Practice Philosophy Archives - Prosthodontist in Johannesburg
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Practice Philosophy

Advice from a Prosthodontist For Your Long-Term Dental Health

You have just seen the dentist for a specific problem and now after asking for an assessment of the rest of your mouth, you are told of the need for much dentistry to provide you with long-term dental health. That is a shock in itself especially when everything else feels fine. And then, on top of it all, comes the cost.

We all want sound, beautiful teeth that will last a lifetime without having to be faced with unexpected dental crises.

Let’s be realistic. Restorative dentistry and implant dentistry are elective procedures which can be planned and done over time. There is no need to approach the treatment without careful thought and understanding. It is not a matter of ‘drill, fill, bill’.

We are not talking about an immediate problem like a broken tooth or an abscess. These have to be taken care of immediately but how does one prevent such problems from happening in the future and preserve one’s long-term dental health? That is what good prosthodontic dentistry is all about.

A broken tooth or an abscessed tooth needs to be treated with a long-term solution in mind. There are treatment choices to consider as part of a solution for long-term dental health. Many times the decision does not have to be made immediately but you, the patient can be given the opportunity of reviewing the options without any pressure of time. It is possible to provide relief of pain and comfort promptly and then set about establishing a long-term dental plan. Know and understand that good dentistry is a wonderful long-term investment.

Go ahead and establish your long-term dental health needs now. Understand the commitment to time, effort and expense but also understand that a holding situation is oftentimes practical and feasible. Good dental care is important but usually not urgent.

The most important factor in long-term dental health is to keep your teeth free of plaque with effective daily brushing and flossing.

Regular professional cleaning and effective home care are essential to prevent any further deterioration whilst preparing to undertake extensive treatment. A holding situation in anticipation of extensive treatment is a very practical approach in achieving a long-term goal and is cost effective.

Don’t neglect your teeth and allow problems to become worse. Seek a specialist opinion from a prosthodontist now and plan accordingly. Be a partner with us in helping to look after you.

We would love to help you keep your teeth a lifetime. Let us plan together. Give us a call.

Choosing a good dentist

Choosing anything be it a service or commodity can oftentimes be a daunting task.

A commodity is easier to choose.

You know what you want and you know what your price range is. You can actually feel and see the article that you are buying in making your choice. Finding the shop to go to is challenging. The lead may be an advert in a newspaper, magazine, radio advert or word-of-mouth. How far does one have to travel to reach the shop and what guarantee is there that the article is in stock? A telephone call can help.

Services are very different.                                                                                    

I know the story of somebody who entered into a business association based on an agreement that was drafted by an “experienced” lawyer. On presentation the agreement ostensibly covered all eventualities and was signed. The financial manager was duly appointed. Several years went past with the relationship based on the agreement working well until there was a takeover of the business. Now the new owner was faced with making staff changes. To his great surprise the financial manager found himself retrenched. The agreement was flawed. It had a loophole.

What is experience?

Is it perhaps doing the wrong thing year in year out? Sometimes it works, sometimes it doesn’t and when it doesn’t, the disappointment is real. Experience means knowledge and expertise. It doesn’t necessarily mean years on the job.

And what about fees for professional services? A patient once told me that his father said “whatever the professional asks for, just pay!”

How’s that for an undertaking. But there was a proviso. You have the right to choose the professional and once that choice has been made, relax with confidence.

So how do you go about choosing a good dentist?

  • Is it based on the appearance of the office?
  • The friendliness of the staff?
  • The way the telephone was answered?
  • The modernness of the equipment?
  • Whether an x-ray apron is used?
  • The location and adequate parking?
  • Good sterilisation of instruments?
  • The lightness of touch?
  • A painless injection?
  • Effective anaesthesia?
  • Good people skills?

All these are things that one can feel and see but dentistry is different. You cannot see what the dentist is doing. It is totally blind!

And so the question remains, how do you choose a good dentist?                      

Let me tell you another story which I’m sure you will enjoy.

