Spotlight Nick Mohindra BDS – the man behind Oralift · Added Dimension Dentistry, the practice...
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www.dental-practice.org 44 October 2010 Spotlight Nick Mohindra BDS – the man behind Oralift C URRENTLY the results from treatment using Oraliſt are mostly anecdotal, but they are really quite striking. Photographic evidence taken at Added Dimension Denstry, the pracce where the treatment is administered, indicates that facial aesthecs are improved, almost as if the youthful vitality has been restored. The face can look younger and even the shape of the eyes change, plus they look clearer and take on more of a sparkle. An interesng point to note about Oraliſt is that its inventor, Dr Nick Mohindra, was not looking for these effects when he devised the treatment; he was looking for a way to increase lower facial height for paents requiring dentures and to treat paents suffering muscular pain. Dr Mohindra’s interest has been the treatment of condions such as TMD and bruxism for some me now, and he has created a system that helps him understand what is happening with the muscles in the face and where the clenching impulse originated. “I find it quite strange,” he said, “that despite increased awareness of the harm caused by clenching the teeth and grinding, a GDP doesn’t just turn to their paents and tell them to stop. We treat the symptoms but don’t address the causes. “Bruxism is not a disease, it is a habit. We have to give paents some tools to help them to stop, such as an appliance to increase the freeway space and a biofeedback system to help them stop the habit.” His first scienfic paper on the use of the pivot appliance to build up the height of the lower face and prepare paents for dentures was published in 1996 and demonstrated that “in edentulous people, lower facial height could be altered by as much as 20mm”, something previously unheard of in the profession. Interested in alteration Dr Mohindra had become interested in the subject of altering the dimensions of the lower face, and he was doing it without surgery or complex manipulaons. When he applied this knowledge to the treatment of fully dentate paents using his new Oraliſt device, he was confronted with the fact that his treatment was resulng in visible an-ageing effects (which he describes as self-rejuvenaon) and it was doing so across a very wide age spectrum. Dr Mohindra proves well grounded when talking about his patented appliances and treatments: “Theories are all to the good but science needs to be based on measurable, observed results and clinical trials. What we have here are a number of anecdotal results and observaons, but they need to be proven and we would be grateful if somebody was to come forward and help with this. “We are in discussion with some research facilies already about clinical trials and we hope more researchers will become interested in this field.” The relaonship between the shape of the face and posion of the lower jaw, the balance of it, can affect the enre posture of the body and may demonstrably be responsible for some physical distress such as earache, neck pain or even migraine. It is the muscles of the face when adapng to different jaw posions that seem to be producing the an- ageing effect. Lower facial height can reduce with age, and in addion to this we see the inverted “ageing triangle” of drooping jowls, sagging eyes and deep grooves from the nose to the jaw, and as a result we see what we perceive as an old face. Oraliſt seems to be effecve in reversing some of the effects of this facial sag, and the results are measurable. Five areas of observation Before starng the Oraliſt treatment, Dr Mohindra and his team will take note of and then monitor five observable aspects of the paent’s face, which are called the SCALE. These are: S: Shape of the face C: The complexion A: The ageing triangle L: The lips E: The eyes All of these aspects can show improvement aſter just weeks of treatment, while longer-term results show an apparent connuous improvement, even with paents in their 80s. Interesngly, if a paent stops the treatment for whatever reason, their faces will not revert to the condions seen at the start, so Oraliſt might be seen as a kind of facial gym – when used at regular intervals it seems to reduce the signs of facial ageing and even slow down the ageing process on the face. What the appliance does is encourage the jaw to rest in a new posion, increasing the freeway space between the posterior teeth to the point that the brain begins to recognise a new, opmum relaxaon state. In bruxers this space is very small due to clenching and the paent’s overall muscle tone. The face becomes cramped and bunched up, the lips are thinner and the paent may become more aware of occlusal problems. The paent will tend to clench connuously and grind at night, with all the resultant wear and cracking of their teeth. The common answer to this problem is to use a rubber or hard acrylic splint, but Dr Mohindra is worried that all this does is to incite the paent to bite down on it during their sleep and thus exacerbate the problem rather than solve it because, although the damage is now being done to the splint rather than the teeth, the muscles are sll suffering. Oraliſt introduces a staged programme of treatments designed to open that freeway space, relax the facial muscles into a new and beer posion and disincenvise the grinding urge, with potenally posive effects across the enre body. As soon as the process of adaptaon starts, matrix metalloproteinases (MMPs) are released. MMPs are endopepdases that are capable of degrading all kinds of extracellular matrix proteins, but also can process a number of bioacve molecules and are known to be involved in the cleavage of cell surface receptors. MMPs are also thought to play a major role on cell behaviour, proliferaon, migraon, adhesion and dispersion as well as differenaon, angiogenesis, apoptosis and host defence. In other words, MMPs are part of the body’s system that help to keep its cells young and healthy and they also repair damage. Two appliances The Oraliſt treatment requires that two appliances with different heights of spacer on them be placed in the mouth for increasing periods of me, working up to an hour-long session twice a day, every three days. What Dr Mohindra asks is that we imagine micro traumas happening in the facial musculature while the appliance is in use, and these heal into new, beer posions during the Before and aſter Oraliſt Fing the Oraliſt device What the appliance does is encourage the jaw to rest in a new position, increasing the freeway space between the posterior teeth to the point that the brain begins to recognise a new, optimum relaxation state. 10october.indd 44 9/22/2010 1:28:49 PM
Transcript of Spotlight Nick Mohindra BDS – the man behind Oralift · Added Dimension Dentistry, the practice...
