Follow Dr. Rapal and her TEAM as they share new dental research, community events and perspectives on overall emotional/physical well-being and health.
Breathing! We all do it naturally without giving it a second thought. But how many of us do it correctly? The truth of the matter is that there are millions of people amongst us who have breathing issues.
One of the significant problems created by incorrect breathing is sleep apnea. According to the American Sleep Apnea Association, approximately 22 million people, including children, suffer from sleep apnea. Various remedies have been discussed, including Continuous Positive Airway Pressure (CPAP) machines and oral appliances. But, very few solutions have focused on breathing — the correct way of breathing!
Nose breathing is optimal, as one of the primary causes of sleep apnea is mouth breathing. While mouth breathing by itself is not wrong, when the majority of your breathing is mouth breathing, it can signify problems with your teeth and facial symmetry. There is evidence that mouth breathing has adverse effects on the development of the jaw, teeth and the shape of the developing skull.
There is one person who happens to look at your teeth and your face structure regularly — your dentist! But not all dentists are well-versed in looking at breathing issues relating to sleep apnea. Most dentists have not received training in diagnosing breathing problems by just looking at your teeth, facial symmetry and physical health.
Breathing and sleep apnea problems can be caught early in children because they see their dentist more frequently. There can be significant health risks associated with sleep apnea, especially in children. In order to diagnose sleep apnea in children, your dentist should ask you questions about
- Your child’s thumb-sucking habit
- Constant nasal congestion
- Inability to play sports because the child is always out of breath
- Nose breathing vs. mouth breathing
- Uneven nostrils
- Snoring or restless sleep
- Dark circles around eyes
- Narrow long face
- Teeth crowding
- Asthma or exercise-induced asthma
- ADD or ADHD
Answers to these types of questions can help the dentist diagnose if the child is having breathing issues that could lead to sleep apnea. Children who grind their teeth may have breathing issues. It is possible that cases of ADHD or ADD stem from sleep apnea, which affects growth and development in children.
In adults, Obstructive Sleep Apnea (OSA) and Upper Airway Resistance Syndrome (UARS) are associated with cardiovascular disease, type 2 diabetes and depression. There are several factors to consider when diagnosing sleep apnea in adults, such as age, obesity, neck circumference, small or recessed chin and teeth grinding. Removal of teeth in childhood orthodontics to straighten out the jawline could also be a factor in causing obstructive sleep disorder. A knowledgeable and skilled dentist can offer suggestions and remedies that can help open the airway.
The bottom line is that the best way to address sleep apnea is by practicing nasal breathing as opposed to mouth breathing. Nasal breathing is healthier as it slows down the heart rate, allows deep sleep and helps the body switch from sympathetic to parasympathetic nervous system. That enables our body chemistry to regulate itself. You’ll feel more alert and have a sharper focus when practicing nasal breathing while sleeping.
At our office, we do a thorough evaluation regarding breathing, apnea risk, malocclusion and teeth grinding. Based on the exam, we suggest remedies and appliances — from a simple snore guard to an evaluation by an orthodontist. We can also guide you on techniques to achieve all the health benefits associated with nasal breathing. A tremendous improvement can happen when we start correcting it in children.
A lot has changed in modern dentistry the last decade – particularly around the business model. For example, many large employers have installed on-site dental facilities to help employees access health services at work. Additionally, large budget dental chains have emerged, offering basic discounted services while you shop for groceries or pick up your prescription.
But even with these many options, a private family practice is still the best choice for most patients. Given my own experience managing a successful dental practice in Saratoga, CA, I am sharing three key benefits to finding a private, not corporate, practice and tips for selecting the right experienced dentist and skilled staff for you and your family.
Experience & Relationships Matter
Dental chains typically hire recent graduates with limited clinical experience and no business training. While this can be a successful model for basic services, it undervalues the importance of experience, long-term relationships and comprehensive care. These chain stores often serve as “drill and fill” stations where doctor turnover is high and diagnosis is happening with the dental practice operator (i.e. a corporation) rather than an experienced dentist. A focus on lowering operating costs can also limit available treatment options, resulting in a one-size-fits-all approach instead of a comprehensive individual treatment plan.
Instead seek an experienced dentist with a consistent and dedicated team to support your dental health. Confirm that they invest in long-term, happy clients by reading their reviews and patient testimonials. Excellent dentists are proud to accept referrals and will gladly share patient references, based on the quality of dental care they provide.
Quality Care is
Patient-Focused, Not Profit-Driven
Corporate dentistry is focused on lower fees but higher volumes in order to be profitable. In a high-volume setting, dentists have limited time to spend with their patients explaining complex procedures, discussing lab work (or the importance of lab selection) or reviewing the merits of higher quality products like crowns or fillings.
