Speaking of Women's Health
The Speaking of Women's Health Podcast is excited to bring you credible women's health information from host and Executive Director, Dr. Holly L. Thacker. Dr. Thacker will interview guest clinicians discussing relevant women's health topics and the latest news and tips.
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Speaking of Women's Health
Dental Health: Just as Important as Your Medical Health
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.
Welcome to the Fit, Healthy and Happy Podcast hosted by Josh and Kyle from Colossus...
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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, and I am glad to be back in the Sunflower House for a new episode. For a new episode. Joining me on this new episode of our Speaking of Women's Health podcast is dental surgeon Dr Kanika Manchanda. She grew up in Orlando Park, a suburb of Chicago, and she earned her bachelor's degree in human nutrition and then she got a bunch of minors. She reminds me of my PhD son. She got into biology, chemistry and Spanish from the University of Illinois at Urbana-Champaign. She then went on to pursue her doctor of dental surgery at Marquette University in Milwaukee.
Speaker 1:Dr Manchanda is an active member of the American Dental Association, the Ohio Dental Association, the Greater Cleveland Dental Society and the Special Care Dental Association, and she keeps up with all the latest advances in aspects of dentistry. And she also attends the women in dentistry meetings. And she enjoys all aspects of general dentistry, from placing fillings to performing root canals, dental implants over dentures, smile makeovers and Botox treatment. Interestingly, in her free time she enjoys experimenting with new recipes, choreographing dances, working out, playing tennis, discovering new coffee shops and, near and dear to my heart, spending time on the golf course with her husband. Hopefully we can get um a golf date set up in the future. I love to golf, so welcome, dr Manchanda. We're so excited to have you as a guest on the Speaking of Women's Health podcast to talk about dental cosmetic procedures and tell our listeners what your first name means. It's so adorable.
Speaker 2:Oh, thank you so much. Thank you so much for having me, dr Thacker. I'm excited to be here. My first name, kanika, means the smallest, most precious piece of gold in the language of Hindi. So I'm the youngest in the family and I was privileged with that name.
Speaker 1:That is lovely, so tell our listeners a little bit more about your professional background and why you got into dentistry.
Speaker 2:Dentistry is not something that I thought I would go into at a young age, so it was a little bit of surprise for myself as well.
Speaker 2:My parents are both in health care. They are both physical therapists, so naturally I knew I wanted to be in healthcare, growing up with appreciation for health and wellness. One day I randomly it was a little random for me I shadowed a dentist sometime before college, just to figure out hey, this isn't healthcare, is this something I could see myself doing? Well, good thing I did, because what I appreciated was the physical help that the dentist was able to provide the patient getting out of pain, and the trust that was built there. And then a physical product that was made with the dentist's hands, because I'm always in motion, always talking with my hands. So a physical career within healthcare was really important to me and I also enjoy all the confidence that was built for a patient once cosmetic work was completed and that has impacted a patient's physical health and also their mental health, and that has been transformative for not only the patient but for me as a provider. I've been so lucky to be a part of that journey for patients.
Speaker 1:Well, that just sounds wonderful. What are some of the more popular dental procedures you perform in the office?
Speaker 2:I have been at my current office for a little while now, and before this I worked in another office with a different socioeconomic population, and that has actually changed a lot of the most common procedures that I've been able to perform. I am a general dentist, which I take great pride in because I enjoy all the variety that we see throughout the field. I will say you know, before I joined this practice, a lot of what I did was we did a lot of fillings. There was a lot of decay to be prevented and we did a lot of extractions to be prevented, and we did a lot of extractions. We did a lot of removal of the teeth, because not everyone can afford to either save their teeth or even replace their teeth. So, um, it was a lot of removing of the teeth.
Speaker 2:If we were to replace them, usually it was with dentures or partials, which are removable devices. They come in and out of the mouth and they work effectively. There are more sound solutions. However, it is very affordable for patients and it does provide teeth in the mouth. Now in this, in another practice I've been a part of at Rockside Family Dental, we see less removing of the teeth.
