April 2, 2025 • 40 mins
Join us on this new Speaking of Women's Health Podcast episode with guest Dr. Kanika Manchanda, a distinguished dentist in Northeast Ohio.
This episode uncovers the truth behind trendy dental care products, offering a critical look at the fleeting allure of purple whitening solutions compared to the tried-and-true reliability of hydrogen peroxide. Dr. Manchanda and Host Dr. Thacker talk about the lifespan of dental fillings, the complex causes of halitosis, and the significance of a healthy oral microbiome.
Dr. Manchanda provides practical advice on avoiding cavities, such as dietary recommendations and dental hygiene tips, while also addressing the often-overlooked emotional side of dental care—managing anxiety.
Whether you're curious about Botox's role in dentistry or seeking effective oral care tips, this conversation is packed with invaluable insights.
For more information on Dr. Manchanda visit rocksidefamilydentalcare.com. You can also follow Dr. Manchanda on Instagram @dr.manchandadds.
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Episode Transcript
Available transcripts are automatically generated. Complete accuracy is not guaranteed.
Speaker 1 (00:05):
Welcome to the Speaking of Women's Health
podcast.
I'm your host, dr Holly Thacker, the Executive Director of
Speaking of Women's Health, andI am glad to be back in the
Sunflower House for a newepisode.
For a new episode.
(00:30):
Joining me on this new episodeof our Speaking of Women's
Health podcast is dental surgeonDr Kanika Manchanda.
She grew up in Orlando Park, asuburb of Chicago, and she
earned her bachelor's degree inhuman nutrition and then she got
a bunch of minors.
She reminds me of my PhD son.
She got into biology, chemistryand Spanish from the University
(00:54):
of Illinois at Urbana-Champaign.
She then went on to pursue herdoctor of dental surgery at
Marquette University inMilwaukee.
Dr Manchanda is an active memberof the American Dental
Association, the Ohio DentalAssociation, the Greater
Cleveland Dental Society and theSpecial Care Dental Association
(01:17):
, and she keeps up with all thelatest advances in aspects of
dentistry.
And she also attends the womenin dentistry meetings.
And she enjoys all aspects ofgeneral dentistry, from placing
fillings to performing rootcanals, dental implants over
(01:38):
dentures, smile makeovers andBotox treatment.
Interestingly, in her free timeshe enjoys experimenting with
new recipes, choreographingdances, working out, playing
tennis, discovering new coffeeshops and, near and dear to my
heart, spending time on the golfcourse with her husband.
(02:00):
Hopefully we can get um a golfdate set up in the future.
I love to golf, so welcome, drManchanda.
We're so excited to have you asa guest on the Speaking of
Women's Health podcast to talkabout dental cosmetic procedures
and tell our listeners whatyour first name means.
(02:21):
It's so adorable.
Speaker 2 (02:22):
Oh, thank you so much .
Thank you so much for having me, dr Thacker.
I'm excited to be here.
My first name, kanika, meansthe smallest, most precious
piece of gold in the language ofHindi.
So I'm the youngest in thefamily and I was privileged with
that name.
Speaker 1 (02:39):
That is lovely, so tell our listeners a little bit
more about your professionalbackground and why you got into
dentistry.
Speaker 2 (02:47):
Dentistry is not something that I thought I would
go into at a young age, so itwas a little bit of surprise for
myself as well.
My parents are both in healthcare.
They are both physicaltherapists, so naturally I knew
I wanted to be in healthcare,growing up with appreciation for
(03:08):
health and wellness.
One day I randomly it was alittle random for me I shadowed
a dentist sometime beforecollege, just to figure out hey,
this isn't healthcare, is thissomething I could see myself
doing?
Well, good thing I did, becausewhat I appreciated was the
physical help that the dentistwas able to provide the patient
(03:32):
getting out of pain, and thetrust that was built there.
And then a physical productthat was made with the dentist's
hands, because I'm always inmotion, always talking with my
hands.
So a physical career withinhealthcare was really important
(03:55):
to me and I also enjoy all theconfidence that was built for a
patient once cosmetic work wascompleted and that has impacted
a patient's physical health andalso their mental health, and
that has been transformative fornot only the patient but for me
(04:15):
as a provider.
I've been so lucky to be a partof that journey for patients.
Speaker 1 (04:27):
Well, that just sounds wonderful.
What are some of the morepopular dental procedures you
perform in the office?
Speaker 2 (04:33):
I have been at my current office for a little
while now, and before this Iworked in another office with a
different socioeconomicpopulation, and that has
actually changed a lot of themost common procedures that I've
been able to perform.
I am a general dentist, which Itake great pride in because I
(04:57):
enjoy all the variety that wesee throughout the field.
I will say you know, before Ijoined this practice, a lot of
what I did was we did a lot offillings.
There was a lot of decay to beprevented and we did a lot of
extractions to be prevented, andwe did a lot of extractions.
(05:20):
We did a lot of removal of theteeth, because not everyone can
afford to either save theirteeth or even replace their
teeth.
So, um, it was a lot ofremoving of the teeth.
If we were to replace them,usually it was with dentures or
partials, which are removabledevices.
They come in and out of themouth and they work effectively.
(05:45):
There are more sound solutions.
However, it is very affordablefor patients and it does provide
teeth in the mouth.
Now in this, in anotherpractice I've been a part of at
Rockside Family Dental, we seeless removing of the teeth.
It's it's a lot of of what I dois try to save our teeth,
(06:09):
because there's nothing likeyour own teeth at the end of the
day.
If that is not possible, if thetooth is cracked or severely
decayed and cannot be saved, wedo remove it.
I have seen that a lot ofpatients would like to replace
their teeth with more soundsolutions such as dental
(06:32):
implants, which are becomingvery popular because they stay
in the mouth, they do not.
They function as your regulartooth at the end of the day,
nothing that you have to insertand remove every night.
So I would say overall,commonly we perform fillings
across the board, but what I doa lot of now, I do a lot of root
(06:55):
canals, I do a lot of crownsand more cosmetic work as well.
Speaker 1 (07:00):
And what is the difference between a crown and a
veneer?
Speaker 2 (07:04):
That's a great question.
So a crown covers the fullfront, top and back of a tooth.
A veneer only covers the frontof a tooth and there are
different indications for eachone In the back of your mouth,
because we do most of ourchewing with our back teeth and
(07:27):
we have most of the load withthe back teeth.
Even if you're doing some typeof cosmetic work A lot of time
with your back molars, youcannot see those teeth.
But even if you can, it'srecommended to have a crown
because it's covering more ofthe tooth and there's less
(07:51):
chance that a crown would falloff in the back of the mouth
than a veneer would In the frontof the mouth.
It depends on how much of thetooth we are changing.
So, cosmetically, there arecertain parameters where veneer
is indicated if we are able tobe more conservative and do less
(08:15):
changing.
So we're talking about apatient that likes the way their
teeth are shaped.
They like the alignment oftheir teeth, but maybe they just
wanted to change the color ofthe tooth.
That would be a good indicationfor a veneer.
If we have to change a shape ofthe tooth dramatically, a crown
(08:38):
may be indicated.