By contrast, private dental practices are founded with a clear mission of customer service. At my dental practice, we regularly see three generations in a family and treat each patient as a whole and unique person. We spend time getting to know our patients beyond their office visit. My team of skilled hygienists and office staff work as a partner to each of our clients, coaching them to overcome potential hurdles in achieving optimal dental health, demonstrating proper techniques and sharing knowledge that will allow them to present their best smile.
When selecting your family dentist, be sure that she is invested in long-term education and that she connects oral hygiene to overall health and quality of life. An exceptional dentist will want to know you better as a person and engage with you in a holistic approach to health and wellness.
Your Dentist is Your Health Partner
Finding the right dentist can be like recruiting an all-star quarterback to your health team. She knows you and your family’s health playbook and can consistently monitor field changes and track patient progress that might affect not only your smile, but also your whole being.
A great dentist will provide one-on-one attention to all health changes and take the time to adequately talk through complementary aspects of dental care, such as understanding how diet and nutrition affect gum disease, cavities and other teeth issues.
Selecting the right dentist for your family is a very important decision. While the business model and tools of dentistry will always change — personalized treatment, genuine care for the individual and a culture of service should not change. We hope you find these important traits in your family dentist’s practice for a lifetime of good health and beautiful smiles.
Dr. Rapal in Los Gatos Magazine
Dr. Rapal was featured in Los Gatos Magazine for her work with clients and in the community.
On January 31 st , 2016, Gracie, my four legged child transitioned into the heavenly world. I went through the normal phase of denial, anger and then just plain grief. Denial – because I just could not accept the fact that there was nothing I could possibly do for Gracie. Anger – because I did everything by the book and how did she end up with cancer. Then Grief and finally acceptance of the truth about our mortality.
Gracie was part of our family for almost 10 years. She was the most graceful, patient and well-behaved dog, unless she was chasing birds or squirrels. I love all animals, but dogs just have a very special place in my heart. The biggest lesson of life to love unconditionally comes from dogs. Gracie, amongst all other dogs, had her own unique way of loving. Her calm spirit, a warm look with her deep brown eyes, and a small delicate kiss – is all I ever needed to know that I am not alone, that I am loved unconditionally, that I am protected and That I am Blessed!
Gracie’s transition really brought life to a halt for me. There was a deep questioning of my own Life Purpose in this brief time period that we live. What will be my contribution to this world and mankind? It was a rediscovery of my own gifts of Courage and Leadership in service to a purposeful living. How can I inspire everyone around me to think Gratitude, Abundance and Well-Being of All? It all starts with small things – giving back to the community that we live in, giving back to the country that we live in and ultimately giving back to the world that we live in. I have expanded my vision to focus on partnering with businesses and organizations that support programs directly helping the underserved in our community.
Gracie continues to be with us, now in an expansive spiritual form – our Guardian Angel. She is a constant reminder to take every moment to Love, to hug the pets that we have and cherish their blessings in our lives. We need to pause for a moment and smile at the messy dog hair on the floor, dug up dirt in the backyard, chewed up paper or missing cookies from the counter – and that innocent look that says,”Oh ooops, I think I messed up”.
So take a moment and hug your four-legged babies, accept a slobbery kiss and wag of tail – and experience the deep opening of your heart to the Unconditional Love that surrounds you.
You are Loved Deeply Gracie!
My son recently went through knee surgery at Kaiser and there is no bigger test of faith as putting my child in the hands of another professional. The lessons that I learnt during the two weeks of his diagnosis and surgery were monumental. As Simon Sinek says, “Start with your Why” – I, definitely reaffirmed and grounded myself in my “WHY”
Starting with this sudden and quite shocking knee injury, I found myself at the Specialist’s office discussing his MRI, not very many questions asked, no diagnosis given and not even a follow up phone call. When I expressed frustration regarding follow up, the specialist at this Kaiser location responded quite arrogantly as if he was being asked to do something outside of his duties.
Another meeting with a second surgeon was again at Kaiser but different facility. He was the one to actually operate on my son. He answered my questions very patiently. All the staff at this facility were very reassuring and supportive. This was absolute team-work and it did not take much for me to trust that my son was in good hands. I walked away knowing that everything will be ok and that I can let go and Trust.
The surgery went remarkable and so has the recovery. I owe this in part to the skilled and supportive team at Kaiser and mainly to the skill of this surgeon. This experience brought forth some deep awareness in several aspects of my own work as a healthcare professional.
First and foremost – Hire the Right Team. A team that has synergy and will instill confidence. One of the noticeable things during my meeting with the surgeon was that his team was cheerful, reassuring and supportive. Their interactions with us brought forth trust and comfort. All the information provided was detailed and thorough. We were given all information regarding who to contact and where to go in case we had questions.
Secondly – Expect Excellence
It seems like we as Professionals are settling more and more into passive roles as far as expectations. Why not expect excellence and encourage a Growth Mindset? And allow the team members to Aspire to a new level. As a patient, I really appreciated how fluidly this team moved and empathized with their patients. I’d much rather see a Doctor who has Higher expectations of their team and inspires them to work towards a unified vision of patient care.