The owl and the peacock were having an argument as to who was the most beautiful bird in the world. The owl said “I am” and the peacock said “I am “. They agreed to resolve the argument by consulting the first animal that they met in the forest and whoever won would bite off the other bird’s tail. Off they went and came upon the wild boar. They asked him to judge the case and eagerly awaited his opinion.

In my opinion said the pig, having thought for a while, “It is the owl”.  The owl rightfully bit off the peacock’s tail and the peacock ran out of the forest crying bitterly and uncontrollably.

The peacock then came across the wise old fox and she told him the story. Said the fox sagely and compassionately, “Look whose opinion you asked”. On what basis is word-of-mouth established?

I asked a periodontist colleague his valued opinion in choosing a good dentist and this is what his patients have told him: –

From the perspective of a layperson I think the primary motivation to select a dentist is the testimonials from other patients of the dentist. Another factor patients look at is the qualifications of the dentist and the institutions from which they were obtained. Affiliations to groups or bodies are also looked at. Patients also look at number of years in practice. If one has a website, patients like to look at photos of work done by the dentist.

Word-of-mouth is very powerful, but consider this…

In the South African Dental Journal March 2016,Vol71 Dr S Naidoo, senior professor and principal specialist, faculty of dentistry, University of Western Cape writes the following:-

The profession of dentistry has both benevolent and protective aspects with regards to duty of care to patients, to always try to do the best for patients and shall for the principles of non-maleficent’s – to do no harm. This principle expresses the concept that professionals have a duty to protect the patient from no harm.

General dentists are usually the first professional patients visit, seeking an evaluation of the oral and dental needs. The general dentist may then treat the patient or may refer the patient for speciality care depending on the conditions which have been assessed and diagnosed. This is because amongst general dentist there are differing levels of expertise, exposure to postgraduate training, and confidence in undertaking treatment of more advanced dental conditions. Whenever necessary, timely and appropriate referral is an ethical imperative which fulfils a professional duty to a patient.

The general dentist is expected to recognise when specialist care is more appropriate to the patient’s needs and completion of the treatment plan and should then refer appropriately.

Interestingly, general dental practitioners are entitled to carry out all dental procedures including those falling within the scope of specialists (provided they have the training).

Now, having made the choice of dentist by whatever criteria, are you satisfied that time has been spent on listening carefully to your past dental history?  Has the initial consultation included gathering of all the diagnostic records needed to formulate a comprehensive diagnosis and treatment plan?

Has a subsequent planning appointment taken place to empower you as the patient to make an informed decision and evaluate the possible treatment options?

The choice is yours… Choose wisely.


It is quite amazing how many people take their teeth for granted!

Everybody wants a beautiful smile with sound healthy teeth. That does not happen just by itself.

As I have written many times, the dental care starts from childhood with parental responsibility and guidance to the young child on how to look after their teeth. Effective brushing and plaque control together with a controlled sugar-free diet is a key to long-term dental health.

Unfortunately teeth sometimes do decay and a restoration is indicated.

What is the appropriate restoration to use?

There are choices of materials to use and each has their pros and cons. This decision needs to be made together with the dentist so that you as the patient can choose appropriately. No filling can last a lifetime but some materials are certainly better than others. The short-term expense should not be a consideration for long-term benefit. Cheap is expensive.

Dentistry is blind. The patient has no idea what the dentist is actually doing nor has the patient any control on the procedure being performed. Has there been a planning appointment designed to discuss and empower the patient prior to the commencement of treatment.

Once treatment has been completed:-

  • Has the appropriate material been chosen?
  • Has the tooth been adequately prepared?
  • Has the tooth been restored to its original anatomy or just filled?
  • Has the filling been properly placed?
  • Is there an open contact?
  • Is there post-operative sensitivity?
  • Is there an ill- fitting margin that will set the tooth up for recurrent decay
  • Is the technical work of the highest standard possible?
  • How many times will the filling need to be replaced in a lifetime?
  • Are the gums now in a healthy state ?
  • Can the restored teeth be adequately kept plaque free?

These are real questions that have an impact on long-term dental health.

So what can you do about it? Is it possible to check. The answer is yes.