Another reason a crown may beindicated over a veneer is more
likely to pop off long term, acrown may be indicated so a
(09:00):
patient doesn't have to dealwith that type of discomfort or
regular visit to put the veneerback on.
Speaker 1 (09:08):
So what are some of the latest and greatest
procedures?
Speaker 2 (09:21):
honestly, a lot of dentistry in the last couple of
decades is turning moreconservative, which is the way I
like to practice as well.
We try to focus on nointervention.
When possible, we talk moreabout a patient's diet and
lifestyle changes they can maketo prevent cavities, instead of
the old drill and fill model.
Any little shadow on the x-raydoes not mean that we as
(09:45):
dentists need to intervene.
We like to tell patients, welike to discuss why you're
getting cavities, where on thetooth they are present, and
intervene that way Now if arestoration or a filling has to
(10:06):
be placed because the lesion hasadvanced to a point of no
return.
Another popular subject indentistry is called biomimetic
dentistry, trying to emulatewhat our body does naturally to
improve a patient's teeth,rather than some of the older
(10:30):
protocols that we have Indentistry.
A common procedure, as we'vediscussed, is fillings, and
(10:52):
fillings have improved over timeso that the chemistry, the bond
between the actual filling andyour tooth, so you don't have to
replace that filling as often,and biomimetic dentistry has
actually helped change some ofthose protocols, which is
wonderful for our patients andus.
Another procedure that weslightly touched on is something
(11:16):
called dental implants, andwhile dental implants have been
around for many years.
There have been so manyadvancements in the type that we
are able to place in apatient's mouth the materials.
There are so many indicationsfor more aggressive dental
(11:37):
implants, less aggressive dentalimplants and where they are in
the mouth to make sure thatthere are less complications
with that.
One thing that I really enjoyare some of the technological
advancements in dentistry, forexample, we are now a lot of
(12:00):
offices are using scanners whichpatients may see or be a part
of, instead of thoseconventional dental impressions
where you take a tray, you putthe goopy material in, put it in
a patient's mouth and let itdry.
Those are not that comfortableand while they're still used,
when a patient can get a scandone instead of that goopy
(12:21):
material in their mouth, I thinka lot of people are happier.
And from there, that scan getsuploaded to a platform and then
a 3D printer can actually printthe patient's mouth versus the
traditional methods we had, andthat tends to be a lot more
(12:41):
accurate.
So from there, when you'remaking crowns or veneers or any
implant crowns anything thatneeds to be fabricated to put in
a patient's mouth there's a lotless error, which has been
really improving the patientflow when the patient comes back
(13:02):
into the chair and from there,from that scan, we can also do a
lot more with digital smiledesign, which is where we can
take pictures of a patient.
We can take a scan of theirmouth and actually combine them
so a patient can see what theirsmile will look like when
(13:26):
they're having a full mouthsmile makeover done.
They can physically see whatthe smile will look like in
their mouth before committing tothe treatment, which has really
been great for patients becauseit increases trust with their
provider and gives themconfidence that this is
something that they like to do.
Speaker 1 (13:46):
That's interesting.
They're doing that in homeimprovement.
When I was looking at making anextension to my house.
They used the computer to saythis is what it's going to look
like.
It does help, doesn't it?
Yes, yes, it sure does.
So let's move on to some commoncomplaints and issues.
Loss of gum tissue Is it normalfor people to lose gums as they
(14:08):
get older?
Speaker 2 (14:09):
It is normal.
The prevalence is about 65%after age 30.
And what varies is the degreeof the gum loss.
So less than a millimeter ispretty standard and normal,
which is why preventative careis so important Because, let's
(14:30):
say, you lose a little bit ofgum tissue throughout the next
couple years.
We can see the changes from nowover the next 10 years and if
that amount has not changed,that is a good sign.
If there are significantchanges over 10 years, that is
(14:54):
abnormal and we'd have to seewhy those changes are occurring
as they occur.
Sometimes this can happenbecause of genetics, overzealous
brushing, something calledperiodontal disease, bruxism,
which is where patients may beclenching or grinding
(15:15):
excessively.
Patients may be clenching orgrinding excessively and mouth
trauma, so maybe getting a blowto the face or having a fall.
So really monitoring how muchwe lose gums and why we lose
gums is important for thetreatment.
What is the treatment?
Usually it depends on theseverity.
(15:35):
So when it's's severe,something called a gum graft may
be indicated.
Um, and I'm saying it's if it'ssevere or not is because the
success of a gum graft dependson the severity of how much
you've lost.
So it's strange, but the moreyou lose sometimes, the better
the outcome of the procedure is.
(15:57):
It can be a painful procedure soit's not recommended for
everybody.
So you know we do have somepatients that lose less than a
millimeter of gum tissue andthey're interested in replacing
it.
But you know everyone'sdifferent.
I don't always recommend itbecause you have to weigh the
benefits, the risks and if iteven works.
(16:18):
Sometimes, when it's very minor, we can actually wear.
You've lost gum tissue.
We can replace it not with gumtissue but with a filling
material.
You don't have to drillanything, you just kind of plop
the filling in and it bonds tothe tooth and it can help
(16:38):
decrease sensitivity.
It can help decrease foodparticles from getting into that
space and making the gum lossworse.
Speaker 1 (16:48):
Oh, that's very interesting.
You have been listening to theSpeaking of Women's Health
podcast and I am your host, drHolly Thacker, and we are in the
Sunflower House with dentalsurgeon general dentist Dr
Kanika Manchanda, and we aretalking all about the teeth and
the smile and gum health.
And let's move on to a fewcosmetic type questions
(17:11):
Whitening it seems like lots ofpeople are interested in having
bright, white, clean teeth.
Speaker 2 (17:17):
Yes, absolutely.
I think whitening is soeffective with traditional
methods and even some newer ones.
There are two things toconsider.
When we talk about whitening,we talk about intrinsic versus
(17:40):
extrinsic stain.
So a lot of the traditionalmaterials of whitening, such as
hydrogen peroxide or carbamideperoxide, really attack both
intrinsic and extrinsic stainfor a whiter and brighter smile.
And what differs between howfast it is versus slow and
steady is actually thepercentage of the hydrogen
peroxide that is used.
So the higher amount is goingto whiten your teeth faster.
(18:05):
However, a higher amount canactually have destructive
effects on your gums not yourteeth, but your gums, teeth but
your gums.
So it's very important that ifyou're using a higher percentage
, you're getting customwhitening trays from your
dentist that only touch theteeth and help prevent burning
(18:25):
of the gums, or you can visityour dentist for an in-house
whitening procedure where higherpercentage is used for a more
dramatic effect and in the inthe, we protect your gums with
it like it's a gum mask, if youwill, so that none of the
product gets on your gums.
Even the at-home whiteningtrays like the Crest whitening
(18:49):
strips or Opalescence trays.
They are very effective withgood, consistent use.
Even though they're a lowerpercentage.
They're very effective and Irecommend them to all my
patients.
In the era of social media andTikTok, a lot of people are
using purple whitening productsand that's been the new and
(19:17):
exciting product for consumers,because it's something different
.
But we have to ask ourselves isit effective?
So purple whitening treatmentis all based on color theory.
Purple cancels out yellow.
So when you're using purple onyour teeth, out yellow.
