My Blog

By Dr. Radhika Rawal
January 20, 2014
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Does your mouth feel drier than the Arizona Desert?  There are different things that may be contributing to this problem:

*  Medications, such as those used to treat anxiety or depression, pain medications, antihistamines,       decongestants, and those used to treat incontinence or Parkinson’s disease.

*  Damage to the salivary glands due to radiation or chemotherapy treatments.

*  Certain conditions or diseases such as Sjogren’s, Alzheimer’s or Stroke.

Saliva is used as a natural digestive aid, and helps with chewing and swallowing.  With a decrease in salivary output, tooth decay and gum disease are more likely to occur.  In cases of dry mouth, you need to practice exceptional oral hygiene techniques to cut down on the risk of dental problems:

  1. Brush your teeth at least two times/day, but preferably after every meal and before bedtime.
  2. Floss daily.
  3. Use fluoride containing toothpaste.
  4. Visit your dentist regularly for checkups (at least 2x/year).  Extra prescription fluoride may be helpful to decrease the harmful effects of dry mouth. Discuss this with your dentist.

There are over the counter artificial saliva products available that may help with minor decreases in salivary function.  Prescription medication may be needed in more severe cases of xerostomia to increase the production of saliva.

If your symptoms of dry mouth are less severe, here are some recommendations to help:

  • Breathe through your nose                                                                                                     
  • Follow a low carbohydrate diet
  • Sip water frequently
  • Avoid caffeine, alcohol, and tobacco
  • Chew sugar-free gum
  • Use xylitol products
  • Keep up with oral hygiene at home
  • Get regular examinations at your dental office

For these and any other dental problems, visit us online:  We welcome your questions and comments!

Radhika Rawal and staff at Desert Ridge Smiles  20950 N Tatum Blvd Ste 280 Phoenix, AZ 85050 480-860-4300

So your dentist tells you that you have gingivitis, or worse yet, that you have bleeding pockets.  What does that mean and what can you do about it?

Bleeding or inflammation in any part of your body is not good.  Your goal for your mouth would be to step up your brushing and flossing techniques to eliminate the bacteria and plaque that cause these problems.  The response in your mouth to the bacteria and plaque is for the gums to become inflamed.  This residual plaque, which is a sticky film of bacteria, is the root of many dental problems. It produces acid on your teeth, causes decay, and should be removed at least every 24 hours.

The majority of the tooth surface can be cleaned by using a toothbrush.  Use either a soft bristle manual toothbrush using a circular motion for 2 minutes throughout your mouth or a good electric toothbrush with a small bristle head for 2 minutes.  My favorite electrics are Rotadent or Sonicare.

If you only use your toothbrush and don’t floss at least once/day, you will miss about 35% of the tooth surfaces and could end up with “flossing cavities” between the teeth, in addition to bleeding gums, which can lead into deepening pockets and more periodontal disease.

An added benefit of daily flossing would be in reducing bad breath!  Getting rid of the plaque and bacteria from between your teeth, keeps the acid production down, and reduces your chance of getting cavities.  Once the flossing removes the decomposing food, normally broken down by bacteria which produce acid, your rate of decay will be less and so will the bad breath!  But it must be done every 24 hours, or the plaque solidifies on the teeth, and then can only be removed by the dental office at your next cleaning.  We call solidified plaque tartar or calculus.

When calculus is present on your teeth, it is a major cause of gum inflammation and bleeding.  The longer it is present, the more likely the bone may become involved.  This is when the pocket depths increase as the bone is shrinking away from the calculus, and the gums are becoming more inflamed due to the calculus.  The biggest problem: gum inflammation can be reversible with good brushing and flossing, but once the bone becomes involved, it is not reversible and it is called periodontal disease.  With a diagnosis of periodontal disease, your cleanings would be done at 3-4 month intervals, since periodontal disease is not curable.  The goal would be to keep the plaque and inflammation under control to  maintain the current level of bone.  The best way to do this is with proper homecare: Brushing 2x/day and Flossing once/day, in addition to having regular cleanings at your dental office.

Remember: Daily plaque removal is good smile insurance!

By Dr. Radhika Rawal
January 20, 2014
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Do worries about the economy or your work, stress you out?  Do you wake with headaches, sore jaw muscles, or sensitive teeth? Have you noticed chips in your enamel or broken teeth, fillings or crowns?

You may be experiencing a behavior that is called bruxism.  Bruxism is an oral parafunctional activity, which includes clenching and grinding of the teeth in a horizontal direction, using forces that are damaging to the teeth and muscles. Bruxism is considered the most common sleep disorder.

