DR.Kaplan, Author at Prosthodontist in Johannesburg
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Author: DR.Kaplan

Our least appreciated organ that’s responsible for so many big things

Our noses are generally the subject of  admiration and criticism. Some love their noses, others would  change it if they could.

But it’s easy to forget that your nose, along with your eyes and mouth, don’t just make up your visual identity. And there may be an argument for loving it the way it is.

Your nose in particular is one of the most complex and elegant organs in your body. It performs critical life functions and really deserves huge props for its  role in keeping you alive and safe –  and quite often satisfied.

It is even responsible for your sex life. (It’s true).

The nose is the first organ in your upper respiratory system and one of the main reasons you both survive and thrive.

Your nose contains your breath

You’re likely already appreciative of your breath, but it’s kind of a big deal as your nose and mouth are  the path of air entering and exiting your lungs.

 In normal everyday breathing,  your nose is the primary pathway.

Even during exercise where mouth breathing becomes more dominant, some air also still passes through your nose

Although the mouth is  a bigger tube, people feel more uncomfortable if their noses are blocked or congested. That is how important your nose really is.

Nasal breathing is also most critical in newborns who breathe through their noses almost all the time. It is a unique feature related to the configuration of their throats that allows them to breathe and suckle at the same time, without choking. 

This doesn’t happen in older children or adults. We have to stop breathing to swallow. Something to appreciate the next  time you  aren’t getting air into your nose for a few seconds.

Your nose humidifies the air you breathe

Your nose processes the air you breathe, preparing it for your lungs and throat which do not tolerate dry air well.

As inhaled air passes through your nose, it is moisturised  and humidified  thanks to a multiple -layer air  pathway with three sets of turbinates ( called upper, middle and lower conchae). These are long bony structures covered with a layer of tissue that expand and contract.

This path is where drainage and moisture is regulated. If you have a dry throat, it means that the air in this passageway may not have been humidified.

This is also the place  where  the tone of your voice is shaped as air  passes through and the passage expands or contracts.

Your nose cleans the air you breathe

The air  we breathe has all kinds of stuff in it – from oxygen and nitrogen to dust, pollen, pollution, allergens, smoke, bacteria, viruses, small bugs and countless other things. Your nose  helps clean it all.

On the surface of the nasal tissues in your turbinates, there are cells  with tiny hair-like appendages called cilia that trap the bad debris in the air so it doesn’t get into your lungs. Instead the debris sits in the mucous and is eventually pushed into your throat and swallowed.

This is extreme beneficial since our stomachs tolerate handling bad debris much better than our lungs do.

Your  nose regulates the temperature of your breath

In the same way your throat and lungs don’t like dirty air, they also  don’t like the air that is  too cold or too hot.

The passing of the air through the nose allows the air to become more like your body temperature, which is better tolerated by your tissues.

Warming cool air in your nose is more common than cooling warm air. That is because humans spend much more of their time in environments below body temperature – 37 degrees Celsius-than above it.

The runny nose you get in  cold weather is the best example of this warming and humidifying effect. It comes  from the condensation of the moisture in your nose when  the cold air gets in.

Your nose protects you through smell

High in your nose are a large number of nerve cells that detect odours. In order to smell, the air we breathe must be pulled all the way up to come in contact with  these nerves.

Smell plays a key role  in taste. We have four primary tastes: bitter, sour, sweet, and salty. All of the refinements in taste  are related to smell. That’s why people feel that food is tasteless when there  ability to smell is decreased.

Smell and taste are necessary for safety. We need our smell to detect smoke, spoiled food, and some toxic poisons or gases.

Whenever we have a cold or allergies, it’s hard for air to get to these receptors, so people notice a decreased ability to smell.

Those who have completely lost their sense of smell need to have alarms for these gases  and must pay closer attention to what they eat.

Smell is important in identification, memory and emotion

Smell partners with your olfactory bulb located in the front of your brain, just above your nasal cavity. It’s the part of your brain’s limbic system and is  associated with memory. We identify other people by the memory of what their personal smell is.