(19:39):
So when you're using purple onyour teeth, it can temporarily
make your teeth look whiter.
But back to what we werediscussing before that's only
attacking the extrinsic stain,that's not getting inside of the
actual tooth structure.
So yes, purple toothpaste orpurple whitening can help, but
it's temporary and it's not aseffective as the hydrogen or
(20:01):
carbamide peroxide.
Speaker 1 (20:03):
Interesting yeah.
Speaker 2 (20:04):
Another thing we see is an LED light.
A lot of times people areputting this little LED light in
their teeth and walking aroundwith it on social media.
From my research one, itdepends on the light source and
how strong it is.
So these cheaper LED lights areprobably not effective.
(20:28):
Some of the more the researchedlights still need more studies
because the studies are varyingwhether it actually whitens
teeth more than the hydrogenperoxide.
So I would say further researchneeds to be done.
If it were me, I would just gowith what is known.
(20:51):
I always recommend the hydrogenperoxide to patients, just
because we know it works, so whynot use it?
Speaker 1 (20:59):
and can you do whitening of existing crowns and
veneers or only natural teeth?
Speaker 2 (21:05):
that's a great question.
Only natural teeth.
So that's why shade selectionis very important with your
dentist when you are talkingabout a smile makeover or even
just having one crown or veneerplaced.
Sometimes that's necessary incases of trauma.
(21:25):
But really making sure you'rehappy with that shade match
before selecting a shade.
Speaker 1 (21:34):
Now in terms of fillings, I've read that the
average lifespan of a filling isseven to nine years.
How is a filling replaced?
Are there risks?
Obviously you want to try toprevent getting cavities and
fillings in the first place.
Speaker 2 (21:47):
Yes, exactly so, when a filling does not need to be
done, that's your best casescenario changing your diet and
lifestyle to help decrease thesize of the cavity.
However, once the cavity hasgotten into the second layer of
the tooth, it will not change,it will only get bigger.
(22:11):
So that's when a filling isindicated.
Replacing a filling and howlong it lasts depends on two
factors.
One is the original size of thecavity.
The bigger the cavity, the morelikely it is to be replaced in
the future, because the morelikely the margins of the
(22:33):
filling are to be destroyed.
The second factor is the skillof the clinician.
If you're having good isolationprotocols and adhesion
protocols, where saliva andother bacteria are not
contaminating the filling asit's being done, you get a
(22:53):
strong bond to the tooth, theless likely it is to be replaced
.
So for average sized filling Icould argue, with good scale of
a clinician and good isolationand no blood contamination, I
believe that the filling couldlast a lifetime.
(23:14):
The filling could last alifetime, that being said, if it
was a really, really bigfilling.
And I would say a filling maydecrease the size of that lesion
.
Obviously, but potentially apatient may need further
treatment, such as a crown ifthe filling fails.
Speaker 1 (23:34):
Let's move on to halitosis, bad breath.
What are some of the causes andsolutions?
Speaker 2 (23:43):
Bad breath is truly dependent on the type of
bacteria you have in your mouth.
So the stronger bacteria, theones that don't need as much
oxygen, or the gram-negativeanaerobic bacteria, cause
halitosis or bad breath, andthis is seen, really, with
patients that have periodontaldisease.
(24:05):
So they have a bad balance ofbacteria in their mouth or they
have a dry mouth where saliva isnot protecting the good
bacteria as much, and this couldbe due to medical conditions,
certain medications and, mostcommonly, smoking.
For the average patient thathas good oral hygiene that gets
(24:29):
bad breath, the solutions aremuch simpler than a patient that
has bad breath due to dry mouthor smoking.
In a normal, healthy patient, Iwould say, increasing your oral
hygiene maybe you're onlybrushing once a day and changing
that to twice a day makes ahuge difference.
(24:51):
So simple solutions, I wouldsay.
For a patient that's morecomplex, changing your type of
toothpaste may be helpful, suchas a toothpaste called
Paradontax or any brand that hasa gum restore label on it, and
you may need something calledscaling and root planning.
(25:14):
This is commonly known as deepcleaning, scaling and root
planning.
This is commonly known as deepcleaning.
When you get more bone and gumloss, the bacteria travel
further and further down thetooth and they kind of just stay
there unless it's physicallyand mechanically removed.
So patients that haveperiodontal disease sometimes
(25:35):
need this procedure to helpchange the bacteria of the mouth
and restore it to good balance.
Speaker 1 (25:43):
So obviously.
Good nutrition and we have somany podcasts on that and
understanding the whole gut andbody microbiome has so much
influence on so many diseasesand I think we're really just
starting to basically understandsome of that and there's so
much more to discover.
Do you promote like xylitolmouthwash or xylitol toothpaste
(26:05):
or chewing xylitol gum to helppromote a better microbiome?
Speaker 2 (26:10):
Absolutely.
That is a wonderful way todecrease the cycle of what we
call remineralization anddemineralization.
So xylitol, amongst otherfactors, some essential oils in
mouthwash, sometimes fluoridatedtoothpaste it just depends on
(26:31):
the patient's regimen and whatfactors work best for them
regimen and what factors workbest for them.
But essentially they help breakthat cycle where when you're
eating high sugar foods, thebacteria will then thrive on
them and produce acid.
Just like we produce pee andpoo is our byproduct.
(26:53):
They produce acid which attacksour enamel and causes
porosities or holes in the outerlayer and sometimes the inner
layer of our teeth.
So xylitol specifically, thebacteria cannot break down like
they can with traditional fruitcans and sucrose and other
(27:14):
sugars that we consume.
It's actually very protectiveagainst that cycle of acid
destruction.
Speaker 1 (27:23):
So tell us what are some of the best ways to brush
and floss our teeth?
Speaker 2 (27:28):
You know, aside from our regular brushing and
flossing regimen, something ingeneral that will help us not
even get cavities is lesssnacking, and so the longer the
sugar is on our teeth, the moredestruction we have.
(27:49):
So, for example, if a patientwere to eat 10 cookies in one
sitting versus one cookiethroughout the day, little
pieces every 10 minutes you'reeating the same cookie.
The patient that eats that onecookie is going to get less cap.
I'm sorry.
The patient that gets eats the10 cookies in one sitting is
(28:12):
going to get less cavitiesbecause they're not having that
acid attack throughout the day.
So really, less snacking wouldbe important and if you're going
to snack, rinsing your mouthout with just regular water
after is important to decreasethat cycle.
Neutralizing your mouth withsomething more basic, such as
(28:35):
milk or cheese or vegetables,even that contain calcium and
better vitamins and minerals tobalance that cycle, is going to
help decrease the amount ofcavities and gum and tissue loss
you have in general.
Speaker 1 (28:53):
So I think for adults , it should be easier for us to
just only eat a couple meals aday and then rinse out our mouth
.
For children, growing childrenand toddlers like my
grandchildren, they love tosnack, and so I think just the
other day my son was admonishingme because I wanted to give
milk to my granddaughters afterhaving tuna fish.
(29:15):
He's like why do that?
That's not good, Let theirstomach settle.
I'm like no, I want to rinsetheir teeth off.
So I'm going to tell him thatthat's the dentist endorses,
that I agree.
