Episode 156 -Getting Real About Root Canals: Myths, Tips, And Your Oral Microbiome With Dr. Sonia Chopra (Full Transcript)
This is a full transcript of the Nirvana Sisters podcast episode 156.
Editor’s Note: Please know that this podcast transcript is automatically generated and may contain minor errors such as typos and word switches. For more information, be sure to listen to the podcast here or view our podcast episode guide.
SPEAKER_00:
Welcome to Nirvana Sisters Podcast, where we take the intimidation out of well-being and beauty to help you achieve your highest state, your nirvana. We are sisters-in-law and your hosts.
SPEAKER_02:
I'm Amy Sherman. And I'm Katie Chandler. So let's get into some real conversation. Welcome to the show, Nirvana Sisters family. Today, we are sitting down with Dr. Sonia Chopra. Dr. Sonia Chopra is a healer and a truth saver. She is a board certified endodontist, TEDx speaker, Forbes contributor, author, endodontic instructor, impact entrepreneur, and founder of the Ballantine Endodontics in Charlotte, North Carolina. Dr. Chopra became passionate about endodontics after a young dental patient was misdiagnosed and had a painful experience. The wrong tooth was extracted. It wasn't until she was referred to a caring endodontist that she was correctly diagnosed and a root canal saved her from pain. Now, Dr. Chopra is on a mission to save teeth wherever possible. On top of running her thriving practice, Dr. Chopra provides groundbreaking digital education and community support to general dentists and endodontists who want to up-level their technical skills, patient experience, and practice efficiency. through her thoughtfully designed courses and in-person programs, such as her award-winning e-school. She's revolutionizing endodontic continuing education through comprehensive lessons. That you are incredibly dynamic and sound like you must be very busy. A little bit.
SPEAKER_01:
Yeah. I have three beautiful kids to add into all that. Oh, wow. So, yeah. Yeah. Life is full. Well, thank you for your time today. Yeah, thank you for having me. I'm so excited to talk about my passion with you. It's hard for people to want to talk about teeth, so I'm grateful to you both.
SPEAKER_02:
Yeah, we're excited to talk about it. Before we get into it, let's do our Nirvana of the Week. Amy, why don't you kick us off?
SPEAKER_00:
OK, so I recently took inspo from Katie and I got a new piece of exercise equipment called the Tonal, which I love. Katie's had it for a long time and I've been like wanting to try it. And so I actually sold my Peloton bike and I got the Tonal. And I just started using it, but I already love it. It's just so cool and so different. And I just feel good because I, I still have my Peloton tread, which I still use happily. And I do a lot of Pilates and yoga, but I was just missing having more of the weight training. And like, I love having just like instruction, someone telling me what to do. So I've just, I've done it a few times this week and I'm really liking it. I just feel like I feel really good from it. So thanks for the inspo, Katie. And that was, that's been a fun Nirvana this week. What about you, Katie? Nice.
SPEAKER_02:
Yeah, I was excited to hear about the review on it. Yeah, I would say I had a girl's dinner the other night, which was so much fun. I don't usually socialize during the week. It's just like it's I mean, as we all know, it's hard to do. But once you get there, it's so worth it. And then I always so worried that the next morning I'm going to just be exhausted. And I was more energized than ever because, you know, it filled my cup. It was great to have some laughs with some friends and some great conversation. So it was nice. So I think that was definitely mine this week. What about you, Dr. Sonia?
SPEAKER_01:
Well, I, I got a little bit of nice feedback from one of my students, um, this week and it's, it's always nice when you, um, when someone actually shares the impact that you make on them. Cause a lot of times they keep it to themselves. So I got some good feedback this week, which was really, you know, just warmed my heart. So that's mine. That's great.
SPEAKER_02:
All right, well, let's get right into it. So we want to kick off with talking about oral microbiome. I think this is a newer topic for a lot of listeners, and maybe you could break that down for us a little bit. What is your oral microbiome? How do we take care of it? What is impacting it, et cetera?
SPEAKER_01:
Yeah, so our oral microbiome is really unique to each and every individual. And I think it's something that we need to start talking about because what is happening in our mouth and the environment in our mouth is really the gateway to the rest of our body. And up until now, I feel like people just kind of you know, maybe just didn't really understand or under undervalued or maybe just didn't pay attention to what was happening in our mouths. And I think things are changing now. And now people are trying to get a little bit more specific about what's happening to them. And one thing I want to say is that our environments and our mouths It's just like our DNA. It's very specific to each individual and every person is going to be different and unique with how we show up in our own microbiome in our mouths and also how we take care of those oral microbiome. So it's really the ecosystem in our mouth and how can we really nurture it and how can we take care of it and how can we really focus even on prevention to make sure that we can live long and healthy lives starting with our mouth.
SPEAKER_02:
Okay, excellent. So let's get into that a little bit. What are some things that we should be doing to take care of our... Actually, just to go back a quick second, does your oral microbiome impact the health of your teeth? I know that seems like an obvious, but I'm curious.
SPEAKER_01:
Yeah. So basically what we're talking about are the several hundreds of species of bacteria that exist in our mouth. And what can we do to make sure that those guys inside are playing well with each other and making sure that we maintain a level of homeostasis that is beneficial to us? The idea is not to get rid of these bacteria. We know that we need a healthy gut microbiome. And this is just the first part of that gut microbiome. So yeah, we're not trying to eliminate things. We're just wanting to make sure that we create this homeostasis that works well for us. Does that make sense?
SPEAKER_02:
It does. Yeah. And what gets us to that homeostasis of a healthy microbiome?