This is how it works: You might remember someone specifically when you smell a certain perfume ,soap or similar body odour. If it  triggers your memory and you get nostalgic and emotional, that’s because the limbic system is associated with the control of  the emotional part of your brain.

Your nose helps find a mate

It’s amazing how many of our body functions are directed towards sexual activity and reproduction.

Not only does your olfactory system trigger memory, but your nose plays a critical role when paired with your olfactory system in your perception of sex.

The characteristic smell of a person’s perfume, cologne or the scent of their shampoo  is important to sexual arousal. The smell of human perspiration also has a direct effect on sexual receptors in the brain. And the loss of smell correlates with decreased sexual drive

Another interesting and widely debated area is the impact of pheromones. These are very important to reproduction in animals, as well as on human sexuality and stimulation.

Your nose shape the sound of your voice

What we hear when people speak and sing is  in large part related to the resonating structures of the throat and nose.

Your voice is produced in the larynx but that sound is really a buzzing sound. The richness of the sound is determined by how the sound is processed above the larynx, which occurs in your nose and throat.

This is the same principle that separates the grand piano from a child’s toy piano. The nasal voice we hear in someone with a cold and allergies  is due to the loss of this nasal resonation since a can’t pass through the nose.

Your nose and sinuses are a powerful duo

Sinuses also play a part in the resonance  of your voice.

Your sinuses are air-filled structures in your own head that make your head lighter  and probably played an important role in allowing us to become upright. They also serve as air  cushion shock absorbers that help protect your brain and eyes.

The partnership between your nose and sinuses help control the amount of nitric  oxide in your body and in your lungs. They also  play a huge role in your immune functionality

The next time you look in the mirror, you may want to consider a new respect for  your incredible  nose.

Acknowledgement. Dr Michael Benninger. Cleveland Clinic.

Implants have been used for many years in dental treatment for the replacement of missing teeth. The benefits are enormous and many a mouth has been restored back to good health.

From  time implants were first introduced into the world of dentistry, vast improvements have taken place. Implant dentistry is a very sophisticated treatment option.

The basic principle is that the implant makes a solid attachment to the bone providing a foundation for many restorative options.  It is  not quite  as simple as just drilling a hole in the bone and screwing in the implant. Much skill is demanded.

There has also been a major advance in the radiographic examination of the underlying bone through  3D visualisation. This is done with a CBCT scan. This x-ray allows for a careful examination of the underlying bone and detailed planning  can take place prior to undertaking the surgical procedures.

Due to many reasons permanent are lost . This is where implants offer another chance but there is no fourth change.

Prevention is always better than cure.

Sleep- when the body and mind are at rest- is a time to rejuvenate the body and organise the mind. In normal sleep, body temperature decreases, breathing rate slows and blood pressure decreases, returning to a normal state upon waking.

Breathing needs to be constant and steady to allow proper oxygenation of the body.

When this breathing is interrupted, changes take place in the body. This interruption of breathing is called apnoea. During apnoea, there is no movement of the muscles of inhalation. Depending how block the airways are they may not be a flow of gas between the lungs and environment.

With obstructive sleep  apnoea, a person stops breathing for a least 10 seconds but the body attempts to breathe. A person may wake up with a startle or jerking or increased tossing.

If left untreated, obstructive sleep  apnoea can cause

impotence

memory loss 

lung hypertension

stroke

headache

heart attacks

arrhythmia

diabetes

fatigue

drowsiness

hypertension

obesity

Snoring is a sign of sleep apnoea and should be taken seriously. There is a need for dentists to treat sleep apnoea by helping to diagnose the problem and to refer a patient to sleep position. Dentists have the chance to save lives or improve the quality-of-life.

An intraoral appliance is a well-recognised form of treatment. This is provided by the dentist on prescription by the sleep physician.

If you snore, perhaps you should consult us for guidance to treat the problem.

DR. G KAPLAN

Tel:  083 391 2281

We hear this question quite often, especially from busy patients who don’t want to spend any more time in a dentist’s chair than they have to.