Speaker 2 (29:26):
Tuna and milk do it.
I think with kids it'sespecially difficult, because
children traditionally love toeat carbohydrate containing food
that sticks to your teethpretzels, goldfish chips.
They just stay on the teeth andthey're they're the inner layer
(29:48):
of their tooth.
Their pulp is very largecompared to adults, so it's
really easy for a child to get acavity and it just grow super
quick.
So changing their snacks oradding something to neutralize
their their snack willdefinitely help.
Speaker 1 (30:06):
And that's why I usually give them little pieces
of cheese, as opposed tocrackers like their parents.
And then they look at methey're getting too much cheese.
Well, I'm an osteoporosisdoctor, a bonehead.
We love cheese, we love milk,we love calcium.
We think it's good for you andI've actually done some research
in the area because it seemslike dentistry and medicine are
(30:27):
so separate but they're soimportant and together.
And we know that.
Your dental health.
I always ask my patients abouttheir dental health because we
know that there's a link withtheir bone status and
osteoporosis.
And the other thing I tell allmy adult patients to brush their
teeth twice a day and do theirKegel exercises for their women,
for their pelvic floor, so Ilink the two, just so you know I
(30:50):
love that.
That is so smart.
Now tell us, what do yourecommend for patients, young
and old, of all ages, who arevery nervous and fearful of
going to the dentist?
I'm not, because it's my onetime to put my feet up and relax
.
I'm strange.
I like going to the dentistbecause I get a few minutes
apiece, but most people don't.
Speaker 2 (31:10):
I would agree, I would say you're in less than 1%
.
But I take dental anxiety veryseriously.
I try to teach it.
I try to treat it as a medicalproblem because it is, and if
people have a bad experiencewhen they're young that that
(31:31):
will shape how much they see adentist in the future.
And any time.
Truly, I would say over 90% ofthe time I have seen a patient
with very, very poor dentalhygiene or severe dental issues.
They have told me that they'vehad a dentist in the past that
(31:51):
they had bad experience with andthen since then they never
wanted to come back.
So treating it like a trueproblem is important to me.
On a non-medication basedregimen, I really just talking
to them and showing empathy andthat I actually care that they
have dental anxiety has workedvery well to create trust
(32:14):
between me and my patient verywell.
To create trust between me andmy patient, small techniques
such as warning them, such astelling them what is to come,
without using scary words, butbeing honest, has also been very
helpful, because they don'tlike surprises.
When you're fearful, the lastthing you need is a surprise.
(32:35):
And then, thirdly, some verysimple changes Making the
environment calmer, so turningoff the TV sound, if that's, you
know, triggering them in theroom, potentially adding
essential oils to the room tomake it feel more calming
spa-like, if you will.
(32:56):
To make it feel more calming,spa-like, if you will, taking
the lead apron that we use forx-rays and placing it over them
so that they could feel a senseof like a hug.
Essentially, it has worked veryeffectively because people like
that weighted, blanket feeling.
So even just small changes likethat or giving somebody a
(33:19):
squeeze ball to squeeze duringan injection, has really built
trust and I really like to startthere and they really do need
it.
Then we talk more aboutmedication and potentially
(33:39):
adding a benzodiazepine to theregimen before they come in,
trying to get them relaxed thatway and then getting everything
we need to done get efficientand letting the patient leave.
Speaker 1 (33:54):
Well, you have an excellent bedside manner and I
think that's so important foranyone in the clinical field.
In our first season of Speakingof Women's Health podcast, we
had pediatric dentist Dr RachelRosen on and I had the
opportunity to take mygranddaughter Artemis there
after she jumped off a table andsmashed in her front baby teeth
(34:15):
, and I was so impressed withthe whole setup of the place
that was geared to children,geared to reducing anxiety,
geared to talking to them ontheir level.
The treats were not candy, theywere little toys that they got.
In fact, I made sure I broughther a different gift because I
was so thankful for her addingus on, as opposed to giving her
(34:37):
chocolate, because I'm like, oh,she's a dentist, I can't do
anything sugar, but I thoughtthat was just so impressive.
And if anyone wants to hear allabout dental care for the very
little ones and when to see adentist getting the first tooth,
go back and listen to our firstpodcast.
And there's so much more I'dlike to talk to you about.
(34:58):
I'd really like to talk about,in the future, the Botox and the
cosmetic stuff that you do.
That's the first time I'veheard about a dentist doing that
, but I guess that's verypopular.
It's used for migraine, it'sused for all sorts of things.
What are some of the majorreasons you do it?
Is it just pure cosmetic forthe face, or is it TMJ?
Speaker 2 (35:17):
That's a great question.
It's something that I wastrained in post-dental school
and there are different levelsof training, so you know it's
important to do your research asa patient as well and find a
provider that you trust, to behonest about what type of
results that they are able toachieve, because, at the end of
(35:39):
the day, we are dentists.
We are not cosmetic surgeons,plastic surgeons or
dermatologists.
Nevertheless, certain resultscan be achieved cosmetically
that can make sense for ahandful of people.
So I do TMJ therapy, which Ithink is a great additive in
(36:02):
addition to a traditional nightguard that a patient uses, and
there are different indicationsfor Botox when discussing TMJ
therapy, and it's not foreverybody.
Tmj therapy is very complex andit depends on the severity of
(36:23):
the problem mild, moderate orsevere.
So in more severe cases, I willalways refer a patient to see a
TMJ specialist.
In more mild to moderate cases,if a patient, for example,
cannot tolerate having a devicein their mouth, because not
everyone can sleep with a thickplastic device in their mouth,
(36:46):
sometimes, when the source ofthe pain really is from the
lower half of the face, they'regetting muscle tension in the
masseter stemming from the tmddisorder that they have it rides
up to their the temples.
Botox has actually been provento be a very good treatment
(37:08):
modality to help decrease thosesymptoms and help decrease their
ability to clench at all,because you're actually
decreasing the muscle movementand their physical ability to
clench their teeth, if that iswhy they have TMD.
Additionally, I do do cosmeticBotox but, like I said, it is
(37:31):
very patient-specific and it ismostly for the upper half of the
face, sometimes lower half ofthe face.
I limit myself, obviously to myprofession, which is head and
neck.
Speaker 1 (37:44):
Well, it has been so interesting talking to you, and
I wanna bring you back in theSunflower House, hopefully,
because we didn't get a chanceto talk about mouthwashes and
fluoride.
Fluoride has been so much inthe news, there's so much
controversy, there's a lot ofplaces that are now taking
fluoride out of the water, andso we have to bring you back,
(38:04):
but I really want to thank youso much for joining us.
Dr Kanika Manchanda, tell ushow people can reach you or get
an appointment with you, or anysocial media that you have or
any resources we can put in theshow notes.
Speaker 2 (38:20):
Thank you so much for having me here.
It's been wonderful I can bereached.
The office that I work at iscalled Rockside Family Dental.
We are located in IndependenceOhio.
If you'd like to reach me viasocial media, I do have my
dental account, which is atKanika Manchanda, my first name
(38:41):
and last name, dds.