Last but not least – My own Epiphany
This was probably the biggest awareness and an “aha” moment for me. My child was in someone else’s hands and I hoped and prayed that the surgeon and his team were the best that they could be. My heartfelt prayer went out for everyone who was undergoing any surgery that day. I understood the trust that my patients have in me. When someone expresses their extreme fear of dentists and needles – it really exists and is very real for them. It is an important aspect of my job as their dentist to understand, acknowledge and empathize with my patients. It is important that my patients clearly understand their treatment. Just as in one of my presentations, my patient commented, “well, I don’t know what I am looking at because I don’t know what is normal and what needs to be fixed”. This was another “aha” moment. How important it is that my patients understand the normal from the abnormal. Their questions are significant and clarity regarding procedures will help relieve their anxiety.
Needless to say – I had just been familiarized with my “WHY”. I know now WHY I drive my team so hard, to think Exceptional, to perform Higher and treat every single patient with compassion and empathy. There is no room for mediocrity – definitely not in my office and not with my team!
I was overcome with a sense of Gratitude – not just for this deep awareness but also for my relentless drive towards excellence, my over-ambitious self that I have judged so harshly in the past and last but not the least – believing that all of us are capable of so much more. I want to be the leader who helps them achieve more, think more and do more so that at the end of our day as we walk out the door – it is with a sense of deep fulfillment and an answer to our “WHY”, a deep desire to come back yet another day to do the same thing again and with the same passion to elevate, to aspire and to reach for the stars.
It was an instant decision to adopt her – this cute, spunky, gorgeous girl. Love at first sight! Jamie called her “Baby” and she seemed to love being the youngest sibling to the boys and the dogs. She became the love of our lives in no time. She roamed around free in the house, no boundaries, no fences, jumping from couch to couch. Until one day – Luna attacked Zeus, just a month after she had been living in our household. Maybe this was a one-time incident or it was because Zeus was the patriarch of the pack and this was a power struggle. But then it happened to Shadow and then Zeus again. There was blood drawn and our hearts pounded as we saw her go for the kill. There was a serious family discussion about keeping Luna or giving her back to the Dog Rescue. She may get adopted, seemed very unlikely but another one of those incidents again and she may be euthanized. The final decision ended up in favor of LUNA – lucky girl! We were doing her a favor.
Was it? Or was it that our lives were ready to be transformed because of this beautiful dog. It wasn’t because Luna stopped attacking the other pets. We all just had to learn to accommodate her. That did not mean that her long legs and 90lb frame could be crammed in a crate all day long. Let’s just say that Luna got the family room, television and the couch. We learnt how to manage having the other dogs and Luna be separated. That meant, establishing different territories for Luna and the other three. We had to learn all the tricks on how to prevent an attack, pepper spray, vinegar spray, butter knife to open her jaw in case it was locked in a vicious bite etc. She was our pet with Special needs.
Boys became more vigilant and the other pets figured out how to stay out of her way. This wasn’t easy by any means. But we had made a commitment to Luna, a good life for her after she had been in the shelters. For us it meant no spontaneous vacations, making sure that she was on a strong leash at all times, separate feeding areas, making sure other dogs are safe at all times, never leaving the house without triple checking everyone’s safety. We found couple of exclusive parks to entertain Luna and always two of us taking her on a fifty-foot leash. One of us would be playing fetch with her while the other person watched out for any other dogs not on leash. We all had to keep an eye out at all times outside or inside the house. Most days it felt like a mountain to climb and obviously a daunting feeling of “what if”.
Today looking back a year later, Luna is still the love of our life. Nothing has changed with her behavior but we all have transformed – humans and the dogs. We have gotten used to our routines, the eye contact, the body language, feeding routines, doing laundry multiple times a day because Luna pees in fear, making sure Luna is exercised and entertained. She does not like to be left alone. She loves her interaction with the boys and is definitely very vocal about her interaction, as we have learnt from the different sounds she makes and her body language. She actually loves to watch TV with us.
As big of a mountain it has been to climb, so has been the profound, deep unconditional love that we all have experienced. Luna has touched our lives in ways beyond words. The love in her deep brown eyes awakens our hearts to such depth. Her gentle kisses, her sweet talk through loving, cooing sounds, all have been a profound gift for us. There is a deep Gratitude every time our eyes gaze into hers. She is Family! Tears brim as I write about this experience. And how close we had come to denying this to ourselves.
In the end, I want to say that as daunting of a challenge as it seemed at first, so has been the depths of love and compassion. I know that Luna has transformed us in ways beyond. And what seems to be The Lesson – that when we shy away from what seems to be impossibility, an inconvenience, a complex situation or may be the task just seems arduous. Those are the opportunities when The Spirit, The Universe, The God, The Consciousness, The Source, whatever is your preferred name, is lifting us up into a deeper experience and transformation. We just need to Trust and Show up in our Loving. The rewards are life changing!