While many of our patients do take very good care of their teeth, everyone can benefit from professional teeth cleaning from a dentist or dental hygienist.

Brushing and flossing can remove the plaque and cavity-causing bacteria that build up on your teeth, but it cannot always remove all of plaque. In time, plaque can harden into tartar that brushing and flossing cannot remove.

Crusty deposits of tartar make it difficult to remove plaque and bacteria.

Plaque and tarter can also destroy the hard enamel the layer of teeth, which can, in turn, lead to tooth sensitivity and cavities.

Tartar and bacteria below the gum line can cause serious gum disease and even tooth loss. Tartar, bacteria, plaque, gum disease and tooth decay can also give you bad breath.

Gum disease can even increase your risk of heart disease and stroke.

While brushing and flossing is important, they cannot remove plaque and tartar as well as professional teeth cleaning.

During a professional cleaning, your our hygienist, Nicole will use tools unavailable to you, such as a scaler, to remove plaque and tartar before they cause problems. She will also use special techniques to clean in between your teeth and those hard-to-reach spots at the back of your mouth.

Professional dental cleanings also make your teeth look and feel their best. During professional teeth cleaning, our hygienist cleans your teeth with a high-powered electric brush and special gritty toothpaste, which removes tartar and polishes your pearly whites. Professional teeth cleanings also freshen your breath and brighten your smile.

Finally, Nicolle, our wonderful and gentle hygienist can detect hidden dental problems during your teeth cleaning. Early detection and treatment of common dental issues typically lead to better outcomes.

You need professional teeth cleaning for a variety of reasons, from improving your oral health to giving you a great smile.
 

Sleep, when the body and mind are at rest, is a time to rejuvenate the body and organise the mind. In normal sleep, body temperature decreases, breathing rate slows and blood pressure decreases, before returning to a normal state upon waking.

Breathing needs to be constant and steady to allow proper oxygenation of the body.

When this breathing is interrupted, changes take place in the body. This interruption of breathing is called apnoea. During apnoea, there is no movement of the muscles of inhalation. Depending how blocked the airways are, there may not be a flow of air between the lungs and environment.

With obstructive sleep apnoea, a person stops breathing for a least 10 seconds but the body attempts to breathe. A person may wake up with a startle or jerking or increased tossing.

If left untreated, obstructive sleep apnoea can cause

  • Image Credit: Dental Sleep Medicine Basics (Mark Collins, DDS)

    Impotence

  • Memory loss
  • Lung hypertension
  • Stroke
  • Headache
  • Heart attacks
  • Arrhythmia
  • Diabetes
  • Fatigue
  • Drowsiness
  • Hypertension
  • Obesity

How Dentists Can Help With the Treatment of Sleep Apnoea

Snoring is a sign of sleep apnoea and should be taken seriously. There is a need for dentists to treat sleep apnoea by helping to diagnose the problem and to refer a patient to sleep physician. Dentists have the chance to save lives or improve patients’ quality-of-life.

An intraoral appliance is a well-recognised form of treatment. This is provided by the dentist on prescription by the sleep physician.

If you snore, perhaps you should consult us for guidance to treat the problem. Please contact our practice for a convenient appointment: 011 483 2281.

Why Snoring In Children Should Never Be IgnoredSnoring in children is the clearest symptom of obstructive sleep apnoea in children, a condition which presents differently in children when compared to adults. Even though sleep apnoea affects middle aged men more than any other demographic, it is often undetected amongst children. And that’s quite surprising when you consider that between 3 and 12% of children snore, and 1-3% of children have obstructive sleep apnoea.

If your child is going for dental check ups every six months, your family dentist probably has the best opportunities to inspect and screen your child for sleep apnoea.

What Are The Causes Of Sleep Apnoea In Children?

Sleep apnoea is common in children who have swollen, infected tonsils and adenoids, but it may also be caused by allergies and developmental defects.

Examples of developmental defects may include

  • Narrow air passages
  • Low muscle tone in the mouth or upper airway
  • Under-developed maxilla (upper jaw)

What Are The Symptoms Of Sleep Apnoea In Children?