SPEAKER_01:
So I tell people it's really easy to avoid somebody like me. I haven't ended on it, so I'm a root canal specialist. So most people don't want to meet me. And for the most part, with the exception of maybe some trauma and an accident, right? Like you should be able to prevent being in my chair. And so that's really what I want to focus on because it's easy to really keep your dental costs down and also try to really avoid not needing that root canal. And it's simple. So I tell everyone, brush twice a day. And you would think that most people do, but it's really interesting how many people don't. And the cost of a toothbrush and toothpaste is so much cheaper than a root canal and a crown, right? I will say flossing every day is really hard for some people. And you know, I hang out with a lot of like biohackers and so they'll be like, they'll cold plunge and sauna and alternate that for like 20 minutes, but they won't floss. And so again, a cheap spool of floss is really, really easy to buy as opposed to a $1,500 root canal. So that right there is gonna keep you out of my chair, like by 80%. And then, of course, keeping up with your dental appointments and not really allowing them to lapse so that the dentist can find your issues while they're small, as opposed to getting big and needing to be referred to my practice. If you just kind of pay a little bit for those two visits a year, again, big savings in the long run, in my opinion. If you clench and grind, or if you find that you are a stressed out person and, you know, some people don't just grind at night, they grind at their desk and they're inducing cracks in their teeth, you know, finding a way to manage that, again, with a night guard. Again, it may be a little bit of an expense on the front end, but maybe you're going to prevent root canals on the back end. So that's where I want to focus like the prevention. It's just really simple daily routines and then sometimes an intervention twice a year. and keeping up with your cleanings as well. That's pretty much it. And you can really keep your dental costs down. I think there's a belief that you need to have dental insurance to do those things and go to the dentist, but that's not the case. A lot of times, dental offices will have their own in-house kind of insurance plan to help you keep your costs down. So if you are not covered, you can still go in and get those services done at a very reasonable cost. And, you know, again, we can find things when they're small. Makes sense.
SPEAKER_02:
Yeah. I have a question about. outside things that can impact the health of your teeth and of your mouth that, aside from the obvious, of course, like sugar and drinking sodas and things, and then everything you said, people that don't have proper dental hygiene, are there some factors that can affect the health of your teeth? Like I have to take glucocorticoid steroids. And so those, I have had a lot of problems with my teeth and I've had dentists tell me that it's because I am dependent on these steroids. Are there certain, does medication affect your teeth health? What are some of those that maybe people don't understand and that's why they're struggling so much?
SPEAKER_01:
Yeah, so there are a number of medications that can actually dry out your mouth and affect your saliva constitution. And saliva is super important. Saliva is your mouth's buffer. And when you have something sugary, and it doesn't just have to be plain old sugar, like anytime you ingest a carbohydrate, you are going to drop the pH in your mouth. and then it's going to become acidic. And when it becomes acidic, then it's going to attack the enamel, break down the enamel, and that's how you're going to create decay. So I don't want there to be this belief that it has to only be sugar or sodas or stuff like that. Any carbohydrate is actually going to make that decrease in the pH. When you don't have saliva, saliva is the buffer. So if our body wants to stay at that level seven, that saliva is necessary. So the moment you have an impact on your saliva, and that could be through medication, sometimes you can have, you know, a disorder or like some sort of disease like Sjogren's, where it attacks your salivary glands and you no longer can produce saliva. Anytime you impact the saliva production in your mouth, your buffering capability in your mouth is going to be impacted, and then you won't have that protection layer that you have from that saliva, and so you're going to get more cavities in somebody like that. And so if you do have that issue, and this is why I know fluoride is such a hot topic, but some people do need it. And people who have difficult manual dexterity, maybe they have arthritis in their hands and they can't brush and floss. you and I could. They're going to need some extra help with fluoride or maybe they had had a neck radiation and they don't have saliva production anymore. You may have to add some fluoride to their regimen because you don't want them to develop decay. So there are some benefits of things like fluoride, even though I feel like a lot of people think it's really taboo. But when you need it, it's important. And if you see that you are prone to cavities, you may want to see what's up with your saliva and if there's anything impacting your saliva, like something as simple as a high blood pressure medication can actually impact your saliva.
SPEAKER_00:
Interesting. Yeah. I want to go back to what you just said about fluoride, because I know There's a lot of conversation about it and I don't really understand. So can you break down like what people are talking about, like fluoride, not fluoride, like why it's bad, why it's good, et cetera?
SPEAKER_01:
Yeah, they believe it's a toxin. And I think probably anything in life if taken too much is a toxin. Yeah. But there are some medical benefits to it. There are some dental benefits. So, of course, if you take too much, it's not good. Right. But there is this happy I remember learning that it was about one part per million. So when you're looking at like well water versus city water, city water typically has the fluoride and well water doesn't. And also if you're using things like reverse osmosis in your household, you know, it's going to take certain things out and then you may no longer have fluoride. But if you have just that right level of fluoride, when you're in the growth and development stage, it can be very beneficial to children. Okay. And that's why they would put it in city water. But the moment you go above certain levels, you can actually create staining on the teeth, like this white kind of chalky look. And so, you know, you're getting too much. So testing your water is important to making sure you know what levels you're getting, if you're getting any at all, because if you're not and you have Your oral microbiome is what we call karyogenic, meaning your bacteria in your mouth causes decay or cavities. Because all of our mouths are going to be different. My teeth get cavities very easily. So when I was younger, I needed fluoride. I did not need fluoride. I don't need it into my adulthood, but during my growth and development, I did need it. My daughter's the same way. When I took her to the, and I'm a dentist, so I was so mortified. I took her to the dentist. Her first visit, she had eight cavities because I was like, no fluoride. I wouldn't let her use fluoride in her toothpaste. And then she got eight cavities. I literally got scolded by the dentist and I was like, Oh my gosh, I need to change something. The only thing I changed in her was her fluoride toothpaste and she stopped getting the cavity. So for her, she needs it. Why? Because she's got mama's bugs. I gave her her oral microbiome. My other children don't have that problem, but she did. And so again, you can see just within our own family, the oral microbiome is different. So one daughter needed fluoride, the other two don't. As their teeth, like, as she goes through growth and development, as children develop manual dexterity, then, you know, you can kind of trust them to take care of their teeth and then also not rely on things like fluoride. Make sense?