www.dental-practice.org
44
October 2010
Spotlight
Nick Mohindra BDS – the man behind Oralift
CURRENTLY the results from treatment using Oralift are mostly anecdotal, but
they are really quite striking. Photographic evidence taken at Added Dimension Dentistry, the practice where the treatment is administered, indicates that facial aesthetics are improved, almost as if the youthful vitality has been restored. The face can look younger and even the shape of the eyes change, plus they look clearer and take on more of a sparkle.
An interesting point to note about Oralift is that its inventor, Dr Nick Mohindra, was not looking for these effects when he devised the treatment; he was looking for a way to increase lower facial height for patients requiring dentures and to treat patients suffering muscular pain.
Dr Mohindra’s interest has been the treatment of conditions such as TMD and bruxism for some time now, and he has created a system that helps him understand what is happening with the muscles in the face and where the clenching impulse originated.
“I find it quite strange,” he said, “that despite increased awareness of the harm caused by clenching the teeth and grinding, a GDP doesn’t just turn to their patients and tell them to stop. We treat the symptoms but don’t address the causes.
“Bruxism is not a disease, it is a habit. We have to give patients some tools to help them to stop, such as an appliance to increase the freeway space and a biofeedback system to help them stop the habit.”
His first scientific paper on the use of the pivot appliance to build up the height of the lower face and prepare patients for dentures was published in 1996 and demonstrated that “in edentulous people, lower facial height could be altered by as much as 20mm”, something previously unheard of in the profession.
Interested in alterationDr Mohindra had become interested in the subject of altering the dimensions of the lower face, and he was doing it without surgery or complex manipulations.
When he applied this knowledge to the treatment of fully dentate patients using his new Oralift device, he was confronted with the fact that his treatment was resulting in visible anti-ageing effects (which he describes as self-rejuvenation) and it was doing so across a very wide age spectrum.
Dr Mohindra proves well grounded when talking about his patented appliances and treatments: “Theories are all to the good but science needs to be based on
measurable, observed results and clinical trials. What we have here are a number of anecdotal results and observations, but they need to be proven and we would be grateful if somebody was to come forward and help with this.
“We are in discussion with some research facilities already about clinical trials and we hope more researchers will become interested in this field.”
The relationship between the shape of the face and position of the lower jaw, the balance of it, can affect the entire posture of the body and may demonstrably be responsible for some physical distress such as earache, neck pain or even migraine.
It is the muscles of the face when adapting to different jaw positions that seem to be producing the anti-ageing effect.
Lower facial height can reduce with age, and in addition to this we see the inverted “ageing triangle” of drooping jowls, sagging eyes and
deep grooves from the nose to the jaw, and as a result we see what we perceive as an old face. Oralift seems to be effective in reversing some of the effects of this facial sag, and the results are measurable.
Five areas of observationBefore starting the Oralift treatment, Dr Mohindra and his team will take note of and then monitor five observable aspects of the patient’s face, which are called the SCALE. These are:S: Shape of the faceC: The complexionA: The ageing triangleL: The lipsE: The eyes
All of these aspects can show improvement after just weeks of treatment, while longer-term results show an apparent continuous improvement, even with patients in their 80s.
Interestingly, if a patient stops the treatment for whatever reason, their faces will not revert to the conditions seen at the start, so Oralift might be seen as a kind of
facial gym – when used at regular intervals it seems to reduce the signs of facial ageing and even slow down the ageing process on the face.
