Hands-On Dental Course | Level 5
Finish the Case
Managing Orthotic Therapy and Choosing Phase 2
Know when Phase 1 is complete, and choose the Phase 2 that makes the correction permanent.
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Level 5 completes the case. Level 4 established the corrected position and held it with an adjusted orthotic. Level 5 covers what happens next: managing orthotic therapy through to the end of Phase 1, then choosing and sequencing the Phase 2 treatment that makes the corrected position permanent.
The orthotic holds the position, but it does not hold it forever. The patient changes over the course of therapy: the muscles release, the joint heals, and the mandible changes position. You will learn to read those changes, to modify the orthotic as the position settles, and to recognize when Phase 1 is complete. From there, the level breaks down Phase 2: orthodontics, restorative and prosthodontic treatment, occlusal equilibration, and surgical referral. You will learn which case calls for which, how to combine them, and how to sequence the finalization so that the position the orthotic established is transferred to the dentition and held without the appliance.
Learning objectives
Upon completion, participants will be able to:
Manage orthotic therapy across the course of Phase 1, and modify the orthotic as the mandibular position settles.
Distinguish expected settling from a problem that requires intervention.
Reassess the position over time using TENS, bite registration, and imaging when it is indicated.
Recognize when Phase 1 is complete: a stable position, resolved or plateaued symptoms, and a repeatable occlusion.
Explain how Phase 2 transfers the corrected position from the orthotic to the dentition.
Select among the Phase 2 options - orthodontics, restorative and prosthodontic treatment, equilibration, and surgical referral - for a given case.
Determine when surgical referral is indicated, and the limits of what orthotic and restorative treatment can achieve.
Sequence a Phase 2 plan that holds the corrected position long-term.
Course details
Location: Smiles by Bis
710 Dorval Dr #220, Oakville, ON L6K 3V7
Date: To be announced
CE Credits: 14 (6.5 lecture, 7.5 participation)
Dentist tuition: To be announced
Format: Two-day, in-person course
Participants: Dentists. This level is not open to hygienists or assistants.
Included: Breakfast and lunch both days, Day 1 reception, course materials, and the Phase 2 Decision and Sequencing Guide
Full refund less a $100 administrative fee more than 30 days before the course. 50% refund or one transfer 15 to 30 days before. No refund 14 days or less before; one transfer may be permitted.
Course content
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The orthotic changes the patient, and the patient does not change all at once. Over the weeks and months of Phase 1, the muscles release, the joints heal, and the symptoms resolve or change. As they do, the mandibular position changes with them. This module teaches you what to expect over the course of therapy, so that a change in mandibular position reads as progress or as a problem, not as a surprise.
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A contact that was correct at delivery is not correct once the mandible has moved. This module teaches you to re-read the occlusion at each visit and to modify the orthotic as the position settles: which contacts to adjust, when to add and when to reduce, and how to keep the orthotic at the corrected position as that position changes.
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The corrected position has to be confirmed, not assumed. This module teaches you to reassess over time - repeating TENS and bite registration, and repeating imaging when it is indicated - to confirm the position is stable and the joint and muscles have responded.
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Phase 1 ends when the position is stable, the symptoms have resolved or plateaued, and the occlusion on the orthotic is repeatable. This module teaches you to judge that endpoint, to document it, and to decide what the case needs next. That decision is the start of Phase 2.
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The orthotic holds the corrected position, but it is removable and temporary. Teeth are the stops that set where the mandible closes; the orthotic replaced those stops. Phase 2 puts permanent stops back into the dentition, so the corrected position is held without the appliance. Every Phase 2 option is a different way to do that.
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Phase 2 has four routes: orthodontics, restorative and prosthodontic treatment, occlusal equilibration, and surgical referral. This module covers what each one does and which case it fits. Orthodontics moves the teeth to the corrected position. Restorative and prosthodontic treatment rebuilds the teeth to it. Equilibration adjusts the existing teeth to it, within limits. Surgical referral addresses the cases the other three cannot. Participants already have restorative training, so the focus is the decision, not the execution.
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Most complex cases need more than one route. This module teaches you to choose among the options for a given case and to combine them: when orthodontics precedes restorative treatment, when equilibration is enough and when it is not, and when the case has reached the limit of what dentistry can do and requires surgical referral.
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The order of Phase 2 treatment determines if the corrected position holds through the transition. This module teaches you to sequence the finalization: what comes first, what depends on what, how to hold the position as the orthotic is withdrawn, and how to retain the result long-term.