The symptoms of sleep apnoea in children may present slightly differently to adults. Adults tend to put weight on because of the hormone fluctuations that take place. By contrast, children are more likely to present with poor physical development and may struggle to put weight on.

Some common symptoms of sleep apnoea in children include

  • Sleepiness and fatigue during the day
  • Pauses in breathing during sleep
  • Concentration problems
  • Breathing through the mouth
  • Short or poor attention span
  • Wetting the bed
  • Issues with behaviour
  • Poor physical development and difficulty with weight gain

As you may have observed many of these symptoms overlap with other conditions, or may have been misdiagnosed in the past. A thorough examination and monitoring is required to ensure an accurate diagnosis is made, and a sound treatment plan is developed. Managing sleep apnoea early on can help to prevent the development of chronic health conditions later in life.

To find out more about treatment options or screening for sleep apnoea in children, please contact our practice for the most convenient appointment: (011) 483 2281

Prevention Is Better Than Cure

Baby teeth are fundamentally important because they are an integral part of the growth and development of the mouth and jaws. The baby teeth are a precursor of the permanent teeth which start to appear in the mouth at about the age of 5 to 6.The permanent teeth erupt by causing the roots of the baby teeth to resorb. That is why the baby teeth become loose and it is so exciting for a young child to know that the mouse is on its way.

I see so many patients who have grown up without having the knowledge to look after the primary teeth and therefore the permanent teeth. The result is unnecessary tooth decay which needs to be treated with fillings. There is no filling in the world that will adequately restore the tooth to its original state and form. The reality is that teeth are designed to last for lifetime with proper care. The one problem that may develop is an orthodontic one in which the crooked teeth may have to be treated with definitive orthodontics. Here genetics also plays a factor.

The most important factor to emphasise to pregnant women in particular is the great advantage of breastfeeding and not the bottle. The reason for this is that the young baby’s mouth adapts to the shape and form of the mother’s breast. This close adaptation allows the muscles of the mouth to move in such a way that it enhances the normal growth and development of the jaws. This is a very important fact that most mothers don’t know about and should be greatly emphasised, certainly when the mother  is pregnant and not feeding yet. It is good to have the knowledge in anticipation.

Giving candy to a child should be a no-no. I know that this is very difficult to prevent. I see it with my grandchildren as well and they have developed cavities. The prolonged sucking of sugar sweet should be avoided. The limiting of time that the mothers exposed to sugar is important. Thus if possible after eating a sweet, the child should be encouraged to rinse with water.

Another important fact is that a young child should be watched to see that they are breathing through their nose and not the mouth. Mouth breathing is a potential problem in the growth and development of young child. An Ear Nose Throat (ENT) specialist should be consulted.

 All children love sweets. It is a fact of life. To keep them away from sweets is almost impossible. It’s part of being sociable with one’s little friends.

Let me share with you what happened to my grandson and great grandniece.

Both my daughter and niece called asking for help. They said that their children were kept up at night with toothache.

Both children are six years old, and a clinical examination on both of them revealed deciduous (baby) teeth ravaged by decay.

Deciduous teeth play a vital role in a child’s dental development. They are the precursor to permanent teeth and hold the space in the jaw for the permanent teeth to erupt from then on until the age of approximately 12. They are precious and need to be looked after appropriately.

That means regular brushing and fluoride treatment. The consumption of sugary sweets needs to be kept to a minimum. Parents have a responsibility.

Children need to be introduced to a dental office at an early age. It is suggested to bring them in regularly from the age of two just to have a ride in the chair and experience the fun. That takes the fear away and certainly encourages parents to look after their precious baby teeth.

 The only way to treat these children was with the help of conscious sedation. A specialist anaesthetist was brought into the rooms. He set up with all his dedicated equipment and was able to allow me, while each child was comfortable and sleeping, to work. I was able to do all the necessary restorative treatment to bring their mouths back to good health.

The purpose of conscious sedation is to produce a state of relaxation and pain relief using the appropriate medication to facilitate performing minor procedures.