Speaker 2:It's it's a lot of of what I do is try to save our teeth, because there's nothing like your own teeth at the end of the day. If that is not possible, if the tooth is cracked or severely decayed and cannot be saved, we do remove it. I have seen that a lot of patients would like to replace their teeth with more sound solutions such as dental implants, which are becoming very popular because they stay in the mouth, they do not. They function as your regular tooth at the end of the day, nothing that you have to insert and remove every night. So I would say overall, commonly we perform fillings across the board, but what I do a lot of now, I do a lot of root canals, I do a lot of crowns and more cosmetic work as well.
Speaker 1:And what is the difference between a crown and a veneer?
Speaker 2:That's a great question. So a crown covers the full front, top and back of a tooth. A veneer only covers the front of a tooth and there are different indications for each one In the back of your mouth, because we do most of our chewing with our back teeth and we have most of the load with the back teeth. Even if you're doing some type of cosmetic work A lot of time with your back molars, you cannot see those teeth. But even if you can, it's recommended to have a crown because it's covering more of the tooth and there's less chance that a crown would fall off in the back of the mouth than a veneer would In the front of the mouth.
Speaker 2:It depends on how much of the tooth we are changing. So, cosmetically, there are certain parameters where veneer is indicated if we are able to be more conservative and do less changing. So we're talking about a patient that likes the way their teeth are shaped. They like the alignment of their teeth, but maybe they just wanted to change the color of the tooth. That would be a good indication for a veneer. If we have to change a shape of the tooth dramatically, a crown may be indicated. Another reason a crown may be indicated over a veneer is more likely to pop off long term, a crown may be indicated so a patient doesn't have to deal with that type of discomfort or regular visit to put the veneer back on.
Speaker 1:So what are some of the latest and greatest procedures?
Speaker 2:honestly, a lot of dentistry in the last couple of decades is turning more conservative, which is the way I like to practice as well. We try to focus on no intervention. When possible, we talk more about a patient's diet and lifestyle changes they can make to prevent cavities, instead of the old drill and fill model. Any little shadow on the x-ray does not mean that we as dentists need to intervene. We like to tell patients, we like to discuss why you're getting cavities, where on the tooth they are present, and intervene that way Now if a restoration or a filling has to be placed because the lesion has advanced to a point of no return. Another popular subject in dentistry is called biomimetic dentistry, trying to emulate what our body does naturally to improve a patient's teeth, rather than some of the older protocols that we have In dentistry. A common procedure, as we've discussed, is fillings, and fillings have improved over time so that the chemistry, the bond between the actual filling and your tooth, so you don't have to replace that filling as often, and biomimetic dentistry has actually helped change some of those protocols, which is wonderful for our patients and us. Another procedure that we slightly touched on is something called dental implants, and while dental implants have been around for many years. There have been so many advancements in the type that we are able to place in a patient's mouth the materials. There are so many indications for more aggressive dental implants, less aggressive dental implants and where they are in the mouth to make sure that there are less complications with that.
Speaker 2:One thing that I really enjoy are some of the technological advancements in dentistry, for example, we are now a lot of offices are using scanners which patients may see or be a part of, instead of those conventional dental impressions where you take a tray, you put the goopy material in, put it in a patient's mouth and let it dry.
Speaker 2:Those are not that comfortable and while they're still used, when a patient can get a scan done instead of that goopy material in their mouth, I think a lot of people are happier.
Speaker 2:And from there, that scan gets uploaded to a platform and then a 3D printer can actually print the patient's mouth versus the traditional methods we had, and that tends to be a lot more accurate. So from there, when you're making crowns or veneers or any implant crowns anything that needs to be fabricated to put in a patient's mouth there's a lot less error, which has been really improving the patient flow when the patient comes back into the chair and from there, from that scan, we can also do a lot more with digital smile design, which is where we can take pictures of a patient. We can take a scan of their mouth and actually combine them so a patient can see what their smile will look like when they're having a full mouth smile makeover done. They can physically see what the smile will look like in their mouth before committing to the treatment, which has really been great for patients because it increases trust with their provider and gives them confidence that this is something that they like to do.