Speaker 1 (38:45):
Well, that is wonderful and I'd like to thank
our listeners for joining us onthe Speaking of Women's Health
podcast, and we're so gratefulfor your support and hope you'll
consider supporting us, sharingthe podcast, leaving a
five-star rating, and to catchall the latest from Speaking of
(39:07):
Women's Health, you cansubscribe for free.
Just hit the follow orsubscribe button.
Anywhere you listen to podcastsApple Podcasts, spotify, tune
in.
Where you listen to podcastsApple Podcasts, spotify, tune in
.
And thanks again for listeningand we will see you next time in
the Sunflower House.
Be strong, be healthy and be incharge.
Welcome to the Speaking of Women's Health
podcast.
I'm your host, dr Holly Thacker, the Executive Director of
Speaking of Women's Health, andI am glad to be back in the
Sunflower House for a newepisode.
For a new episode.
(00:30):
Joining me on this new episodeof our Speaking of Women's
Health podcast is dental surgeonDr Kanika Manchanda.
She grew up in Orlando Park, asuburb of Chicago, and she
earned her bachelor's degree inhuman nutrition and then she got
a bunch of minors.
She reminds me of my PhD son.
She got into biology, chemistryand Spanish from the University
(00:54):
of Illinois at Urbana-Champaign.
She then went on to pursue herdoctor of dental surgery at
Marquette University inMilwaukee.
Dr Manchanda is an active memberof the American Dental
Association, the Ohio DentalAssociation, the Greater
Cleveland Dental Society and theSpecial Care Dental Association
(01:17):
, and she keeps up with all thelatest advances in aspects of
dentistry.
And she also attends the womenin dentistry meetings.
And she enjoys all aspects ofgeneral dentistry, from placing
fillings to performing rootcanals, dental implants over
(01:38):
dentures, smile makeovers andBotox treatment.
Interestingly, in her free timeshe enjoys experimenting with
new recipes, choreographingdances, working out, playing
tennis, discovering new coffeeshops and, near and dear to my
heart, spending time on the golfcourse with her husband.
(02:00):
Hopefully we can get um a golfdate set up in the future.
I love to golf, so welcome, drManchanda.
We're so excited to have you asa guest on the Speaking of
Women's Health podcast to talkabout dental cosmetic procedures
and tell our listeners whatyour first name means.
(02:21):
It's so adorable.
Speaker 2 (02:22):
Oh, thank you so much .
Thank you so much for having me, dr Thacker.
I'm excited to be here.
My first name, kanika, meansthe smallest, most precious
piece of gold in the language ofHindi.
So I'm the youngest in thefamily and I was privileged with
that name.
Speaker 1 (02:39):
That is lovely, so tell our listeners a little bit
more about your professionalbackground and why you got into
dentistry.
Speaker 2 (02:47):
Dentistry is not something that I thought I would
go into at a young age, so itwas a little bit of surprise for
myself as well.
My parents are both in healthcare.
They are both physicaltherapists, so naturally I knew
I wanted to be in healthcare,growing up with appreciation for
(03:08):
health and wellness.
One day I randomly it was alittle random for me I shadowed
a dentist sometime beforecollege, just to figure out hey,
this isn't healthcare, is thissomething I could see myself
doing?
Well, good thing I did, becausewhat I appreciated was the
physical help that the dentistwas able to provide the patient
(03:32):
getting out of pain, and thetrust that was built there.
And then a physical productthat was made with the dentist's
hands, because I'm always inmotion, always talking with my
hands.
So a physical career withinhealthcare was really important
(03:55):
to me and I also enjoy all theconfidence that was built for a
patient once cosmetic work wascompleted and that has impacted
a patient's physical health andalso their mental health, and
that has been transformative fornot only the patient but for me
(04:15):
as a provider.
I've been so lucky to be a partof that journey for patients.
Speaker 1 (04:27):
Well, that just sounds wonderful.
What are some of the morepopular dental procedures you
perform in the office?
Speaker 2 (04:33):
I have been at my current office for a little
while now, and before this Iworked in another office with a
different socioeconomicpopulation, and that has
actually changed a lot of themost common procedures that I've
been able to perform.
I am a general dentist, which Itake great pride in because I
(04:57):
enjoy all the variety that wesee throughout the field.
I will say you know, before Ijoined this practice, a lot of
what I did was we did a lot offillings.
There was a lot of decay to beprevented and we did a lot of
extractions to be prevented, andwe did a lot of extractions.
(05:20):
We did a lot of removal of theteeth, because not everyone can
afford to either save theirteeth or even replace their
teeth.
So, um, it was a lot ofremoving of the teeth.
If we were to replace them,usually it was with dentures or
partials, which are removabledevices.
They come in and out of themouth and they work effectively.
(05:45):
There are more sound solutions.
However, it is very affordablefor patients and it does provide
teeth in the mouth.
Now in this, in anotherpractice I've been a part of at
Rockside Family Dental, we seeless removing of the teeth.
It's it's a lot of of what I dois try to save our teeth,
(06:09):
because there's nothing likeyour own teeth at the end of the
day.
If that is not possible, if thetooth is cracked or severely
decayed and cannot be saved, wedo remove it.
I have seen that a lot ofpatients would like to replace
their teeth with more soundsolutions such as dental
(06:32):
implants, which are becomingvery popular because they stay
in the mouth, they do not.
They function as your regulartooth at the end of the day,
nothing that you have to insertand remove every night.
So I would say overall,commonly we perform fillings
across the board, but what I doa lot of now, I do a lot of root
(06:55):
canals, I do a lot of crownsand more cosmetic work as well.
Speaker 1 (07:00):
And what is the difference between a crown and a
veneer?
Speaker 2 (07:04):
That's a great question.
So a crown covers the fullfront, top and back of a tooth.
A veneer only covers the frontof a tooth and there are
different indications for eachone In the back of your mouth,
because we do most of ourchewing with our back teeth and
(07:27):
we have most of the load withthe back teeth.
Even if you're doing some typeof cosmetic work A lot of time
with your back molars, youcannot see those teeth.
But even if you can, it'srecommended to have a crown
because it's covering more ofthe tooth and there's less
(07:51):
chance that a crown would falloff in the back of the mouth
than a veneer would In the frontof the mouth.
It depends on how much of thetooth we are changing.
So, cosmetically, there arecertain parameters where veneer
is indicated if we are able tobe more conservative and do less
(08:15):
changing.
So we're talking about apatient that likes the way their
teeth are shaped.
They like the alignment oftheir teeth, but maybe they just
wanted to change the color ofthe tooth.
That would be a good indicationfor a veneer.
If we have to change a shape ofthe tooth dramatically, a crown
(08:38):
may be indicated.
Another reason a crown may beindicated over a veneer is more
likely to pop off long term, acrown may be indicated so a
(09:00):
patient doesn't have to dealwith that type of discomfort or
regular visit to put the veneerback on.
Speaker 1 (09:08):
So what are some of the latest and greatest
procedures?
Speaker 2 (09:21):
honestly, a lot of dentistry in the last couple of
decades is turning moreconservative, which is the way I
like to practice as well.
We try to focus on nointervention.
When possible, we talk moreabout a patient's diet and
lifestyle changes they can maketo prevent cavities, instead of
the old drill and fill model.
