Sleep physiology and architecture

   a. Importance of monitoring stage 3 sleep transitions, duration and QOL

   b. Remmers statement: AHI only determines reimbursement

   c. Looking beyond the airway choke point and into the signaling of sleep

5. Trigeminal Cardiac Reflex

   a. Etiology

   b. Diagnostics

   c. Treatment options

   d. Misdiagnosis and consequences

6. Cranial nerve stimming and toning

   a. Literature review

   b. Clinical applications

7. The mental dental connection

   a. Interpretation of pain through limbic pathways

   b. Depotentiation through Havening

8. The Me5 (mesencephalic nucleus of the trigeminal nerve)

   a. Pathway

   b. Implications in dentistry

   c. Primary vs permanent dentition

9. Fascia, Fascia, Fascia

  a. The role of the buccopharyngeal fascia

      i. Mandibular labial tendon

      ii. Buccinator aponeurosis

      iii. Airway corset

   b. Sublingual fascia

      i. Mills research

   c. Upper cervical fascia and influences on the dural membrane system

10. Fit2BTied – Tongue restriction analysis

   a. Visual vs functional assessment

   b. ROM and palpation

   c.  Tongue anatomy and physiology

   d.  Tongue/jaw dissociation and grading/fixing  

11. Airway assessment

   a. Tonsil

   b. Nose

   c. Mallampati

   d. Tongue posture

12. Osteopathy in the Cranial Field

   a. Sutural homeostasis

   b. Symmetry

   c. Fluids and membranes

   d. Growth and developmental influences

   e.  Intracranial inflammation

      i. Symptoms 

      ii. Solutions

      iii. Williams research/Zamboni effect

13. Dysautonomia

   a. Connective tissue implications

   b. Autonomic nervous system implications

   c. Vascular considerations

   d. HRV as an effective screening tool for the complex patient

14. Clinical exam for neurological, fascial and structural restrictions

   a. Relating the SO to the AP

   b. Significance of palpation exam findings related to diagnosis and treatment

   c. If this, then that: Treatment sequencing

15. Indications for referral for structural co-treatment

16. Metabolic and nutritional considerations

   a. Vit D, B, K, Ferritin and Mg

   b. Insulin resistance and sleep fragmentation

   c. Inflammatory markers

   d.  Dopamine pathways

   e.  Restless leg syndrome/periodoc limb movements and their relevance to  sleep disordered breathing

   f.  The endocannibinoid system

   g. Discussion of upcoming research on apnea biomarkers by Dr. Gozal

17. COVID Vaccine and virus: short term and long-term implications

18. NINJA fabrication

19. Dento-Cranial osteopathic releases

20. R&B Home care

21. Clinical examination: Letting your fingers do the walking and the patietn's fingers do the talking

   a. Palpation (finger and thumb, finger game)

   b. Cranial sutural release response assessment

22. Wrapping it up and moving on

   a. Documentation

   b.Clinical implementation

   c..Communication with referring providers

   d.  How to build a treatment TEAM 

23.  Now what?  How not to get overwhelmed by the unanswered questions