Speaker 1:That's interesting. They're doing that in home improvement. When I was looking at making an extension to my house. They used the computer to say this 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 common complaints and issues. Loss of gum tissue Is it normal for people to lose gums as they get older?
Speaker 2:It is normal. The prevalence is about 65% after age 30. And what varies is the degree of the gum loss. So less than a millimeter is pretty standard and normal, which is why preventative care is so important Because, let's say, you lose a little bit of gum tissue throughout the next couple years. We can see the changes from now over the next 10 years and if that amount has not changed, that is a good sign. If there are significant changes over 10 years, that is abnormal and we'd have to see why those changes are occurring as they occur.
Speaker 2:Sometimes this can happen because of genetics, overzealous brushing, something called periodontal disease, bruxism, which is where patients may be clenching or grinding excessively. Patients may be clenching or grinding excessively and mouth trauma, so maybe getting a blow to the face or having a fall. So really monitoring how much we lose gums and why we lose gums is important for the treatment. What is the treatment? Usually it depends on the severity. So when it's's severe, something called a gum graft may be indicated. Um, and I'm saying it's if it's severe or not is because the success of a gum graft depends on the severity of how much you've lost. So it's strange, but the more you lose sometimes, the better the outcome of the procedure is.
Speaker 2:It can be a painful procedure so it's not recommended for everybody. So you know we do have some patients that lose less than a millimeter of gum tissue and they're interested in replacing it. But you know everyone's different. I don't always recommend it because you have to weigh the benefits, the risks and if it even works. Sometimes, when it's very minor, we can actually wear. You've lost gum tissue. We can replace it not with gum tissue but with a filling material. You don't have to drill anything, you just kind of plop the filling in and it bonds to the tooth and it can help decrease sensitivity. It can help decrease food particles from getting into that space and making the gum loss worse.
Speaker 1:Oh, that's very interesting. You have been listening to the Speaking of Women's Health podcast and I am your host, dr Holly Thacker, and we are in the Sunflower House with dental surgeon general dentist Dr Kanika Manchanda, and we are talking all about the teeth and the smile and gum health. And let's move on to a few cosmetic type questions Whitening it seems like lots of people are interested in having bright, white, clean teeth.
Speaker 2:Yes, absolutely. I think whitening is so effective with traditional methods and even some newer ones. There are two things to consider. When we talk about whitening, we talk about intrinsic versus extrinsic stain. So a lot of the traditional materials of whitening, such as hydrogen peroxide or carbamide peroxide, really attack both intrinsic and extrinsic stain for a whiter and brighter smile. And what differs between how fast it is versus slow and steady is actually the percentage of the hydrogen peroxide that is used. So the higher amount is going to whiten your teeth faster. However, a higher amount can actually have destructive effects on your gums not your teeth, but your gums, teeth but your gums. So it's very important that if you're using a higher percentage, you're getting custom whitening trays from your dentist that only touch the teeth and help prevent burning of the gums, or you can visit your dentist for an in-house whitening procedure where higher percentage is used for a more dramatic effect and in the in the, we protect your gums with it like it's a gum mask, if you will, so that none of the product gets on your gums. Even the at-home whitening trays like the Crest whitening strips or Opalescence trays. They are very effective with good, consistent use. Even though they're a lower percentage. They're very effective and I recommend them to all my patients.
Speaker 2:In the era of social media and TikTok, a lot of people are using purple whitening products and that's been the new and exciting product for consumers, because it's something different. But we have to ask ourselves is it effective? So purple whitening treatment is all based on color theory. Purple cancels out yellow. So when you're using purple on your teeth, out yellow. So when you're using purple on your teeth, it can temporarily make your teeth look whiter. But back to what we were discussing before that's only attacking the extrinsic stain, that's not getting inside of the actual tooth structure. So yes, purple toothpaste or purple whitening can help, but it's temporary and it's not as effective as the hydrogen or carbamide peroxide.
Speaker 1:Interesting yeah.