It is suggested that you visit a prosthodontist for his assessment and evaluation. This is the way to possibly avoid unnecessary long-term problems the treatment of which may involve a commitment to time, effort and expense.

Have the work done right the first time. Please us a call. You will certainly be coming to the right place.


It is ALL About the patient- Part 2


Your mouth belongs to you and nobody else. It is your private domain and only you know how it looks, feels and functions. It’s only you who is aware of something wrong if there is pain or discomfort. The ownership is yours.

We ask you the questions

  • how does your mouth feel
  • what do you value most about your teeth
  • do you want to chew comfortably
  • do you want them to function well
  • looking ahead 5 to 10 or even 15 years down the line, what you hope your teeth will look like
  • what role does prevention play for you when it comes to your mouth
  • is the extent of treatment limited by third-party providers

These are your unique and personal wants and desires .We as dentists are here to provide solutions to these wants and desires. It’s also our professional duty to make you aware of your dental needs and help you address them.

As I said in my previous article, many dental problems are painless but nevertheless require attention, sometimes immediate and sometimes they can be delayed. How these problems are dealt with in terms of time, effort and expense is your choice .These choices need to be discussed in a treatment planning session. There are options which have differing outcomes and differing costs. This is an important and essential appointment.

As one of my teachers once said; “Inform before you perform”. The success of treatment is in the planning and the skill of the operator and what you choose to have done.

Your trust in us is implicit and there needs to be value for the service. You really do not know what technical issues we face. You don’t want to know what type of impression material we use; nor what lining material is chosen; nor what luting cement is based. You rely on us that the impression is accurate and that the final restoration fits accurately and is of high quality-no leaking margins; no food trap. The competence of the dentist is taken as given.

No patient is interested in the selection of instruments used; the make of the compressor; or with a high velocity suction machine is located. The patient just wants to know that the dentist is adequately equipped and trained for the task at hand.

Your whole dental experience is based on how you feel. Was the staff pleasant? Was the Dr on time? Was the restroom clean and tidy? Did the injection hurt? Were the magazines fresh and up-to-date? Was the dental assistant efficient and empathetic? Did you appreciate the quality of the service? Were there cobwebs on the corners of the walls? Was the background music pleasant? Was practice accessibility and parking easy?

And so how do you value the service?

Are you limited by your medical aid third-party contribution or are you willing to pay a fee that is reasonable and fair and does not compromise your long-term expectations. They have no long-term interest in your dental health. Do you want to be dictated to by a disinterested third party?

Not only is dentistry a science but it is an art. Consummate skill, adequate time,and much effort are all needed to serve you well.

Dentistry today offers an array of wonderful solutions which are tailor-made to you. The choice of materials and treatment options is large.

What value and benefit to you place on experience? What value do you place on art and what price are you prepared to pay for a unique service?

Did you feel the benefit and are you happy to refer your friends and family?

We want to see you for regular maintenance visits to ensure long-term results.

Enjoy healthy and easily maintainable teeth.

Why not share a good thing with others?

By: Dr Gerald Kaplan

What to do you value most about your teeth?

Do you want them to look good?

Do you want to be able to chew comfortably?

Do you want them to function well?

Looking ahead 5, 10 or15 years down the line what you hope your teeth will look like?

What role does prevention play for you when it comes to your mouth?

The good news is that fine dentistry can offer excellent solutions that will help you accomplish your long-term goals beautifully.

A detailed clinical examination will many times reveal problems which are generally pain-free but yet need to be dealt with to provide long-term dental health

Nobody feels an overhanging margin; a leaking restoration; a failing root canal; a large defective amalgam or composite filling; a root treated tooth, a tooth that has not been crowned; and even quite simply early dental decay!

What are the long-term consequences of unattended pain-free problems?

  • An overhanging margin is the precursor of periodontal disease. Periodontal disease is caused by the accumulation of plaque. The overhanging margin is a plaque trap and is uncleansable with regular flossing. The long-term consequence is the onset of periodontal disease and bone loss.
  • A leaking restoration will lead to the development of dental decay. If detected early, the tooth can be restored with a conservative restoration and not an extensive or expensive alternative.
  • A failing root canal is oftentimes and symptomatic but yet can lead to the development of an abscess at any time. Regular x-ray examination oftentimes reveals a host of problems.
  • A root treated tooth must be restored with appropriate restoration to protect the underlying tooth material to prevent tooth fracture.
  • Dental decay should be detected early on long before the tooth becomes symptomatic. Regular x-ray examination is essential.

