Predictable comprehensive dentistry

Search Dental Tribune

Predictable comprehensive dentistry

Dr Sam Kherani addresses occlusion, sleep breathing disorders and esthetics.
Dr Shamshudin (Sam) Kherani, USA

Dr Shamshudin (Sam) Kherani, USA

Thu. 10 December 2009


In performing long-lasting comprehensive dentistry, form, function, esthetics and stability are the attributes that we strive for and should for good reason. In the end, it is ‘physiology’ that informs and governs the long-term end result. In generalities, anatomy (i.e., form) gives us guidance whereas physiology determines the end result.

There have been exponential changes in how we use technology to help us witness what happens in the human body in real time, both in terms of imaging and physiological events. Coupled with that is the advancement in material science that helps us get closer to replicating nature and, at the same time, allowing such human interventions to serve us for a relatively long time.

Such advancements have been made possible by the synergies between accredited higher learning institutions, industry committed to research and development and continuing education institutions. Such synergy is the requirement for the advancement that we witness today.

The health professional also has to become a perennial student who should be given access to such information in a manner that makes it practical to use such information for the benefit for the general public.

Suffice it to say that such an environment does make it open to frivolous and unsubstantiated treatment regimens that should be monitored. In the absence of a robust policing mechanism, which would in turn be stifling, a peer-to-peer mechanism is the most efficient and practical.

Continuing education facilities provide a fertile ground for such a mechanism that fosters excellence and allows for the practitioners to gain knowledge that would help them incorporate such knowledge into practice.

This year at the Greater New York Dental Meeting (GNYDM), I discussed the theory and science behind the neuromuscular occlusion philosophy and its application in treating numerous cases that range from esthetic needs to pain management in a contemporary setting. This philosophy of treatment is predicated on measuring physiological parameters so that one can be sure that the balance within the stomatognathic system has been attained.

Another area that needs to be mentioned is the area of sleep breathing disorders that affects at least 20 per cent of the American population. The gold standard of sleep center-orchestrated sleep studies, coupled with the gold standard of prescribing CPAPs (Continuous Positive Air Pressure), is meeting with a lot of resistance such that the majority of the patients needing the treatment are not complying for various reasons.

Ambulatory sleep studies that are considered diagnostic in nature along with the delivery of mandibular advancement appliances are gaining ground as a viable alternative to the “gold standard.” Therefore, physicians and dentists are combining their abilities for the benefit of the patients needing help with their affliction.

Furthermore, there is correlation between sleep breathing disorder and the lack of balance within the stomatognathic system and, therefore, exploration within both of these areas can lead to a win-win for the patient, whereby the patient gets relief from the sleep breathing disorder as well as balance within the stomatognathic system. Suffice it to say that this body of knowledge requires further work and as time goes on, we will see more information including best practices.

In my lecture at the GNYDM, I discussed this much-ignored arena of sleep disordered breathing in the overall diagnosis leading to treatment that allows the alleviation of this harmful disorder with far reaching complications that can result in increased mortality and morbidity. Successful long-term treatment outcomes will be shared along with patient testimonials.

Finally, I would like to underscore that we, at the Las Vegas Dental Institute, offer a comprehensive series of continuing education courses that are specifically organized so you may avail yourself with all this information in an organized manner, which also allows it to be practical as we do offer live-patient treatment programs.

About the author

Dr Sam Kherani, DDS, FAGD, LVIM, is a graduate of University of Western Ontario and has been in general practice since 1981 with a special interest in adhesive dentistry. Prior to joining LVI full-time, he served as a clinical instructor at the institute as well as a regional director. Awarded fellowship from the Academy of General Dentistry and appointed Trustee of Public Colleges Foundation by the government of Alberta, Kherani is also one of 14 recipients of the coveted mastership designation from the LVI. Additionally, he serves on the board of directors of the International Association of Comprehensive Aesthetics and teaches dentists from all over the world in the latest treatments for cosmetic dentistry, full-mouth reconstruction and neuromuscular occlusion.

Leave a Reply

Your email address will not be published. Required fields are marked *