Speaker 2:Another thing we see is an LED light. A lot of times people are putting this little LED light in their teeth and walking around with it on social media. From my research one, it depends on the light source and how strong it is. So these cheaper LED lights are probably not effective. Some of the more the researched lights still need more studies because the studies are varying whether it actually whitens teeth more than the hydrogen peroxide. So I would say further research needs to be done. If it were me, I would just go with what is known. I always recommend the hydrogen peroxide to patients, just because we know it works, so why not use it?
Speaker 1:and can you do whitening of existing crowns and veneers or only natural teeth?
Speaker 2:that's a great question. Only natural teeth. So that's why shade selection is very important with your dentist when you are talking about a smile makeover or even just having one crown or veneer placed. Sometimes that's necessary in cases of trauma. But really making sure you're happy with that shade match before selecting a shade.
Speaker 1:Now in terms of fillings, I've read that the average lifespan of a filling is seven to nine years. How is a filling replaced? Are there risks? Obviously you want to try to prevent getting cavities and fillings in the first place.
Speaker 2:Yes, exactly so, when a filling does not need to be done, that's your best case scenario changing your diet and lifestyle to help decrease the size of the cavity. However, once the cavity has gotten into the second layer of the tooth, it will not change, it will only get bigger. So that's when a filling is indicated. Replacing a filling and how long it lasts depends on two factors. One is the original size of the cavity. The bigger the cavity, the more likely it is to be replaced in the future, because the more likely the margins of the filling are to be destroyed.
Speaker 2:The second factor is the skill of the clinician. If you're having good isolation protocols and adhesion protocols, where saliva and other bacteria are not contaminating the filling as it's being done, you get a strong bond to the tooth, the less likely it is to be replaced. So for average sized filling I could argue, with good scale of a clinician and good isolation and no blood contamination, I believe that the filling could last a lifetime. The filling could last a lifetime, that being said, if it was a really, really big filling. And I would say a filling may decrease the size of that lesion. Obviously, but potentially a patient may need further treatment, such as a crown if the filling fails.
Speaker 1:Let's move on to halitosis, bad breath. What are some of the causes and solutions?
Speaker 2:Bad breath is truly dependent on the type of bacteria you have in your mouth. So the stronger bacteria, the ones that don't need as much oxygen, or the gram-negative anaerobic bacteria, cause halitosis or bad breath, and this is seen, really, with patients that have periodontal disease. So they have a bad balance of bacteria in their mouth or they have a dry mouth where saliva is not protecting the good bacteria as much, and this could be due to medical conditions, certain medications and, most commonly, smoking. For the average patient that has good oral hygiene that gets bad breath, the solutions are much simpler than a patient that has bad breath due to dry mouth or smoking. In a normal, healthy patient, I would say, increasing your oral hygiene maybe you're only brushing once a day and changing that to twice a day makes a huge difference. So simple solutions, I would say.
Speaker 2:For a patient that's more complex, changing your type of toothpaste may be helpful, such as a toothpaste called Paradontax or any brand that has a gum restore label on it, and you may need something called scaling and root planning. This is commonly known as deep cleaning, scaling and root planning. This is commonly known as deep cleaning. When you get more bone and gum loss, the bacteria travel further and further down the tooth and they kind of just stay there unless it's physically and mechanically removed. So patients that have periodontal disease sometimes need this procedure to help change the bacteria of the mouth and restore it to good balance.
Speaker 1:So obviously. Good nutrition and we have so many podcasts on that and understanding the whole gut and body microbiome has so much influence on so many diseases and I think we're really just starting to basically understand some of that and there's so much more to discover. Do you promote like xylitol mouthwash or xylitol toothpaste or chewing xylitol gum to help promote a better microbiome?
Speaker 2:Absolutely. That is a wonderful way to decrease the cycle of what we call remineralization and demineralization. So xylitol, amongst other factors, some essential oils in mouthwash, sometimes fluoridated toothpaste it just depends on the patient's regimen and what factors work best for them regimen and what factors work best for them. But essentially they help break that cycle where when you're eating high sugar foods, the bacteria will then thrive on them and produce acid. Just like we produce pee and poo is our byproduct. They produce acid which attacks our enamel and causes porosities or holes in the outer layer and sometimes the inner layer of our teeth. So xylitol specifically, the bacteria cannot break down like they can with traditional fruit cans and sucrose and other sugars that we consume. It's actually very protective against that cycle of acid destruction.