Besides facilitating the necessary treatment, the child wakes up with no recall of the experience and no long-term fear of visiting a dentist in the future. How many people do you know who dread coming to the dentist because of being poorly handled as a child?

Both children now have healthy, decay-free mouths that need to be properly looked after from now on.

Perhaps you know of children who may need the service. Please feel free to call. We would love to help.

 

 Tooth decay is the most common cause of tooth loss in young people, whereas gum disease (periodontal disease) is the most common cause for tooth loss in the elderly.

Although every effort is made to keep a patient’s teeth, sometimes it is unavoidable, and the teeth need to be extracted.
It is now widely accepted that implant prostheses are a great improvement over conventional denture. Unfortunately, millions of individuals can’t afford fixed prostheses and therefore most are still wearing conventional dentures.
When this happens, there are many ways to replace the missing teeth ranging from extensive (and expensive) implant dentistry to complete upper and lower dentures. The complete denture treatment becomes a practical and affordable solution.
The complete dentures are made of acrylic (special plastic).


They rely on the soft tissue and bone in the jaw for retention and support. For many people this works adequately.
However, when there is extensive bone loss in the jaws construction of dentures is much more difficult. Good fit and retention are often very difficult to achieve. Bone loss is usually more pronounced in the lower jaw leading to an unstable lower denture. Generally speaking, the upper denture is less problematic.

Patients without natural teeth are often compromised because of the looseness of their teeth; lack of suction and stability because of their extensive bone loss. The wearing of dentures does not become a pleasure for many people.

Loose and unstable dentures can be managed by placing implants. These implants are strategically placed to support the denture. In so doing there is a vast improvement in the ability to chew foods and gain more retention, stability and support. Such a modified denture is referred to as an overdenture. Like other dentures, overdentures are removable.

This is where implants make a world of difference.

Eating replenishes the body’s nutrients facilitating the maintenance of body composition. Chewing is the first step in this process and prepares a bolus of food for the alimentary tract. The enjoyment of the food is highly dependent on the functioning dentition. A healthy mouth influences diet and nutrition.

Like conventional dentures, one’s facial appearance and smile is improved.

Two-implant overdentures provide patients with increased satisfaction and quality of life. In addition, these simple implant overdentures have been shown to significantly improve the nutritional state of elderly patients.

In broad outline, the treatment protocol involves first making comfortable dentures and then using those dentures to guide the implant positioning. The implants are placed either by an oral surgeon or periodontist. There is a waiting period of several months for the implant to integrate into the bone. Thereafter the denture is then connected to the implants with special attachments. This treatment will give you comfort for many years.

Maintenance of the dentures with effective cleaning is essential as well as careful brushing of the implant connections.

You will really appreciate the difference in the quality of life that overdentures provide.

The teeth, the gums and the bone all function as a unit and all need to be kept healthy all the time. They are all susceptible to the ravages of plaque.

The teeth may develop dental decay and need filling; Caps may be ill-fitting and unsightly; teeth may need to be replaced. The treatment of these challenges is the field of the prosthodontist.

The gums may become swollen, red and inflamed.

The bone may start to erode under the gums.

The treatment of gums and bone and implant placement is the field of the periodontist.

Both the prosthodontist and the periodontist are able to diagnose these changes and recommend the appropriate approach to restoring long-term dental health.

What are the benefits of the prosthodontist and the periodontist working so closely together?

  • Joint diagnosis and treatment planning. The ideal prosthodontic treatment plan based on a sound periodontal foundation.
  • The ease of access of one to the other to your benefit. No need for long distance planning nor a long wait for the next appointment.
  • Close collaboration in the placement of implants in the correct and appropriate position.
  • The choice of implant system
  • Saving you time and expense
  • and many more reasons…

Comprehensive dentistry is multidisciplinary . The best practices seek to provide this service and we strive to do the same. It is all about having the best team.

Dr Rakesh Chandran , periodontist and I as the prosthodontist, work together as a great team to offer you world-class dentistry right here in Johannesburg .