SPEAKER_02:
Yeah, it definitely makes sense. And I think for children, I mean, one of my daughters is horrible with her hygiene and my other one is excellent with it. But even the one that is excellent with it, she has the dexterity. It's really hard. So I'm going to make sure that they have fluoride in there. and their products but it's also I want to I just want to say really quickly because it's something that I've always felt and the last time I saw a dentist she spoke to me about it to to your point of what you just said is that some people just have it's almost like the DNA is to have a harder time with your teeth no matter how excellent your dental hygiene is and so there can be like embarrassment behind it and shame behind it and so you know for a long time I'd be like embarrassed to go to the dentist and and this dentist told me very clearly she said there's this is just the way that your mouth is and I I have a lot of patients that feel embarrassed about their teeth and you shouldn't because you could be doing everything right and still have a hard time. Yep.
SPEAKER_01:
And that, that's me. Like I always had eight cavities every time I went to the dentist. I even like, if I don't floss every day, like I can feel my teeth are just fuzzy. It just feels full in my mouth. And so I need to do that. And I look at my husband. And he can get away with doing nothing for weeks. If I skip one day of flossing, I feel it and my gums start to bleed. His don't. Me too.
SPEAKER_00:
I love flossing. It's like a massage.
SPEAKER_01:
Totally different oral microbiome between people. And so that's why I think it's really important. There are plenty of dental influencers out there who will say you don't need to floss, and then people are going to stop flossing. And that's not beneficial for that individual, that particular person. And so I think we really have to be careful what we say and who we say it to, because it is dependent on who you are as a person.
SPEAKER_00:
Right. And trust the professionals. Don't listen to people online that are
SPEAKER_02:
That's wild that people are saying that you should have flossed. I know. Influencers are trying to de-influence flossing. That's insane.
SPEAKER_01:
Yeah, it happens. I see it all the time. Like, that's not good advice. Like, you know, and luckily now, and it's very new, but they're starting to become those kits, you know, like how you can test like 23andMe, you can test your DNA and stuff. Now you can start to test your oral microbiome. It is very new. Oh, wow. I just did one. It didn't really give me much information yet, but I think it's starting to come on the scene. So you can start to see, do you have the bugs that cause decay, or do you have the bugs that cause periodontal disease, or do you have both, or do you have none? And it would be nice to know that so that you know, hey, maybe you need to go for cleanings more than twice a year. Okay, and you don't have to see the evidence of the destruction before to say, yeah, I want my teeth cleaned three or four times a year as opposed to two.
SPEAKER_02:
Yeah, absolutely. It's interesting. OK, so let's get into some root canal myths, because Amy, have you had a root canal? I have. I've had a couple.
SPEAKER_00:
I had one and it was well, it actually I was so nervous about it because I had this like cavity. I thought whatever. And to your point, I go to the dentist, you know, every six months. And it was like we were watching it. And then it got to a point where like it was really throbbing. It was like I was in so much pain. And this was actually during COVID when I had to get the root canal and I was like so scared. And it was Not fun, but it wasn't as bad as I thought it was. Yeah.
SPEAKER_02:
I think that's like debunking a myth for sure. I don't think they're as bad as people think they are. Like I've had a few and it's not it's not a fun experience, but it's like the pain. If you have pain in your tooth and you go get a root canal, your pain is instantly gone.
SPEAKER_00:
Yeah. I was like so miserable that I was like, I've got to get this fixed immediately. And you're right. You leave and you're just sore. But then you like you don't have that pain.
SPEAKER_02:
So it's much worse. Yeah.
SPEAKER_01:
I get it. We're not giving you a facial in that chair. But we are giving you, you know, we are helping to heal you, which is great. And we do rescue so many people. So if you could find a way to, I mean, I give my patients Valium to just kind of take the edge off. They kind of doze off a little bit. I also have a TV that as they recline, it reclines back with them so they can, you know, Netflix. Netflix and chill in the chair, you know? I mean, there's ways that we can make it a good time pass, a good enough time pass where you're like, you get out of the chair and you're like, that was it? Like, that's the reaction we want, you know? Because there's a lot of personal beliefs, again, that we can't debunk on a patient who's pretty apprehensive. We just have to do it and then they believe us after, at the end, right? I think myth number one is root canals are not as bad as you think they are. And if you can request things like Valium and a TV or headphones and music, and we could just kind of get you through it as quickly as possible. Nowadays, root canals, I would say 95% of my cases I do in one visit and you're done in an hour and a half. Now, there are some teeth that are more infected than we would like to see or they're just harder treatments. So I would say worst case scenario, it could be a two visit appointment. Usually doesn't make it twice as expensive. It's just we need more time and we need your body to kind of like be done clearing this infection before we can finalize the root canal.