Any little shadow on the x-raydoes not mean that we as
(09:45):
dentists need to intervene.
We like to tell patients, welike to discuss why you're
getting cavities, where on thetooth they are present, and
intervene that way Now if arestoration or a filling has to
(10:06):
be placed because the lesion hasadvanced to a point of no
return.
Another popular subject indentistry is called biomimetic
dentistry, trying to emulatewhat our body does naturally to
improve a patient's teeth,rather than some of the older
(10:30):
protocols that we have Indentistry.
A common procedure, as we'vediscussed, is fillings, and
(10:52):
fillings have improved over timeso that the chemistry, the bond
between the actual filling andyour tooth, so you don't have to
replace that filling as often,and biomimetic dentistry has
actually helped change some ofthose protocols, which is
wonderful for our patients andus.
Another procedure that weslightly touched on is something
(11:16):
called dental implants, andwhile dental implants have been
around for many years.
There have been so manyadvancements in the type that we
are able to place in apatient's mouth the materials.
There are so many indicationsfor more aggressive dental
(11:37):
implants, less aggressive dentalimplants and where they are in
the mouth to make sure thatthere are less complications
with that.
One thing that I really enjoyare some of the technological
advancements in dentistry, forexample, we are now a lot of
(12:00):
offices are using scanners whichpatients may see or be a part
of, instead of thoseconventional dental impressions
where you take a tray, you putthe goopy material in, put it in
a patient's mouth and let itdry.
Those are not that comfortableand while they're still used,
when a patient can get a scandone instead of that goopy
(12:21):
material in their mouth, I thinka lot of people are happier.
And from there, that scan getsuploaded to a platform and then
a 3D printer can actually printthe patient's mouth versus the
traditional methods we had, andthat tends to be a lot more
(12:41):
accurate.
So from there, when you'remaking crowns or veneers or any
implant crowns anything thatneeds to be fabricated to put in
a patient's mouth there's a lotless error, which has been
really improving the patientflow when the patient comes back
(13:02):
into the chair and from there,from that scan, we can also do a
lot more with digital smiledesign, which is where we can
take pictures of a patient.
We can take a scan of theirmouth and actually combine them
so a patient can see what theirsmile will look like when
(13:26):
they're having a full mouthsmile makeover done.
They can physically see whatthe smile will look like in
their mouth before committing tothe treatment, which has really
been great for patients becauseit increases trust with their
provider and gives themconfidence that this is
something that they like to do.
Speaker 1 (13:46):
That's interesting.
They're doing that in homeimprovement.
When I was looking at making anextension to my house.
They used the computer to saythis is what it's going to look
like.
It does help, doesn't it?
Yes, yes, it sure does.
So let's move on to some commoncomplaints and issues.
Loss of gum tissue Is it normalfor people to lose gums as they
(14:08):
get older?
Speaker 2 (14:09):
It is normal.
The prevalence is about 65%after age 30.
And what varies is the degreeof the gum loss.
So less than a millimeter ispretty standard and normal,
which is why preventative careis so important Because, let's
(14:30):
say, you lose a little bit ofgum tissue throughout the next
couple years.
We can see the changes from nowover the next 10 years and if
that amount has not changed,that is a good sign.
If there are significantchanges over 10 years, that is
(14:54):
abnormal and we'd have to seewhy those changes are occurring
as they occur.
Sometimes this can happenbecause of genetics, overzealous
brushing, something calledperiodontal disease, bruxism,
which is where patients may beclenching or grinding
(15:15):
excessively.
Patients may be clenching orgrinding excessively and mouth
trauma, so maybe getting a blowto the face or having a fall.
So really monitoring how muchwe lose gums and why we lose
gums is important for thetreatment.
What is the treatment?
Usually it depends on theseverity.
(15:35):
So when it's's severe,something called a gum graft may
be indicated.
Um, and I'm saying it's if it'ssevere or not is because the
success of a gum graft dependson the severity of how much
you've lost.
So it's strange, but the moreyou lose sometimes, the better
the outcome of the procedure is.
(15:57):
It can be a painful procedure soit's not recommended for
everybody.
So you know we do have somepatients that lose less than a
millimeter of gum tissue andthey're interested in replacing
it.
But you know everyone'sdifferent.
I don't always recommend itbecause you have to weigh the
benefits, the risks and if iteven works.
(16:18):
Sometimes, when it's very minor, we can actually wear.
You've lost gum tissue.
We can replace it not with gumtissue but with a filling
material.
You don't have to drillanything, you just kind of plop
the filling in and it bonds tothe tooth and it can help
(16:38):
decrease sensitivity.
It can help decrease foodparticles from getting into that
space and making the gum lossworse.
Speaker 1 (16:48):
Oh, that's very interesting.
You have been listening to theSpeaking of Women's Health
podcast and I am your host, drHolly Thacker, and we are in the
Sunflower House with dentalsurgeon general dentist Dr
Kanika Manchanda, and we aretalking all about the teeth and
the smile and gum health.
And let's move on to a fewcosmetic type questions
(17:11):
Whitening it seems like lots ofpeople are interested in having
bright, white, clean teeth.
Speaker 2 (17:17):
Yes, absolutely.
I think whitening is soeffective with traditional
methods and even some newer ones.
There are two things toconsider.
When we talk about whitening,we talk about intrinsic versus
(17:40):
extrinsic stain.
So a lot of the traditionalmaterials of whitening, such as
hydrogen peroxide or carbamideperoxide, really attack both
intrinsic and extrinsic stainfor a whiter and brighter smile.
And what differs between howfast it is versus slow and
steady is actually thepercentage of the hydrogen
peroxide that is used.
So the higher amount is goingto whiten your teeth faster.
(18:05):
However, a higher amount canactually have destructive
effects on your gums not yourteeth, but your gums, teeth but
your gums.
So it's very important that ifyou're using a higher percentage
, you're getting customwhitening trays from your
dentist that only touch theteeth and help prevent burning
(18:25):
of the gums, or you can visityour dentist for an in-house
whitening procedure where higherpercentage is used for a more
dramatic effect and in the inthe, we protect your gums with
it like it's a gum mask, if youwill, so that none of the
product gets on your gums.
Even the at-home whiteningtrays like the Crest whitening
(18:49):
strips or Opalescence trays.
They are very effective withgood, consistent use.
Even though they're a lowerpercentage.
They're very effective and Irecommend them to all my
patients.
In the era of social media andTikTok, a lot of people are
using purple whitening productsand that's been the new and
(19:17):
exciting product for consumers,because it's something different
.
But we have to ask ourselves isit effective?
So purple whitening treatmentis all based on color theory.
Purple cancels out yellow.
So when you're using purple onyour teeth, out yellow.
(19:39):
So when you're using purple onyour teeth, it can temporarily
make your teeth look whiter.
But back to what we werediscussing before that's only
attacking the extrinsic stain,that's not getting inside of the
actual tooth structure.
So yes, purple toothpaste orpurple whitening can help, but
it's temporary and it's not aseffective as the hydrogen or
(20:01):
carbamide peroxide.
Speaker 1 (20:03):
Interesting yeah.
Speaker 2 (20:04):
Another thing we see is an LED light.