As a dentist, I look for damage to the teeth that may be caused by bruxism.  Often my patients are unaware of this behavior, unless informed by their sleeping partners.  Some common signs in bruxers may include:

  • Headaches
  • Notched teeth
  • Chipped teeth or restorations
  • Pain in teeth, muscles or jaw joints
  • Mobility of teeth
  • Broken crowns or fractured teeth
  • Recession of gums

Causes of bruxism include stress, anxiety, worry, depression, bite problems such as uneven bite, medical conditions and some medications.  Bruxism can be further complicated if it includes a disorder such as sleep apnea. In these patients a sleep study is needed for full treatment of the disorders.

Treatments for bruxism vary from conservative methods such as a protective hard acrylic night guard appliance or bite adjustments that help to equilibrate the minor bite discrepancies, to complete orthodontics, repair of broken teeth with crowns, or full mouth rehabilitation to recreate the most stable bite,  lost due to the parafunctional habit of bruxism.

If you feel you might be suffering with these symptoms, make an appointment for an evaluation today.

Dr. Radhika Rawal & the staff at Desert Ridge Smiles  20950 N. Tatum Blvd Ste. 280 Phoenix, AZ 85050                   480-860-4300

Diabetes is a metabolic disease in which insulin is not regulating glucose properly.  It is one of the most common chronic illnesses, according to the CDC (Centers for Disease Control), and as of January 2011, 26 million Americans have diabetes and 79 million are considered pre-diabetic.

Glucose is what all cells use for energy production, including cells in the brain.  When insulin action is a problem, it triggers inflammation.  In the dental world, we see this as periodontal disease.  By controlling periodontal disease, a diabetic’s blood sugar control is also enhanced.

Diabetics are more prone to infections due to a weaker immune system.  Some ways to help repair the immune system include:

  • quitting smoking
  • eating a proper, well-balanced diet
  • brushing 2x/day, flossing 1x/day
  • exercising
  • weight loss

We monitor a patient’s risk for developing periodontal disease by reviewing peridontal probe scores, bleeding or inflammation points and medications at every hygiene maintenance visit.  Our goal is to keep inflammatory processes in the mouth to a minimum, by continually improving our patient’s oral health.

Complications of diabetes include: fatigue, dehydration, infection, eye disease, hearing loss, kidney disease, nerve damage in the hands and feet, high blood pressure, cardiovascular disease and gum and periodontal disease.

Diabetes can be managed by proper education-changing diet and nutrition, monitoring blood sugar regularly, exercising to lose weight, becoming healthier by quitting smoking, and monitoring your periodontal health at your dentist.  Remember: Good Oral Health Leads to Good Overall Health!

Radhika Rawal, DDS and Staff at Desert Ridge Smiles

20950 N Tatum Blvd Ste 280  Phx, AZ  85050 480-860-4300

January 15, 2014
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In Arizona, many cities have been adding fluoride to the water supply for years, resulting in a marked decrease in children with decayed teeth.  Coming in  September 2012, the Phoenix City Council will reassess fluoridation in the water system.

Is water fluoridation a good thing or a bad thing?  Let’s look at the facts:

*  Fluoride is a mineral, not a medication, and is added at a therapeutic level depending on the natural content of fluoride in the water. Phoenix has added .7 to 1.2 mg/L to the city water.

* The CDC (Center for Disease Control & Prevention) recognizes community water fluoridation as one of ten great health achievements of the 20th century, by protecting teeth from decay.

* Reports in 2011 found Fluoride did not cause bone cancer, and was not found to be carcinogenic by the California Office of Environmental Health Assessment’s Cancer Identification Committee.

* Reputable organizations such as the American Dental Association, The World Health Organization, American Medical Association and many others recognize the health benefits of preventing decay by community water fluoridation.

* According to the April 2000 Journal of Dental Research, half of children between the ages of 5 and 17 have not had a cavity in their permanent teeth, due to the use of fluoride.

As a practicing dentist, I have seen children with the ill effects of being raised in non-fluoridated communities  and have also seen young adults with NO decay, as a result of fluoride exposure.  The only people I have seen with fluorosis due to too much fluoride exposure were kids from Mexico where many things are unregulated, and who lived in rural areas where well water with high fluoride content was the main water source.

I believe that taking fluoride out of the city water would be a mistake, especially for the children, who need extra fluoride protection during the formative years.  Water fluoridation has been effective at reducing cavities in both children and adults.  We have come this far in cavity prevention.  Why reverse this now?  Show your support to the Phoenix City Council for keeping water fluoridation in the City of Phoenix water, on September 11, 2012.

Radhika Rawal, DDS and the staff at Desert Ridge Smiles

20950 N Tatum Blvd Ste 280 Phoenix, AZ  85050  480-860-4300

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