SPEAKER_02:
Yeah, that makes sense. The headphones thing is really a good tip for any of you listeners that don't like dental work, listening to music or just anything while you're getting it done, I think helps a lot, right? Do a lot of people do that with you?
SPEAKER_01:
Yeah, like, I have a TV and I offer headphones, but if your dentist doesn't, like, bring your iPhone, listen to this podcast.
SPEAKER_00:
Right. Right. Because the worst thing is hearing the sound. Yeah. Agreed.
SPEAKER_01:
Agreed. And then crank it up. Like, if I tell my patients, I'll tap on you if I need you. Otherwise, like, ignore me. I'm going to get you out of here in no time.
SPEAKER_00:
What's so funny, because I remember I feel like I was talking about it on the show, Katie, when I got the root canal, because I was like, it wasn't as bad as I thought. And I was like, I actually like it was so nice to like lay there for an hour and do nothing. Yeah. Literally just let it doze off. Yeah. I was like, when do you get time to just sit there and doze off?
SPEAKER_01:
That's how it's kind of the same feeling you get when you travel without your children. Right. On the plane. I don't love being on a plane. Right. But you're like, I'm here by myself. It's kind of relaxing.
SPEAKER_00:
Yeah, it's so true.
SPEAKER_02:
So funny. Do you ever find yourself when you're traveling without your children? Just like I have brought all this is a tangent, but I'll bring all the things I have, like the magazines and the podcast downloaded and all the stuff. But I just sit there in the silence. It's like just having the peace and quiet. Yeah.
SPEAKER_00:
Anyway, I digress.
SPEAKER_02:
Yes, I agree with that one. So tell us about some modern advancements in root canals. It has been a couple years since I've had one. I'm curious if anything has changed since.
SPEAKER_01:
It's crazy. So I opened my practice 16 years ago and I swear every couple years there's a new piece of technology that just changes the game. And so now even like I would say the biggest advancements came in 2012 and 2018. So, you know, there's a lot of people who haven't had a root canal in a long time. Things are totally different. And how we treat teeth now is so different than before that I really hope that this knowledge helps debunk the myths that like root canals are toxic because it's crazy what we can treat. Like we know that there's a lot of connections on the anatomy. Like the canals aren't just like these straight canals. They're canals that go down and they have little branches. And nowadays, like when I graduated my residency, I was only treating somebody's tooth through a microscope. So not like those little glasses with the magnifiers on them. I have a microscope that comes out of my wall and I look through this giant thing and I do the whole procedure through the microscope. So that helps me find these itty bitty canals. But then there's still smaller tributaries, which you can't see. And then we started using 3D technology. So it's called a cone beam image, and it's basically, it looks like a Panerex. So sometimes patients can get confused whether they got a Panerex or a 3D image. Panerex is still a two-dimensional image, and the cone beam is a three-dimensional image. And we can see the tooth in this direction, this direction, like side to side, front and back, and then up and down. And it's really cool what kind of anatomy we can see. And then from understanding anatomy a little bit more, we realized, okay, we need something better than just those little reamers that go up and down your tooth to clean out your tooth. So now we have two pieces of technology. One is the gentle wave, which is like a power wash for the tooth. If I can explain it and simplify terms, basically what it does is It creates a closed seal, closed system with your tooth and this handpiece goes on the tooth. We build this little platform and the handpiece sits on it and it creates this closed system. And then it pulls all the air out of the tooth because if there's any air bubbles when we're like rinsing your tooth out with a disinfectant, with a normal hand syringe, Bubbles are going to form in that tooth, and those bubbles are going to prevent that disinfectant from going down all the way to the tip. And root canals only work if you find all the canals and get to the end of every canal. So this pulls out all that air, and then it uses sound waves to pump the solution through your tooth, getting into all those inner connections. So now when I look at a root canal that I've filled on the x-ray, you can see that I've filled all the connections. It's really kind of neat. And then the last piece of technology that we use is also a laser in order to help disinfect. So, I mean, these things were just not a part of my armamentarium in 2008 to 2012. Like there were four years where I just went the, you know, the way I was taught in my residency. And now I'm a completely different ended honest. And we're seeing things heal like we've never seen before. So typically when patients have an issue and the dentist sees it on an x-ray, there's a dark shadow. So I don't know if they were watching like a dark shadow on your tooth before you had that root canal. And that's a sign of bone loss. And so when bacteria gets into the tooth, whether it's from a cavity, whether we've cracked a tooth and created that doorway for bacteria to get in, The bacteria wants to go to the source. The food is the pulp. And they go to the pulp and they eat up the pulp and they kill the pulp. And once the pulp dies, the bacteria just kind of stays in that housing of the canals. Then the bone around the tooth starts to respond. And the response is that the bone pulls away from the tooth because it doesn't want to hang out with a dirty grin, right? So the bone pulls away and you get the shadowing in the x-ray. It takes a while for this to show up. isn't like a long-standing problem. You won't see it on an x-ray. That's the problem with the two-dimensional. And now working with the 3D, we're able to pick up on these infections a lot faster and then heal them a lot quicker instead of letting them fester to the point where they get really big and then they're detectable on 2D. So when we do the root canal, um, and we eliminate all that bacteria, those dark shadows disappear and they disappear because we as humans have this amazing superpower. We can actually regenerate our own bone. So I don't know if you went for a followup or if you had that black shadow, if they followed you up to show you the evidence that you not only saved your tooth, but you also regenerated bone.
SPEAKER_00:
I don't know if I had a follow-up, I can't remember. But I might have, yeah. I mean, it doesn't hurt, and I have never had a problem since, so I'm assuming everything's fine, but yeah.