What the appliance does is encourage the jaw to rest in a new position, increasing the freeway space between the posterior teeth to the point that the brain begins to recognise a new, optimum relaxation state.
In bruxers this space is very small due to clenching and the patient’s overall muscle tone. The face becomes cramped and bunched up, the lips are thinner and the patient may become more aware of occlusal problems. The patient will tend to clench continuously and grind at night, with all the resultant wear and cracking of their teeth.
The common answer to this problem is to use a rubber or hard acrylic splint, but Dr Mohindra is worried that all this does is to incite the patient to bite down on it during their sleep and thus exacerbate the problem rather than solve it
because, although the damage is now being done to the splint rather than the teeth, the muscles are still suffering.
Oralift introduces a staged programme of treatments designed to open that freeway space, relax the facial muscles into a new and better position and disincentivise the grinding urge, with potentially positive effects across the entire body.
As soon as the process of adaptation starts, matrix metalloproteinases (MMPs) are released. MMPs are endopeptidases that are capable of degrading all kinds of extracellular matrix proteins, but also can process a number of bioactive molecules and are known to be involved in the cleavage of cell surface receptors.
MMPs are also thought to play a major role on cell behaviour, proliferation, migration, adhesion and dispersion as well as differentiation, angiogenesis, apoptosis and host defence. In other words, MMPs are part of the body’s system that help to keep its cells young and healthy and they also repair damage.
Two appliancesThe Oralift treatment requires that two appliances with different heights of spacer on them be placed in the mouth for increasing periods of time, working up to an hour-long session twice a day, every three days.
What Dr Mohindra asks is that we imagine micro traumas happening in the facial musculature while the appliance is in use, and these heal into new, better positions during the
Before and after Oralift
Fitting the Oralift device
What the appliance does is encourage the jaw to rest in a new position, increasing the freeway space between the posterior teeth to the point that the brain begins to recognise a new, optimum relaxation state.
10october.indd 44 9/22/2010 1:28:49 PM
www.dental-practice.org
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October 2010
rest periods, which after eight to 10 months will have trained the tissues into a younger, firmer state. He wonders if perhaps stem cells in the muscles are responding positively to an improved environment.
The treatment starts by ascertaining the state of the muscles in the patient’s face. This is done by a “tick test”, which is the biofeedback component of the treatment.
Briefly, the tick test is a quick exercise, which helps Dr Mohindra to measure the ability of the patient to create a new freeway space with the appliance in place, while at the same time teaching the patients how to monitor this space for themselves when they continue treatment at home. The appliance should not at any point cause any pain, though it may be uncomfortable initially.
Dr Mohindra explains: “People have differing tolerances; a long-term bruxist might just have to keep to 15-minute sessions for that while longer before they can move on to the longer periods, but the long-term benefits speak for themselves.
“Younger looking, healthier skin, a firmer jaw line, an improved smile window changing from oval to classic, fuller lips and up-tilted eyes are just some of the results we have observed in patients that have had the treatment, and the boost to self-confidence becomes self-evident.
“These demonstrated results with the appliance are based on the body’s natural responses and its ability to heal itself, and the results look a lot more natural than other more artificial treatments such as surgery or injections.”
Right now Dr Mohindra and his team are encouraging orthodontists to see if Oralift could be a practical way forward and perhaps be used before orthodontic treatment starts.
He explains: “When we change the facial relationship, the mandible’s relationship with the maxilla is interlinked with lower facial height. Perhaps proper balance between
the maxilla and mandible should be our aim before fitting braces or aligners. This is also very important with cosmetic work because just to restore facial form by increasing the size of the teeth will throw the weight of stress elsewhere.”
Based on the results of treatments and studying photograph after photograph looking for SCALE improvements, there would seem to be a very good case for making this non-invasive, drug-free, completely natural treatment more widely available.
Dr Mohindra is already running courses to teach other dentists to be able to provide this kind of treatment in their surgeries, and slowly but surely a network of Oralift trained dentists is emerging across the UK and overseas.
Clinical trials are an essential part of proving the results and establishing the science without resorting to the media buzz terms of “miracle” or “regained youth”.
Something very interesting is happening in Dr Mohindra’s practice: shouldn’t research right now be 3M_98B Lava Loyalty Ad_A4.pdf 12/5/10 11:03:17
READER ENQUIRY DP 132
Dr Mohindra with his wife – and practice manager – Fran
seeking out the causes and longer-term implications, for the patients’ sake? Indeed, what other benefits might be uncovered?
10october.indd 45 9/22/2010 1:28:57 PM