The clinical situation that exists in one’s mouth extends from simple to complex. The earlier a patient is taken in hand and treated appropriately, the less likely will serious problems develop.

Many patients wait until the crisis situation before seeking treatment! This crisis is often only one of a host of existing problems that need attention to restore your mouth back to long-term dental health.

Patients look forward to good dentistry from their dentist with the expectation that treatment is providing long-term benefits and eliminating any unforeseen crises. A long-term treatment plan is essential combined with regular visits to the dentist to achieve your goals.

Many complex and advanced dental problems are best handled as a collaborative exercise with the appropriate specialists. These usually include a prosthodontist, periodontist, orthodontist, and oral surgeon. Your dentist should be quite willing to refer you on for even a seemingly simple problem. The prosthodontist should in most cases be the first port of call because it is he that is able to formulate, together with his colleagues, a comprehensive diagnosis and treatment plan.

Be proactive in recognising the pitfalls of inadequate treatment that is often done under pressure of time and compromise.

Teeth are designed to last a lifetime…make sure yours do!!!


By: Dr Gerald Kaplan

Often the perception of dental treatment is skewed by fear. Who actually likes to come to the dentist? It involves time, effort and expense. By nature we procrastinate and let things go for far too long.

I had a patient in the other day requesting that his upper front tooth restored. He did not like the way he looked and he was embarrassed. He turned for help.

I asked him a very simple question: “Are you fully aware of what’s happening in your mouth”. “No”, he replied. This is a typical answer for most people because they only turn for help in crisis when  there is pain or  trauma.

The possibility of, trauma, pain, danger and lack of control is a major cause of fear.

But, this does not have to be so. The health of your mouth is so important for many reasons including chewing, smiling, and  talking.

You need to know exactly what the status of your dental health is. You deserve to have a mouth that is healthy and in which you will have continual comfort. Teeth should just belong without an awareness of their being there.

How do you gain control of your long-term dental health?

Of course it starts in seeing the dentist long before a problem develops. Most dental problems are painless and take many years to develop. In the clinical examination, if we see some teeth that aren’t hurting you at this point but could potentially pose a problem, what would you like to do about it?

Ongoing dental maintenance of a healthy mouth is low-cost. Problems can become expensive.

We offer a different dental experience by spending time getting to know you and finding out exactly what you would like to achieve before treatment starts. In dentistry today there are many treatment options. Every patient is an individual and every treatment plan should be tailor-made. In this office it is not “drill, fill, bill”.

You are special to us.

Give us a call and let’s help you change your life.

By: Dr Gerald Kaplan

The benefits of quality dentistry:

A beautiful smile

A smile doesn’t just indicate healthy teeth and gums; your dental health also plays a significant role in  how  confident you feel. Think about it… If you are self-conscious about your smile, you’re not going to feel very good about interacting with others.

Research shows that the better you feel about your looks, the better you feel about yourself. You can be more relaxed, being in the moment and able to laugh joyfully. You feel more confident and radiant.

The fact that smiling itself boosts your mood has a further positive impact because smiling has a contagious effect.” When you smile, others are more likely to smile back and are more drawn to you, thereby increasing your confidence and happiness even more. Most people are not aware of how important a smile is in how perceive them or in  how they feel about themselves “, say psychologist Ann Demarais, Ph.D

Eat with comfort

Have you ever sat  for  a meal at home or in a restaurant and had to decline the serving because of a  tooth problem ? Have you been bothered about food wedging between your teeth as you eat or had the immediate need for a toothpick? Have you had pain when eating?  How many people have you seen cover their mouths with their hand to deal with an irritating dental problem? That is not pleasant and shouldn’t be.