SPEAKER_01:
Well, and that's one of the problems is that a lot of people don't show up for their follow-ups. I tell them, I'm like, you get a free checkup one year after this visit. But many people, they say just that, oh, it doesn't hurt, and they probably forget. But I'm like, no, I want to see you back. But they think they don't need to come because they don't have any pain. But some people have come back and they still have a problem. So I want to encourage people to make sure you keep your follow-up so that we make sure that, you know, we are seeing the evidence of healing.
SPEAKER_02:
How many canals are in a tooth? It depends.
SPEAKER_01:
Every tooth is different. Okay. Yeah. So, um, yeah, it all depends.
SPEAKER_02:
Okay, like what's a ballpark? Is it 2? Is it 20? We have no idea.
SPEAKER_01:
Okay, so let me walk you through the mouth. So the front of the mouth, you'll have like one canal to maybe 2, and then it's typically around 2 around the premolars, and then the molars have 3, 4, but sometimes we've been able to find 5 or 6. Okay. Yeah.
SPEAKER_00:
I know. Interesting. I never thought I would learn so much about teeth.
SPEAKER_01:
This is so interesting. Are you okay? Am I able to show you something like? Yeah. Yeah. Yeah.
SPEAKER_00:
Yeah. Because we're on video.
SPEAKER_01:
So we can show it. Can I, I can share my screen? I just feel like this is what makes it like, yeah. Okay. So this is a patient who had some pain swelling, right? Like the body notified him like, Hey, there's a problem. He went to his dentist and you see this big black shadow, like here to here, that that's not normal. Okay. And so the dentist was like, okay, send him to me. And it looks like it's covering this is tooth number two, three and four. It looks like it's like engulfing three teeth. OK, so this is what 3D looks like. So let me just go back. This is a two dimensional image. And this is the three. Okay. So you can see the clarity is so much different, right? And again, now you see that dark shadow. So this is what normal bone looks like over here, this white, and this is where the bone is getting eaten away. This is just a response. This is not the infection. This is the body's response. This is what your immune response is when there's bacteria in these canals. Okay. I mean, this is huge, like his whole maxilla, like one side of his maxilla is missing. So here's the other problem is most, some dentists would be like, you need three root canals, which is pretty expensive. Other dentists would be like, that's not fixable. All of these three teeth need to come out. And this is where I, why I'm on this mission, because I want to empower patients to really understand, because sometimes you're gonna get a dentist with a different belief system than what's actually happening. So I did the root canal. I actually, when you do the testing, you'll see like a nerve that doesn't feel cold. So we'll do this cold test on teeth. The one that doesn't feel cold is the one responsible to all these, so to this black shadow. Okay. So this tooth did not feel cold. These teeth did. So that means that the nerve is alive and well in these teeth. This one didn't feel cold. So even though it looked like three teeth were contributing to this area, it was really the culprit of one. So that diagnosis is so, so, so important. Okay. And actually when the patient was referred to me, this is the tooth that was circled on the referral slip. Oh wow. So the dentist thought it was this tooth, but that tells me he didn't do any testing. Okay.
SPEAKER_02:
Yeah, so not only not only did you save two of his teeth, but you also saved him from being misdiagnosed and having bigger problems after losing one tooth.
SPEAKER_01:
And I will say it's not the dentist's fault. It's really the dental education, because we get two weeks crash course in root canals and four years of dental school. And, you know, we only have to do two to four root canals in order to graduate dental school, and then we can go do it on our own.
SPEAKER_02:
Wow. Yeah. And then being an endodontist is, is that a specialty that you do? Correct. In addition to your dental school.
SPEAKER_01:
Okay. So I went to another two years and then I had to do another 250 cases on just that procedure in dentistry, no other procedure. So, um, that's why I would, my personal preference, if I need a root canal, I'm going to see a specialist cause I know that's what they do all day, all night. Some people really want their dentist to be a jack-of-all-trades. I'm not that type of person.
SPEAKER_00:
Yeah, my dentist, like, doesn't do root canals. He always sends people to an endodontist, which I would, yeah.
SPEAKER_01:
Yeah. And you want to trust people with boundaries, right? Right. So on the picture on the left is that preoperative image where we hadn't done treatment yet. And the picture on the right is you can see the root canal filling. You can see that means that this tooth only had three canals. Okay, not four. Typically, these maxillary molars have four, but this one only had three. But now, 11 months later, you can see the bone is starting to regenerate and fill back in. But this was a monster of an infection, so I knew it wasn't going to be all healed up in a year. It's probably going to take a few years.
SPEAKER_02:
When you lose that much, so the bone regenerates. But if the infection is bad enough and it doesn't get taken care of and the bone just continues to regenerate, what does that do? So I'm sorry, the bone continues to not regenerate, but if the bone continues to get eaten away and it just gets bigger and bigger and bigger.
