The Dento-Cranial Competency Exam

The exam given by the Cranial Academy for competency in Osteopathy in the Cranial Field was first given in 1985.

In 1988 Dr. Harris Kimbrough and Dr. Craig Zunka, as long standing associate dental members of the Cranial Academy, sat for and passed this examination with the other Cranial Academy members who were Osteopathic physicians. Due to the particular emphasis that the dentists have on structures related to the oral-facial and TMJ complex, the examiners found that the dento-cranial examination would be slightly different from the Osteopathy in the Cranial Field examination.The Board members of the Cranial Academy, who were the examiners at the time, then requested the W. G. Sutherland Temporomandibulo-Cranial Dental Group. Inc. develop a competency exam for associate dental members of the Cranial Academy.

The exam was developed and completed with the help of Osteopathic manipulative faculty physicians, Doctors Herbert Miller, John Harakel, Robert Fulford, Gerald Cooper, Michael Lochwood, James Jealous and Thomas Schooley.

The dental competency exam, accepted by the Cranial Academy, is now administered by the W. G. Sutherland Temporomandibulo-Cranial Dental Group, Inc. A dentist passing this examination is given a special listing of dento-cranial competency in the Cranial Academy Membership Roster.

The exam is given four times a year on the day before the basic and advanced courses in Warrenville, Illinois. The fee for the Examination is $ 950.00.  A $400.00 deposit is required at time of registration to reserve your exam time.  The prerequisites for a dental candidate to sit for the competency exam are:

1. Dental Degree
2. 40-hour Approved Course in Cranial Osteopathy
3. Implementing the Sutherland cranial concept in dental practice for three (3) years

There is a study guide for the written examination, and this is an excellent review. This will be forwarded to a candidate upon receipt of a $400.00 deposit for the $950.00 examination fee.

The Competency Exam consists of the following parts.

Oral: questions asked by the examiners while the practical examination is in progress.

Written examination: sample questions are:

1. At birth :
   1. The occiput is in ___ parts.
   2. The Sphenoid is in ___ parts.
   3. The Temporal is in ___ parts.
   4. The Maxilla is in ___ parts.
   5. The Mandible is in ___ parts.
   6. The Ethmoid is in ___ parts.
   7. The Frontal is in ___ parts.
2. The five components of the Primary Respiratory Mechanism are:
   1. _________________________
   2. _________________________
   3. _________________________
   4. _________________________
   5. _________________________
3. Flexion and Extension occur in the following bones: name four
   1. _________________________
   2. _________________________
   3. _________________________
   4. _________________________
4. External and internal rotation occur in the following bones: name six
   1. _________________________
   2. _________________________
   3. _________________________
   4. _________________________
   5. _________________________
   6. _________________________

Practical: There is considerable latitude in this section as each patient is different, and each dentist's approach is may vary. Basically the candidate should be able to:

1. Detect a lesion or strain.
2. Make a change in the lesion
3. Perform a CV4.
4. Perform a mandibular decompression
5. Perform a thoracic inlet release
6. Restore c.r.i. in the area of a treated tooth.

Presentation: Two chronic dental cases using Dento-cranial therapy will be presented:

Parts of a sample case:

Chief Complaints:
In February 1998, a 58 year old female patient came to my office for treatment of TMJ pain, bruxism, dizziness/vertigo and headaches. The dizziness and vertigo, which began in 1994 after the first molar tooth on the upper right was filled, were her primary concerns. She was unable to walk without a cane and often fell down at home when she did not use the cane. She had taken early retirement from her job because of this condition. Treatment had been sought from an ENT physician, specializing in dizziness and vertigo, who prescribed Paxil and various diuretics for her conditions; these medications were not effective. She had also been diagnosed with hypothyroidism for which she took Synthroid. Her history of headaches began 15 years ago after a car accident. The headaches were located on the right and left frontal, parietal and occipital areas occurring 2-3 times a week, and lasting for several hours...........

Dento-Cranial Diagnosis:
The TMJ problems began after she had periodontal surgery in 1992 and had to keep her mouth open for a long period of time. The trapezius, lateral pterygoid and medial pterygoid on the right side and left were painful to palpation.. There was pain on the left side of the cervical spine and at the base of the skull. She presented with a right sidebending rotation cranial pattern. The left temporal bone was lesioned in internal rotation. She had an exaggerated forward head posture. Jaw opening was limited to 37mm (norm 48-52mm) and deviated 3mm to the left.............

Conclusion:
................I have continued to see this patient at six month intervals since May 2000. She continues to wear her dental appliance ( which is harmonized with the cranial structures ) and she has remained free of her symptoms.