Schedule
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8:00–8:30am — Registration and breakfast
8:30–9:30am — Lecture: The patient over the course of therapy: what changes and what it means
9:30–10:30am — Breakout 1: Reading a changing bite across sequential records
10:30–10:45am — Break
10:45–11:30am — Lecture: Modifying the orthotic as the position settles: when to add and when to reduce
11:30am–12:30pm — Breakout 2: Planning the orthotic modification for a settled position, from case records
12:30–1:30pm — Lunch
1:30–2:15pm — Lecture: Reassessment with TENS, bite registration, and imaging. Recognizing the end of Phase 1
2:15–3:30pm — Breakout 3: Reassessment and the Phase 1 endpoint, on case records
3:30–3:45pm — Break
3:45–4:30pm — Lecture: From the orthotic to the dentition: what Phase 2 does
4:30–5:00pm — Day 1 review and questions
5:00–6:00pm — Cocktails and hors d'oeuvres
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8:00–8:30am — Registration and breakfast
8:30–9:30am — Lecture: The Phase 2 options: orthodontics, restorative and prosthodontic treatment, equilibration, surgical referral
9:30–10:45am — Breakout 4: Combining Phase 2 options: building a combined plan
10:45–11:00am — Break
11:00–11:45am — Lecture: Sequencing the finalization, and holding the position as the orthotic is withdrawn
11:45am–12:45pm — Breakout 5: Sequencing workshop: ordering a Phase 2 plan from a completed Phase 1 case
12:45–1:45pm — Lunch
1:45–2:30pm — Lecture: Compromised treatment planning, and presenting Phase 2 to the patient
2:30–3:30pm — Breakout 6: Compromised-plan workshop, and presenting Phase 2: group treatment planning discussion
3:30–3:45pm — Break
3:45–4:45pm — Review of cases submitted by attending dentists
4:45–5:00pm — Introduction to Level 6. Evaluations and certificates
Bring your own cases. Attending dentists may submit their own cases for review on Day 2. Instructions are sent after registration.
Workshops
Reading a changing bite across sequential records
Planning the orthotic modification for a settled position, from case records
Combining Phase 2 options: building a combined plan
Presenting Phase 2: group treatment planning discussion
Sequencing workshop: ordering a Phase 2 plan from a completed Phase 1 case
Compromised treatment planning workshop: re-sequencing the plan when the patient declines a component - the case that requires orthodontics before restorative treatment and a patient who refuses the orthodontic phase. What remains achievable, what the compromise costs, how it is documented, and where the line falls between a compromised plan and one that should not be undertaken.
Your Monday-morning toolkit
Every level ends with a single-page tool you can apply the next working day. It is not a course summary. It is an instrument, built for chairside use by you and your team.
Level 5 - The Phase 2 Decision and Sequencing Guide.
A one-page instrument that first confirms the Phase 1 completion criteria are met, then maps the Phase 2 routes - orthodontics, restorative and prosthodontic treatment, equilibration, surgical referral - to the features of the case, and sets the sequence with its dependencies. It takes you from a completed Phase 1 to a Phase 2 plan and its order.
The economics of finishing the case
Level 5 is where the case is completed or left unfinished. The difference is most of the value in the case. Three drivers follow from the material.
Phase 2 is the largest treatment in the case. The finalization - orthodontic, restorative, or prosthodontic, or a combination - is where most of the production sits. It is realized only when Phase 1 is completed correctly and the Phase 2 route is chosen well. A case that stalls at the orthotic never reaches this point.
A finished case holds; an unfinished one relapses. The corrected position is temporary until it is made permanent. A case left on the orthotic, or finalized in the wrong sequence, relapses, and the work and the patient's trust are lost with it.
The right route, not the most treatment. Choosing among the Phase 2 options means matching the treatment to what the case requires: equilibration when that is sufficient, orthodontics when the teeth must move, restorative treatment when they must be rebuilt, or a combination of these when the combination produces a better, more conservative, or more cost-effective result. Matching the route to the case avoids both over-treatment and repeated correction.
Beyond
the orthotic
Level 5 teaches you how to manage the patient through the end of Phase 1, recognize when the corrected position is stable, and choose the Phase 2 treatment that will hold that position long-term.
New to the Hands-On Series? Start with Level 1 to build the diagnostic foundation first.
Bridge to Level 6
Level 5 completes the standard complex case, from orthotic through Phase 2. Level 6 addresses the hardest cases: full-mouth reconstruction, cases that combine several disciplines, and cases that have failed previous treatment and must be diagnosed and rebuilt from the beginning.
Have a question before registering?
Not sure which level is right for you, or what to expect? Send us your question and our team will get back to you.
About the instructor
Dr. Agatha Bis has spent nearly 30 years treating complex cases in private practice with a clinical focus on TMJ disorders, occlusion, restorative dentistry, and the systems that make treatment more predictable. She is also the founder of TMJ Whisperer Academy, an educational platform built for dentists who want to understand cases more clearly, diagnose with more confidence, and practice with more control.