SPEAKER_01:
Yeah. So sometimes you have to also do surgery. But again, that's why we want to catch things while they're small. Right. But again, a well done root canal. will allow your body to regenerate. That's the key. There's just so many not so good root canals in the world that that's why people think they're toxic. Because we only needed to do two to graduate. We can do it. We don't have the proper armamentarium or, you know, we're doing it to the best of our ability. The problem is our ability wasn't like really taught that well. Right. And so 50% of my practice is redos of root canals. So let's say, cause you know, I'm not a hundred percent, I'll never be right. I'll be about 97% success rate, but when my stuff doesn't work, that doesn't mean I can't try again. So we retreat, right? Just like when people get a knee replacement, sometimes a surgeon has to go back in and do a revision. It's just biology. Sometimes that happens and we need to, but those instances are small. Sure. Okay. So let me just point out here, you can see even this wall of bone is back, right? And all this bone is growing inwards. And then two years later, I mean, look at the bone that shadows going away. This is going to take about four years to fully grow back in. But like, look at the bone is coming back. That's amazing. And without a graft, right? Like you don't, you don't need all that stuff. Um, so let me show you another one, not this one, because it does not prove a point. Let me find one of a, ah, this is a good one. Okay. So this one, the root canal has been done. It's not a great root canal, okay? So I can show you here, this is the 3D. Now I'm looking at it in a cross section. You can see there's one, two, three canals filled, but what about this guy, right? If we don't follow the rules, if we don't find every canal and get to the end of every canal, we're gonna have a problem. And you can see in this angle, you can actually see the canal here, okay? And then we can see that the border of the maxillary sinus is getting eaten away as well. And the membrane of the sinus is actually getting thicker, which is a response to the tooth infection. This is a really good picture where you can see the border of the maxillary sinus is gone. It's been eaten from the infection. But we are regenerative humans, so we can actually grow that back. So now you can see the root canal has been redone. I redid it. And there's one, two, three, four canals found. Okay. And one year later, look at that border of the maxillary sinus is completely restored and all this cloudy thickening mucus junk is gone. Wow. And so that when we do a good root canal, we can actually regenerate ourselves inside. And that's the coolest part.
SPEAKER_02:
It's it's incredibly cool. I have a question about the site. So that where you said the gray, like mucus in the sinus, does that actually impact your sinuses? Like, would that person be experiencing stuffy nose and pressure and congestion?
SPEAKER_01:
Probably just on one side. Interesting.
SPEAKER_00:
Interesting. Yeah.
SPEAKER_01:
A hundred percent. And this is how it impacts like your breath. And we all know like breathing and breath work is so important. Right. And it'll impact your sleep too. Wow. So a hundred percent. I've cured a lot of sinusitis by doing root canals. Oh, that's interesting.
SPEAKER_02:
A lot of symptoms aside from just a toothache, right, are potential that people maybe don't know.
SPEAKER_01:
This person's had a root canal, right? So they're not going to get the sharp pain. They're going to feel like it'll be intermittent because what happens in a moment like this is like, OK, your body is smart. The immune system is smart. the infection will grow, right? And then the body will mount an immune reaction, and then it'll push it down, right? And then it'll think, oh, I won, and then it'll back off. And now this bacteria has the ability to regrow. And then the body will be like, hey, I thought I got rid of you, right? And then it'll mount a response and then push it back down. So the patient won't be in constant pain. It's intermittent, right? And so they'll be like, oh, it went away or, oh, there was a bubble. I popped it. No, that bubble is your cue that something's wrong. You know, even though it goes away or you think it went away, there's still something happening underneath.
SPEAKER_02:
Yeah. Pain is the body's way of saying something's wrong. Yeah. Right. That's right.
SPEAKER_00:
Fascinating. It is fascinating. Thank you for that lesson. I know. I loved it. I know.
SPEAKER_01:
I hate to like geek out on you, but I know it's so cool.
SPEAKER_00:
We love it. We love it. OK, so back to so we were talking about the daily routine. So the brushing, the flossing mandatory. OK, right. What about like what are your thoughts on? Because we've talked about this in the show a lot, like tongue scraping, oil pulling, things like that. Helpful, not helpful. Neutral. What are your thoughts?
SPEAKER_01:
So I think It's great if you can do all those things. But I think they're all an adjunct to the brushing and the flossing and the checkups, right? Yeah. I am a tongue scraper. I love it. Me too. I love it. I need to do it twice a day. So if you can do that, that's great. Um, you couldn't pay me to oil pull because I find it, I cannot, I never done it. I can't tolerate it. And maybe it's cause I don't love pulling with coconut oil, but I do believe you can pull with different kinds of oils. So I don't think there's anything wrong with that, but I don't think it's a replacement for other things. Whereas again, you'll find dental influencers that'll say, don't floss, just oil pull. I, the, here's the difference in flossing. So when you brush, you're basically breaking up bacterial colonies, right? You're making sure that they don't grow and proliferate to the point of a biofilm. Okay. Um, when you brush, you can't get the contact point. So your teeth touch, right? And when you floss, you hear that click, right? That click is the contact point. That is the point that a waterpig, a toothbrush, mouthwash, none of those things can reach. And that's the point where the bacteria will love to just stick. and cultivate and that's where they burrow in the teeth. And then you can't even see it. You can't look in the mirror and be like, oh, I got a black spot because you won't see that. You can only pick that up with imaging and you'll need bite-wing x-rays to get that. So again, you may not think you have a problem because there's no pain because bacteria are smart. They're very smart. They don't want to be found out. They will only make noise when they hit the pulp and it's actually your body making the noise then. So Really going for those checkups, flossing, and brushing, those are, I think, critical. And then anything on top of that, I think, is just the cherry on top.
SPEAKER_02:
So you do or you don't think that oil pulling can have benefits?
SPEAKER_01:
I do think it can. I also think that there's going to be different oils that are going to be better for different people. Like just kind of knowing a little bit of Ayurveda, like for my particular like dosha, like I'm probably better off with sesame oil than coconut oil. And again, you couldn't pay me to swish with coconut oil. I'm like, Oh, I can put it in my coffee, but I cannot swish with it in my mouth. But I think for my, I think for my body, sesame oil is probably better. So I do think there's benefits, but I also think, you know, saltwater is a little, is also antibacterial naturally. So you can rinse with that. I don't love mouthwashes because again, you're going to kill the bacteria and you don't want to get rid of them. You just want to keep them stable.
