tips on using the mrc pre-ortho trainer in myofunctional orthodontics

Some tips and tricks for using MRC’s pre-

orthodontic Trainer By

Dr. Barry [email protected]

Part of a presentation for MRC At the Rancho Cucamonga training center in Sept. 2011

The Process: Myofunctional Ortho

Light Wire Expanders•To undo damage and make room for the tongue

Trainers• To get the tongue on the palate

The Goal: To get the tongue on the palate

The Process: Trainers

Appliance Delivery Comfort check Routine visits Training Sessions Exercises

The Try-on

Trainers: Appliance Delivery

The Try-on“The Four Things”

Bite DownLips togetherBreath through your noseTongue on Tag

“The Two Things”Lips togetherTongue on Tag


The Try-onThe Two ThingsWearing Schedule

1hr/day plus sleepingNo “Two Things” while Sleeping

OK to Ramp up


5 min 10 min 20 min 30 min 60min60+slee

p5 min 10 min 20 min 30 min5 min 10 min 20 min5 min 10 min5 min

The Try-onThe Two ThingsWearing Schedule

1hr/day plus sleepingNo “Two Things” while Sleeping

OK to Ramp upChoose activities and make calendarOK to Split time

Sun Mon Tue Wed Thu Fri SatActivity

1 TV Homework

Homework

Ride to Soccer

Homework

TVMovie

Activity 2

Gaming

Reading

Gaming

Reading

Laundary


The Try-onThe Four ThingsWearing ScheduleScore Card


q

The Try-onThe Four ThingsWearing ScheduleScore CardWarnings

Don’t chewDon’t let Dog chewFee to replace

$85-200


The Try-on“The Four Things”Wearing ScheduleScore CardWarningsSend them home


So, how does it feel? Is it comfortable?

Buccal gingiva, especially around erupting

teeth

Retromolar pads

Incisive papilla

Doesn’t fit over BWS

Unexplained apthous ulcers

Allergic Reactions

Trainers: Comfort Check

Comfort check1. Comfort: Common irritations

Buccal gingival, especially around erupting teeth

Retromolar padsIncisive papilla


2.1.2) Protocols: Trainers: Comfort Check

Buccal Gingiva blanching

Trainers: Comfort CheckRetromolar Pads

Trainers: Comfort CheckIncisive Papilla

Trainers: Comfort CheckDoesn’t Fit over BWS

•Not related to contact with trainer• Use oral ointment• Restart use when sores gone• Ramp up time

Trainers: Comfort CheckApthous Ulcers

Trainers: Comfort CheckAllergic Reactions

3 Days of wear


Next: T4K Hard

2. How is your daytime wear?• Great! Here’s my card• Too Busy• Not Linking to other activities• Excuses

• I was sick• I told her she didn’t have to wear

it.• We had a family blah blah

• Sad Puppy Eyes• Can’t Breathe, Gagging

Education


(Bite your tongue)

SunMon

TueWed

Thu Fri Sat

Activity 1

TVReading

Homewor

k

Ride to Soccer

Homework

Spongebob Mo

vieActivity 2

Gaming

Gamin

g

Reading

Laundary

Encouragement, Offer

alternatives

Airway training

3. Nighttime wear

• Normally takes time

• Can’t fall asleep

• Falls Out At Night (FOAN)


Delay starting

15 Min before sleep,

Airway training

Check Daytime wear,Airway training

4. Motivation

• Attitude check

• Looking for results

• Encourage Patience

• Talk about alternatives


4. Motivation : The bicycle speech

7 out of 7


4. Motivation : The bicycle speech

5 out of 7


Check scorecard

Video and Mirror to review

exercises

Comfort and Troubleshoot

Adjust BWS

Prescribe new exercises

Plan next Trainer or BWS

Trainers: Routine Visits

Trainers : Training Sessions

• 1/2 hour• Up to 8 patients/hour• Assure proper wearing• Exercises to boost progress• 3-4 sessions• Extra sessions if needed

Patient FlowActivity Area

Workbook Session

Doctor Visit

Progress Records and

Notes

1.3 Trainers : Training Sessions: Training Sessions

Their “one hour” of wear

Activity Area


Activity Area


“So how ya do’in?”

Workbook Session


“Here’s your password…”


Workbook Session

“Don’t put these on the furniture….”


Workbook Session


“No, you can’t share it with the dog”

Workbook Session


“So how ya do’in?”

Doctor Visit


“How’s your wire thingy?”

Doctor Visit


“S’comfortable?”

Doctor Visit


(The Look)

Doctor Visit

Trainers : Training SessionsProgress

Records and Notes



Notes



Notes

10/1/10

Was talking the entire time. Told to be quiet while wearing

trainer.

Doctor-time Scheduling

Code

Appt ActionAsst Time

Dr Time

Total Time

640 spacers Spacers 10 0 10

604 BWS insert Band, cement, fit 35 25 60

605 BWS adj Remove, adj, replace 0 10 10

606Trainer insert

Instruct, check

15 5 20

607Trainer check

Coop/comfort/progress 10 10 20

608 Activities Workbook/video/practice 10 0 10

609Group

ActivitiesWorkbook/video/

practice 30 0 30

860 Progress Photos Pictures only 20 0 20

Trainers: Exercises

•MRC Activities Workbook•Groups 1,2,3, extras

•www.trainerkids.com

Trainers: Exercises

• Practice with and without trainer• Phantom Trainer• 5min on, 5 min off• do the “two things” without

Trainer• Decrease daytime wear

• ramp down • down to 5 minutes for daily “warmups”

• Give Nighttime “vacations”

Trainers: Exercises

• From Rogers• Jaw Stretches • Neck Stretches• ( 5sec x 5 reps x 3

sessions/day)

Trainers: Exercises

• From Kondo•Tongue Lift (with gum)

Trainers: Exercises

• Additional Exercises• From Rogers

• Jaw Stretches• Neck Stretches

• From Kondo• Tongue Lift (with gum)

• TicTac hold (From Joy Moeller)• Hold it on the spot ‘til gone.• 5x/day

Trainers: Exercises




• Tongue Spot• Hydrocolloid bead pressed on

“Spot”• Lasts for 2 hours• Practice “Quite Face swallows”

Trainers: Exercises

Trainers: Exercises

• Additional Exercises• From Rogers• Jaw Stretches• Neck Stretches


• From Flutter/Buteyko• 3M Micropore tape

If you show these to If you show these to anyone, I’ll kill you...anyone, I’ll kill you...

Trainers: Exercises




• From Flutter/Buteyko• 3M Micropore tape

• Nasal rinsing

tips on using the mrc pre-ortho trainer in myofunctional orthodontics

Health & Medicine

comfort check delay

tryon trainers

comfort check retromolar

bws trainers

tongue trainers

comfort check apthous

exercises comfort

time trainers