A lot of times people areputting this little LED light in
their teeth and walking aroundwith it on social media.
From my research one, itdepends on the light source and
how strong it is.
So these cheaper LED lights areprobably not effective.
(20:28):
Some of the more the researchedlights still need more studies
because the studies are varyingwhether it actually whitens
teeth more than the hydrogenperoxide.
So I would say further researchneeds to be done.
If it were me, I would just gowith what is known.
(20:51):
I always recommend the hydrogenperoxide to patients, just
because we know it works, so whynot use it?
Speaker 1 (20:59):
and can you do whitening of existing crowns and
veneers or only natural teeth?
Speaker 2 (21:05):
that's a great question.
Only natural teeth.
So that's why shade selectionis very important with your
dentist when you are talkingabout a smile makeover or even
just having one crown or veneerplaced.
Sometimes that's necessary incases of trauma.
(21:25):
But really making sure you'rehappy with that shade match
before selecting a shade.
Speaker 1 (21:34):
Now in terms of fillings, I've read that the
average lifespan of a filling isseven to nine years.
How is a filling replaced?
Are there risks?
Obviously you want to try toprevent getting cavities and
fillings in the first place.
Speaker 2 (21:47):
Yes, exactly so, when a filling does not need to be
done, that's your best casescenario changing your diet and
lifestyle to help decrease thesize of the cavity.
However, once the cavity hasgotten into the second layer of
the tooth, it will not change,it will only get bigger.
(22:11):
So that's when a filling isindicated.
Replacing a filling and howlong it lasts depends on two
factors.
One is the original size of thecavity.
The bigger the cavity, the morelikely it is to be replaced in
the future, because the morelikely the margins of the
(22:33):
filling are to be destroyed.
The second factor is the skillof the clinician.
If you're having good isolationprotocols and adhesion
protocols, where saliva andother bacteria are not
contaminating the filling asit's being done, you get a
(22:53):
strong bond to the tooth, theless likely it is to be replaced
.
So for average sized filling Icould argue, with good scale of
a clinician and good isolationand no blood contamination, I
believe that the filling couldlast a lifetime.
(23:14):
The filling could last alifetime, that being said, if it
was a really, really bigfilling.
And I would say a filling maydecrease the size of that lesion
.
Obviously, but potentially apatient may need further
treatment, such as a crown ifthe filling fails.
Speaker 1 (23:34):
Let's move on to halitosis, bad breath.
What are some of the causes andsolutions?
Speaker 2 (23:43):
Bad breath is truly dependent on the type of
bacteria you have in your mouth.
So the stronger bacteria, theones that don't need as much
oxygen, or the gram-negativeanaerobic bacteria, cause
halitosis or bad breath, andthis is seen, really, with
patients that have periodontaldisease.
(24:05):
So they have a bad balance ofbacteria in their mouth or they
have a dry mouth where saliva isnot protecting the good
bacteria as much, and this couldbe due to medical conditions,
certain medications and, mostcommonly, smoking.
For the average patient thathas good oral hygiene that gets
(24:29):
bad breath, the solutions aremuch simpler than a patient that
has bad breath due to dry mouthor smoking.
In a normal, healthy patient, Iwould say, increasing your oral
hygiene maybe you're onlybrushing once a day and changing
that to twice a day makes ahuge difference.
(24:51):
So simple solutions, I wouldsay.
For a patient that's morecomplex, changing your type of
toothpaste may be helpful, suchas a toothpaste called
Paradontax or any brand that hasa gum restore label on it, and
you may need something calledscaling and root planning.
(25:14):
This is commonly known as deepcleaning, scaling and root
planning.
This is commonly known as deepcleaning.
When you get more bone and gumloss, the bacteria travel
further and further down thetooth and they kind of just stay
there unless it's physicallyand mechanically removed.
So patients that haveperiodontal disease sometimes
(25:35):
need this procedure to helpchange the bacteria of the mouth
and restore it to good balance.
Speaker 1 (25:43):
So obviously.
Good nutrition and we have somany podcasts on that and
understanding the whole gut andbody microbiome has so much
influence on so many diseasesand I think we're really just
starting to basically understandsome of that and there's so
much more to discover.
Do you promote like xylitolmouthwash or xylitol toothpaste
(26:05):
or chewing xylitol gum to helppromote a better microbiome?
Speaker 2 (26:10):
Absolutely.
That is a wonderful way todecrease the cycle of what we
call remineralization anddemineralization.
So xylitol, amongst otherfactors, some essential oils in
mouthwash, sometimes fluoridatedtoothpaste it just depends on
(26:31):
the patient's regimen and whatfactors work best for them
regimen and what factors workbest for them.
But essentially they help breakthat cycle where when you're
eating high sugar foods, thebacteria will then thrive on
them and produce acid.
Just like we produce pee andpoo is our byproduct.
(26:53):
They produce acid which attacksour enamel and causes
porosities or holes in the outerlayer and sometimes the inner
layer of our teeth.
So xylitol specifically, thebacteria cannot break down like
they can with traditional fruitcans and sucrose and other
(27:14):
sugars that we consume.
It's actually very protectiveagainst that cycle of acid
destruction.
Speaker 1 (27:23):
So tell us what are some of the best ways to brush
and floss our teeth?
Speaker 2 (27:28):
You know, aside from our regular brushing and
flossing regimen, something ingeneral that will help us not
even get cavities is lesssnacking, and so the longer the
sugar is on our teeth, the moredestruction we have.
(27:49):
So, for example, if a patientwere to eat 10 cookies in one
sitting versus one cookiethroughout the day, little
pieces every 10 minutes you'reeating the same cookie.
The patient that eats that onecookie is going to get less cap.
I'm sorry.
The patient that gets eats the10 cookies in one sitting is
(28:12):
going to get less cavitiesbecause they're not having that
acid attack throughout the day.
So really, less snacking wouldbe important and if you're going
to snack, rinsing your mouthout with just regular water
after is important to decreasethat cycle.
Neutralizing your mouth withsomething more basic, such as
(28:35):
milk or cheese or vegetables,even that contain calcium and
better vitamins and minerals tobalance that cycle, is going to
help decrease the amount ofcavities and gum and tissue loss
you have in general.
Speaker 1 (28:53):
So I think for adults , it should be easier for us to
just only eat a couple meals aday and then rinse out our mouth
.
For children, growing childrenand toddlers like my
grandchildren, they love tosnack, and so I think just the
other day my son was admonishingme because I wanted to give
milk to my granddaughters afterhaving tuna fish.
(29:15):
He's like why do that?
That's not good, Let theirstomach settle.
I'm like no, I want to rinsetheir teeth off.
So I'm going to tell him thatthat's the dentist endorses,
that I agree.
Speaker 2 (29:26):
Tuna and milk do it.
I think with kids it'sespecially difficult, because
children traditionally love toeat carbohydrate containing food
that sticks to your teethpretzels, goldfish chips.
They just stay on the teeth andthey're they're the inner layer
(29:48):
of their tooth.
Their pulp is very largecompared to adults, so it's
really easy for a child to get acavity and it just grow super
quick.
So changing their snacks oradding something to neutralize
their their snack willdefinitely help.