SPEAKER_00:
Oh, really? I use mouthwash all the time. I feel like after I floss, I have to do the mouthwash.
SPEAKER_02:
You have to do like a rinse to get it out, right? That feeling. But so you can rinse with salt water. I started using the TOMS of Maine, all natural products. Would that also kill the bacteria, that type of mouthwash, a natural mouthwash?
SPEAKER_01:
I'm sure there's some with like essential oils that would be just fine. You know, but I, I wouldn't be too dependent on them. The ones that are blue, like the Listerines and stuff, number one, they have alcohol in them and they can really. Like just kind of kill your mucosa. Um, I would probably stay away from the blue stuff.
SPEAKER_02:
Okay. That's good. All right. Well, then speaking of products, what are some of your favorite dental products that you like? Like what's your, what toothpaste do you use? What's your favorite toothbrush, et cetera.
SPEAKER_01:
My favorite toothbrush is a Sonicare toothbrush. Because I like the sonic action because that also helps lace the cell wall of bacteria. So the actual motion allows me to be gentle on my gums because if I'm using a manual one, even if it's a soft one, I'll be really heavy handed. Whereas the sonic toothbrush just lets it, I just stand there and let it do the work. Right. So I like an electrical toothbrush and my vote goes for Sonicare over Oral-B or anything like that. I don't get paid to say that, just so you know. And then my favorite floss is probably Coco Floss because there is coconut oil in it. And I like the fact that it's expansive. So like it'll go in thin, but then it'll expand and grab and then I can pull out. Oh, nice. I haven't heard of that one. Yeah. I like Coco Floss a lot. Yeah, so what about toothpaste? I haven't found one that I love, but honestly, like even if you brush without toothpaste, it's fine because it's the mechanical movement that's doing more of the of the job than the actual toothpaste itself. So depending on where you are in your life or growth and development, figure out what's good for you, what you need in that moment. If you do need fluoride, if you don't need fluoride, if you need something that's sensitive based, maybe you got a recent filling and you're having some normal post-op pain and you just want to increase the speed to normal feeling again. Like sometimes I'll tell people to use a Sensodyne toothpaste for eight weeks because it'll reverse that sensitivity quickly, and then you can go back to a regular toothpaste. I'm currently using a Crest Deep Clean, but I feel like sometimes toothpastes are like deodorants. You kind of have to cycle through, like all of a sudden it stops working for you.
SPEAKER_00:
You know, it's funny that you said that about the tooth sensitivity, because I haven't really had any recently, but I was at the dentist once and the dental hygienist told me that if I was having sensitivity, like in my gums or my tooth, just to take toothpaste and like put it on there and just let it sit. Yeah.
SPEAKER_01:
But a Sensodyne toothpaste would be better because... Yeah, Sensodyne, because that's what I use.
SPEAKER_00:
And it does help. I was like, OK. And then I I've tried that a few times when my teeth feel sensitive and it totally works.
SPEAKER_01:
So that was a cool little hack. When you're bleaching your teeth, it's a good hack, too, because I don't know if you've ever bleached your teeth and it works so bad. It's hard for me to bleach my teeth because I'm so sensitive to cold after that. But if you put Sensodyne toothpaste in there, then on your teeth after you do it, you won't be as sensitive during bleaching.
SPEAKER_02:
So after the bleaching or after like even a whitening strip, once you take it off?
SPEAKER_01:
Whitening strips aren't going to be as sensitive as like if you had like a tray and then they give you the take-home bleach or if you do an in-office. In-office is the strongest. The bleaching tray is kind of like the middle of the road. And then the strips are like your over-the-counter least amount of percentage. I'm sure that one would hurt me, too, because my teeth are just so sensitive.
SPEAKER_02:
They bother me. Yeah.
SPEAKER_01:
I can't even drink ice water. It's just not on my diet. Like, I don't understand how people can freeze grapes or put cannoli in the fridge.
SPEAKER_00:
I know. I can't do that either. How do people do that?
SPEAKER_01:
I know. So, I have to put Sensodyne on my teeth after I use my bleaching trays. Okay. It helps. It really does help. So, if you find it with your With your strips, try that trick and it might not be as.
SPEAKER_02:
I'm going to. Yeah. Cause it's like the first day or two that I do them, it's fine. But then like the third or fourth day I start to get the little zaps, you know, like it gets uncomfortable. I'm not going to tell my 10 year old that you said that toothpaste can come or go. You can take it or leave it because. She always pretends she's putting the toothpaste on, but then we look and she's really not.
SPEAKER_01:
The bristles are more important than the stuff. I just got to know. It's called dry brushing, right? So as long as you can break up the colonies, that's what they used to teach us in the hygiene part of dental school. It's like dry brush. If you can do nothing else, dry brush.
SPEAKER_02:
I've heard conflicting opinions on toothbrushes for children. I've I have had some dentists say get the like the sonic care and then I've had other dentists say don't do that because it teaches it prevents them from learning how to like brush properly. So what do you suggest?