Speaker 1:So tell us what are some of the best ways to brush and floss our teeth?
Speaker 2:You know, aside from our regular brushing and flossing regimen, something in general that will help us not even get cavities is less snacking, and so the longer the sugar is on our teeth, the more destruction we have. So, for example, if a patient were to eat 10 cookies in one sitting versus one cookie throughout the day, little pieces every 10 minutes you're eating the same cookie. The patient that eats that one cookie is going to get less cap. I'm sorry. The patient that gets eats the 10 cookies in one sitting is going to get less cavities because they're not having that acid attack throughout the day. So really, less snacking would be important and if you're going to snack, rinsing your mouth out with just regular water after is important to decrease that cycle. Neutralizing your mouth with something more basic, such as milk or cheese or vegetables, even that contain calcium and better vitamins and minerals to balance that cycle, is going to help decrease the amount of cavities and gum and tissue loss you have in general.
Speaker 1:So I think for adults, it should be easier for us to just only eat a couple meals a day and then rinse out our mouth. For children, growing children and toddlers like my grandchildren, they love to snack, and so I think just the other day my son was admonishing me because I wanted to give milk to my granddaughters after having tuna fish. He's like why do that? That's not good, Let their stomach settle. I'm like no, I want to rinse their teeth off. So I'm going to tell him that that's the dentist endorses, that I agree.
Speaker 2:Tuna and milk do it. I think with kids it's especially difficult, because children traditionally love to eat carbohydrate containing food that sticks to your teeth pretzels, goldfish chips. They just stay on the teeth and they're they're the inner layer of their tooth. Their pulp is very large compared to adults, so it's really easy for a child to get a cavity and it just grow super quick. So changing their snacks or adding something to neutralize their their snack will definitely help.
Speaker 1:And that's why I usually give them little pieces of cheese, as opposed to crackers like their parents. And then they look at me they're getting too much cheese. Well, I'm an osteoporosis doctor, a bonehead. We love cheese, we love milk, we love calcium.
Speaker 1:We think it's good for you and I've actually done some research in the area because it seems like dentistry and medicine are so separate but they're so important and together. And we know that. Your dental health. I always ask my patients about their dental health because we know that there's a link with their bone status and osteoporosis. And the other thing I tell all my adult patients to brush their teeth twice a day and do their Kegel exercises for their women, for their pelvic floor, so I link the two, just so you know I love that. That is so smart. Now tell us, what do you recommend for patients, young and old, of all ages, who are very nervous and fearful of going to the dentist? I'm not, because it's my one time to put my feet up and relax. I'm strange. I like going to the dentist because I get a few minutes apiece, but most people don't.
Speaker 2:I would agree, I would say you're in less than 1%. But I take dental anxiety very seriously. I try to teach it. I try to treat it as a medical problem because it is, and if people have a bad experience when they're young that that will shape how much they see a dentist in the future. And any time. Truly, I would say over 90% of the time I have seen a patient with very, very poor dental hygiene or severe dental issues. They have told me that they've had a dentist in the past that they had bad experience with and then since then they never wanted to come back. So treating it like a true problem is important to me.
Speaker 2:On a non-medication based regimen, I really just talking to them and showing empathy and that I actually care that they have dental anxiety has worked very well to create trust between me and my patient very well.
Speaker 2:To create trust between me and my patient, small techniques such as warning them, such as telling them what is to come, without using scary words, but being honest, has also been very helpful, because they don't like surprises.
Speaker 2:When you're fearful, the last thing you need is a surprise. And then, thirdly, some very simple changes Making the environment calmer, so turning off the TV sound, if that's, you know, triggering them in the room, potentially adding essential oils to the room to make it feel more calming spa-like, if you will. To make it feel more calming, spa-like, if you will, taking the lead apron that we use for x-rays and placing it over them so that they could feel a sense of like a hug. Essentially, it has worked very effectively because people like that weighted, blanket feeling. So even just small changes like that or giving somebody a squeeze ball to squeeze during an injection, has really built trust and I really like to start there and they really do need it. Then we talk more about medication and potentially adding a benzodiazepine to the regimen before they come in, trying to get them relaxed that way and then getting everything we need to done get efficient and letting the patient leave.