Speaker 1 (30:06):
And that's why I usually give them little pieces
of cheese, as opposed tocrackers like their parents.
And then they look at methey're getting too much cheese.
Well, I'm an osteoporosisdoctor, a bonehead.
We love cheese, we love milk,we love calcium.
We think it's good for you andI've actually done some research
in the area because it seemslike dentistry and medicine are
(30:27):
so separate but they're soimportant and together.
And we know that.
Your dental health.
I always ask my patients abouttheir dental health because we
know that there's a link withtheir bone status and
osteoporosis.
And the other thing I tell allmy adult patients to brush their
teeth twice a day and do theirKegel exercises for their women,
for their pelvic floor, so Ilink the two, just so you know I
(30:50):
love that.
That is so smart.
Now tell us, what do yourecommend for patients, young
and old, of all ages, who arevery nervous and fearful of
going to the dentist?
I'm not, because it's my onetime to put my feet up and relax
.
I'm strange.
I like going to the dentistbecause I get a few minutes
apiece, but most people don't.
Speaker 2 (31:10):
I would agree, I would say you're in less than 1%
.
But I take dental anxiety veryseriously.
I try to teach it.
I try to treat it as a medicalproblem because it is, and if
people have a bad experiencewhen they're young that that
(31:31):
will shape how much they see adentist in the future.
And any time.
Truly, I would say over 90% ofthe time I have seen a patient
with very, very poor dentalhygiene or severe dental issues.
They have told me that they'vehad a dentist in the past that
(31:51):
they had bad experience with andthen since then they never
wanted to come back.
So treating it like a trueproblem is important to me.
On a non-medication basedregimen, I really just talking
to them and showing empathy andthat I actually care that they
have dental anxiety has workedvery well to create trust
(32:14):
between me and my patient verywell.
To create trust between me andmy patient, small techniques
such as warning them, such astelling them what is to come,
without using scary words, butbeing honest, has also been very
helpful, because they don'tlike surprises.
When you're fearful, the lastthing you need is a surprise.
(32:35):
And then, thirdly, some verysimple changes Making the
environment calmer, so turningoff the TV sound, if that's, you
know, triggering them in theroom, potentially adding
essential oils to the room tomake it feel more calming
spa-like, if you will.
(32:56):
To make it feel more calming,spa-like, if you will, taking
the lead apron that we use forx-rays and placing it over them
so that they could feel a senseof like a hug.
Essentially, it has worked veryeffectively because people like
that weighted, blanket feeling.
So even just small changes likethat or giving somebody a
(33:19):
squeeze ball to squeeze duringan injection, has really built
trust and I really like to startthere and they really do need
it.
Then we talk more aboutmedication and potentially
(33:39):
adding a benzodiazepine to theregimen before they come in,
trying to get them relaxed thatway and then getting everything
we need to done get efficientand letting the patient leave.
Speaker 1 (33:54):
Well, you have an excellent bedside manner and I
think that's so important foranyone in the clinical field.
In our first season of Speakingof Women's Health podcast, we
had pediatric dentist Dr RachelRosen on and I had the
opportunity to take mygranddaughter Artemis there
after she jumped off a table andsmashed in her front baby teeth
(34:15):
, and I was so impressed withthe whole setup of the place
that was geared to children,geared to reducing anxiety,
geared to talking to them ontheir level.
The treats were not candy, theywere little toys that they got.
In fact, I made sure I broughther a different gift because I
was so thankful for her addingus on, as opposed to giving her
(34:37):
chocolate, because I'm like, oh,she's a dentist, I can't do
anything sugar, but I thoughtthat was just so impressive.
And if anyone wants to hear allabout dental care for the very
little ones and when to see adentist getting the first tooth,
go back and listen to our firstpodcast.
And there's so much more I'dlike to talk to you about.
(34:58):
I'd really like to talk about,in the future, the Botox and the
cosmetic stuff that you do.
That's the first time I'veheard about a dentist doing that
, but I guess that's verypopular.
It's used for migraine, it'sused for all sorts of things.
What are some of the majorreasons you do it?
Is it just pure cosmetic forthe face, or is it TMJ?
Speaker 2 (35:17):
That's a great question.
It's something that I wastrained in post-dental school
and there are different levelsof training, so you know it's
important to do your research asa patient as well and find a
provider that you trust, to behonest about what type of
results that they are able toachieve, because, at the end of
(35:39):
the day, we are dentists.
We are not cosmetic surgeons,plastic surgeons or
dermatologists.
Nevertheless, certain resultscan be achieved cosmetically
that can make sense for ahandful of people.
So I do TMJ therapy, which Ithink is a great additive in
(36:02):
addition to a traditional nightguard that a patient uses, and
there are different indicationsfor Botox when discussing TMJ
therapy, and it's not foreverybody.
Tmj therapy is very complex andit depends on the severity of
(36:23):
the problem mild, moderate orsevere.
So in more severe cases, I willalways refer a patient to see a
TMJ specialist.
In more mild to moderate cases,if a patient, for example,
cannot tolerate having a devicein their mouth, because not
everyone can sleep with a thickplastic device in their mouth,
(36:46):
sometimes, when the source ofthe pain really is from the
lower half of the face, they'regetting muscle tension in the
masseter stemming from the tmddisorder that they have it rides
up to their the temples.
Botox has actually been provento be a very good treatment
(37:08):
modality to help decrease thosesymptoms and help decrease their
ability to clench at all,because you're actually
decreasing the muscle movementand their physical ability to
clench their teeth, if that iswhy they have TMD.
Additionally, I do do cosmeticBotox but, like I said, it is
(37:31):
very patient-specific and it ismostly for the upper half of the
face, sometimes lower half ofthe face.
I limit myself, obviously to myprofession, which is head and
neck.
Speaker 1 (37:44):
Well, it has been so interesting talking to you, and
I wanna bring you back in theSunflower House, hopefully,
because we didn't get a chanceto talk about mouthwashes and
fluoride.
Fluoride has been so much inthe news, there's so much
controversy, there's a lot ofplaces that are now taking
fluoride out of the water, andso we have to bring you back,
(38:04):
but I really want to thank youso much for joining us.
Dr Kanika Manchanda, tell ushow people can reach you or get
an appointment with you, or anysocial media that you have or
any resources we can put in theshow notes.
Speaker 2 (38:20):
Thank you so much for having me here.
It's been wonderful I can bereached.
The office that I work at iscalled Rockside Family Dental.
We are located in IndependenceOhio.
If you'd like to reach me viasocial media, I do have my
dental account, which is atKanika Manchanda, my first name
(38:41):
and last name, dds.
Speaker 1 (38:45):
Well, that is wonderful and I'd like to thank
our listeners for joining us onthe Speaking of Women's Health
podcast, and we're so gratefulfor your support and hope you'll
consider supporting us, sharingthe podcast, leaving a
five-star rating, and to catchall the latest from Speaking of
(39:07):
Women's Health, you cansubscribe for free.
Just hit the follow orsubscribe button.
Anywhere you listen to podcastsApple Podcasts, spotify, tune
in.
Where you listen to podcastsApple Podcasts, spotify, tune in
.
And thanks again for listeningand we will see you next time in
the Sunflower House.
Be strong, be healthy and be incharge.
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