SPEAKER_01:
It's funny because I don't think anyone brushes and flosses properly. Well, let's talk about that. What does properly mean, right? So really, ideally, so if you look at a tooth and you look at the tissue, like that junction of the tooth and the tissue, there is actually like a moat that goes around the tooth. Okay. And, um, that moat is where the plaque likes to accumulate. Okay. So ideally you want to get your bristles to go under that moat and shake. That gingival collar, you want bristles. So if you can take your toothbrush and actually angle it at a 45 degree angle so that the bristles kind of like splay out and you can get under that tissue and shake, that's the ideal way of brushing. I've never seen anybody brush like that, not even adults that have had manual toothbrushes their whole life. And then same thing with flossing. I just witnessed somebody flossing. Like she literally put the floss piece here and the floss piece here and she just started going like this. Oh my God. No, no, no. You want to put it down in one between two teeth and then you want to wrap the floss like a C around the tooth and then scrape up and down the tooth. And then you want to wrap it around the tooth on the other side and scrape up and down and making sure you get that click.
SPEAKER_02:
Oh, see, I haven't been doing it like that. That's good to know.
SPEAKER_01:
OK. So, yeah, I think and really the hygienist at your general dentist office is really the one who should walk you through it. Or if you have questions like, hey, can you watch me? Let them watch you and see if they agree with how you're doing it. That's really where you're going to get that hygiene education.
SPEAKER_00:
Yeah, I was just my younger son just got his braces off and so he was using like a excuse me, a water pick, you know, until he got his braces off and then he just got them off. And so I had to like show him how to floss properly because before that, before he had braces, he had those like ones that you hold, but it's not like the string. And I had to show him like in the mirror how to do it with the string in between the teeth and the gums and all that. And it's your point, like it's hard for him to like figure it out. And then I think he got it. So now he's been doing a good job at it.
SPEAKER_02:
Yeah, I haven't been wrapping it around my tooth. That's like the trick that I need.
SPEAKER_00:
I go like in between the gum. I was telling him to go in between the gums. I don't know if that's right, but it's kind of wrapping. I don't know.
SPEAKER_01:
I just make sure you're scraping up and down, making wrap it, make a C, scrape and then turn it on the other tooth and then go to the next side.
SPEAKER_00:
All right, we'll think of you tonight when we floss.
SPEAKER_02:
Yes. Before we let you go, I just have one more quick question because I just thought of this. Maybe you can give us some insight. Receding gums, is that from brushing too hard, too aggressively?
SPEAKER_01:
It can be from a number of things. It could be from brushing too hard. It could also be from clenching and grinding or if your occlusion is off. So a lot of clencher grinders will I don't know they just they create these things also call them fractions so it's almost like you can get your fingernail stuck at the neck of the tooth because it's kind of you feel like a gouge that's from clenching grinding also the receding gums from the toothbrush and I would also say sometimes if you have like a crown like I have some restorations in my mouth And my tissue doesn't love it. So it's going to pull away because I have a nickel allergy too. And I think some of my old crowns, the base metal was made out of nickel and my tissue didn't love it and it pulled back. Interesting. So just like you have a different oral microbiome, you also have different biotypes of your tissue. And I have a very thin biotype. And so the three to four millimeters of tissue that are adjacent to my teeth, it's very thin. So any manipulation is actually going to make my tissue recede. But not everybody's like that.
SPEAKER_02:
Interesting. Okay. All right. Well, this was fascinating. I really enjoyed it.
SPEAKER_00:
Yes, it was so cool.
SPEAKER_01:
Try to tell people it's not boring.
SPEAKER_00:
No. Yeah. The more you know. That's right. All right. We're going to end with our quick wrap session. So what is your favorite wellness or beauty hack besides teeth bleaching? Because we know you do that.
SPEAKER_01:
I'm going to say as long as I have mascara on, I'm good to go. Good ones.
SPEAKER_02:
All right. And then this might be the same answer, but the next one, we call it your five minute flow. You just got out of the shower and Uber has pinged you. They're five minutes away. What are you going to do to, like, get yourself together and get out the door on time?
SPEAKER_01:
Well, that sounds like the story of my life, so this is pretty easy. So concealer and mascara and a little lip gloss. And that's really all I need. And I'm loving my baseball cap lately. So I'm going to put that on.
SPEAKER_00:
Yeah. Nice. Good one. Okay. How do you maintain your daily nirvana?
SPEAKER_01:
I will just be okay, like not getting everything done and just putting it on tomorrow's to-do list and always try to start my day with a little five to 10 minute session at a minimum by myself with either my music, my thoughts, or my breath.
SPEAKER_02:
Nice. So gratitude and giving yourself grace, it sounds like, at the end of the day, if you don't get it all done, that's great. All right, well, before we let you go, also, please tell us, where can our listeners find you? Where in North Carolina are you, if they want to come visit you?
SPEAKER_01:
Yeah, I'm in Charlotte, North Carolina. And just so, just to be clear, I am a root canal specialist. So, and I feel like we do like really banging root canals to save people's teeth that are like, you know, people would normally throw those teeth in the garbage. We're going to save them. Um, you're welcome to come see me, but just for clarity, like I'm not a general dentist. I'm a root canal specialist. That's all I do. So I don't do cleanings. I don't do crowns, even though I know a lot about those things, but, um, my specialty is root canals.
SPEAKER_02:
Great. Thank you, Dr. Chopra. We appreciate your time. Thank you so much.
SPEAKER_00:
It's been a pleasure. Thanks for listening to Nirvana Sisters. For more information on this episode, check out the show notes. Please subscribe and leave us a review. Also, find us on Instagram at Nirvana Sisters. If you loved what you just listened to or know someone that would, please share it and tag us. Tune in next week for a fresh new episode of Nirvana Sisters. We'll continue to watch out for all things wellness so you don't have to. Bye.