Boost your self-esteem and gain more confidence

Why feel embarrassed to smile and feel withdrawn and introverted? Make a positive change and feel so much better. Have a look at our “smile analysis form” and let us work together.

Avoid pain and inconvenience

Ouch! No patient wants  the pain and inconvenience of a cracked tooth. Avoiding a cracked tooth is oftentimes not rocket science. It can sometimes happen unexpectedly but most times it is preventable. A detailed clinical assessment will highlight any potential problems that need attention The goal is hasslefree long-term dental comfort. It is all in the planning.

Avoiding an abscess developing can also be nipped in the bud. Don’t wait for a crisis.

By: Dr Gerald Kaplan

There is a need, want or desire. Something has motivated the caller to make the call. The telephone number may hav…e been gotten by recommendation or the person may have taken the time and effort to surf the Internet looking for the particular procedure in mind.

Oftentimes the call has an urgency to fulfil a pressing need or may just be a spur of the moment flash.

So too with a call to our dental office. Our staff are trained to take the call and guide you.

This morning a patient called asking about laser tooth bleaching. We did not know how he had found the practice or how much you knew about the procedure. The receptionist enquired if he had researched the subject on YouTube. He was surprised to know that even laser tooth bleaching is featured on YouTube.

We told him that tooth bleaching has specific indications and is a prescriptive procedure. The natural teeth need to be in a condition for bleaching. This can only be assessed by clinical examination. In this office we offer complete dental care designed to help you keep your teeth for life. Bleaching may in fact be one of the treatment modalities needed in this case.

A simple phone call about bleaching may be the catalyst in helping you get good advice about the total health of your mouth and teeth. Teeth are designed to last a lifetime and you want them to feel good and look good.

Give us a call on 011 483 2281 for a free consultation. We will guide you in the way that you want to go. Your telephone call will certainly have been worthwhile.

By: Dr Gerald Kaplan

Many years ago at Graduate School in Boston we were taught that the patient is an integral part of the treatment process. One mustn’t lose sight of the fact that it is the patient who  is going through extensive treatment. The patient needs to be relaxed and confident that the treatment that they want will be done to their satisfaction.

The dictum taught to us was “inform before you perform”. An informed patient is essential. Informing the patient of the proposed treatment takes time and care by the dentist in ensuring that the patient fully understands what is to be done. There are many ways to explain to a patient conveying the necessary information that they need to make an informed decision. Painting a word picture or showing a diagrammatic chart  are ways  of effective communication. The patient needs to be allowed the opportunity to ask questions.

We live in an information age with access to knowledge with a push of a button. You probably landed on the site through Google but don’t forget how much more can be gained by YouTube.

How does one use YouTube to empower you to find the knowledge that you are looking for. The answer is to type in keywords like ‘implants”; “gum disease”;” dentures”; “extractions; et cetera et cetera.

Many times the videos are directed to practitioners themselves and not to the lay public. However there is much to be gleaned from YouTube.

Please feel free to contact us should you require more information to answer your questions.

By: Dr Gerald Kaplan

Dental aesthetics is a subject on which books have been written and is a topic of continuous postgraduate education at every level.

Every dentist strives to improve his skill in providing his patients with good-looking teeth be they their natural teeth or teeth that have needed to have restorative treatment.

Natural teeth present their challenge in achieving beautiful aesthetics. The treatment may involve minor adjustments; orthodontic treatment; composite restorations or even veneers.

I have a questionnaire on the website which leads you through many questions that allow a diagnosis to be made for the suitable treatment plan to be followed.

Teeth that have had previous dentistry like extensive anterior composite restoration which have now become unsightly and discoloured need their own special approach. The clinical situation determines the treatment plan.

Teeth that have been crowned and that now have a black margin around the gum can also be improved with aesthetic dentistry.

The choice of materials that are available today are so wide and again which material to use is dependent on the clinical situation. It is so important for the prosthodontist to work with a talented technician to provide beautiful anterior aesthetics when teeth are to be capped.

As in every aspect of restorative dentistry an initial consultation is the starting point of establishing exactly your wants and desires. One can take the treatment from there.

Maybe you would like to give us a call?