Speaker 1:Well, you have an excellent bedside manner and I think that's so important for anyone in the clinical field. In our first season of Speaking of Women's Health podcast, we had pediatric dentist Dr Rachel Rosen on and I had the opportunity to take my granddaughter Artemis there after she jumped off a table and smashed in her front baby teeth, and I was so impressed with the whole setup of the place that was geared to children, geared to reducing anxiety, geared to talking to them on their level. The treats were not candy, they were little toys that they got. In fact, I made sure I brought her a different gift because I was so thankful for her adding us on, as opposed to giving her chocolate, because I'm like, oh, she's a dentist, I can't do anything sugar, but I thought that was just so impressive.
Speaker 1:And if anyone wants to hear all about dental care for the very little ones and when to see a dentist getting the first tooth, go back and listen to our first podcast. And there's so much more I'd like to talk to you about. 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've heard about a dentist doing that, but I guess that's very popular. It's used for migraine, it's used for all sorts of things. What are some of the major reasons you do it? Is it just pure cosmetic for the face, or is it TMJ?
Speaker 2:That's a great question. It's something that I was trained in post-dental school and there are different levels of training, so you know it's important to do your research as a patient as well and find a provider that you trust, to be honest about what type of results that they are able to achieve, because, at the end of the day, we are dentists. We are not cosmetic surgeons, plastic surgeons or dermatologists. Nevertheless, certain results can be achieved cosmetically that can make sense for a handful of people. So I do TMJ therapy, which I think is a great additive in addition to a traditional night guard that a patient uses, and there are different indications for Botox when discussing TMJ therapy, and it's not for everybody.
Speaker 2:Tmj therapy is very complex and it depends on the severity of the problem mild, moderate or severe. So in more severe cases, I will always refer a patient to see a TMJ specialist. In more mild to moderate cases, if a patient, for example, cannot tolerate having a device in their mouth, because not everyone can sleep with a thick plastic device in their mouth, sometimes, when the source of the pain really is from the lower half of the face, they're getting muscle tension in the masseter stemming from the tmd disorder that they have it rides up to their the temples. Botox has actually been proven to be a very good treatment modality to help decrease those symptoms and help decrease their ability to clench at all, because you're actually decreasing the muscle movement and their physical ability to clench their teeth, if that is why they have TMD. Additionally, I do do cosmetic Botox but, like I said, it is very patient-specific and it is mostly for the upper half of the face, sometimes lower half of the face. I limit myself, obviously to my profession, which is head and neck.
Speaker 1:Well, it has been so interesting talking to you, and I wanna bring you back in the Sunflower House, hopefully, because we didn't get a chance to talk about mouthwashes and fluoride. Fluoride has been so much in the news, there's so much controversy, there's a lot of places that are now taking fluoride out of the water, and so we have to bring you back, but I really want to thank you so much for joining us. Dr Kanika Manchanda, tell us how people can reach you or get an appointment with you, or any social media that you have or any resources we can put in the show notes.
Speaker 2:Thank you so much for having me here. It's been wonderful I can be reached. The office that I work at is called Rockside Family Dental. We are located in Independence Ohio. If you'd like to reach me via social media, I do have my dental account, which is at Kanika Manchanda, my first name and last name, dds.
Speaker 1:Well, that is wonderful and I'd like to thank our listeners for joining us on the Speaking of Women's Health podcast, and we're so grateful for your support and hope you'll consider supporting us, sharing the podcast, leaving a five-star rating, and to catch all the latest from Speaking of Women's Health, you can subscribe for free. Just hit the follow or subscribe button. Anywhere you listen to podcasts Apple Podcasts, spotify, tune in. Where you listen to podcasts Apple Podcasts, spotify, tune in. And thanks again for listening and we will see you next time in the Sunflower House. Be strong, be healthy and be in charge.
