A Beverly Hills Smile with Cosmetic Dentist Anjali Rajpal, DMD

Many thanks to Anjali Rajpal, DMD, for joining me on this episode of The Art of Medicine with Dr. Andrew Wilner! Dr. Rajpal practices cosmetic dentistry at Beverly Hills Dental Arts.

During our 25-minute conversation, we discussed Dr. Rajpal's passion for hands-on creative work, like improving her patients' smiles. She explained that new electric tools vs air-powered ones have made the patient experience more comfortable. I

Dr. Rajpal employs AI in her practice, which has many applications. Digital imaging powered by AI has replaced the old-fashioned and not entirely pleasant putty used to take impressions. Aesthetics can be fully realized with improved accuracy and efficiency. AI offers a "second set of eyes" to examine dental X-rays to ensure nothing is missed. Robots also assist with implant surgery. AI can also provide a look into the future for patients to see what their smile will look like after a complete makeover.

To contact Dr. Rajpal, please check out her website:

https://bhdentalarts.com

Instagram, TikTok, YouTube: @beverlyhillsdentalarts

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Transcript

[Andrew Wilner, MD] (0:08 - 1:15)

Welcome to the Art of Medicine, the program that explores the arts, business, and clinical aspects of the practice of medicine. I'm your host, Dr. Andrew Wilner. Today, I am pleased to welcome Dr. Anjali Rajpal. Dr. Rajpal is a dentist with a background in painting and sculpture, a true practitioner of the art of dentistry. She practices cosmetic dentistry at Beverly Hills Dental Arts. We're going to talk about some of the advances in cosmetic dentistry, and maybe something to smile about.

But first, a word from our sponsor, LocumStory.com. LocumStory.com is a free, unbiased educational resource about locum tenens. It's not an agency.

LocumStory answers your questions on their website, podcasts, webinars, videos, and they even have a Locums 101 crash course. Learn about locums and get insights from real-life physicians, PAs, and NPs at LocumStory.com. And now to my guest, welcome Dr. Rajpal.

[Anjali Rajpal, DMD1] (1:16 - 1:17)

Thank you.

[Andrew Wilner, MD] (1:18 - 1:33)

Dr. Rajpal, thanks for taking time out of your busy day. Step away from drilling for a moment. I know you have patients lined up.

So let's start with your training. What kind of training does a cosmetic dentist have?

[Anjali Rajpal, DMD1] (1:34 - 2:28)

So we have the basic pre-med requirements that if you don't get weeded out in college and you make it through, then you go into four years of dental school. So I did my pre-medical training in college at the University of Michigan Honors Program. And I studied biopsychology, which was really interesting.

And then I got into Tufts University in Boston for my dental school, which has an emphasis on medicine education. So it's actually a DMD degree instead of a DDS. So we just have a little extra medical training.

And then I ended up matching for my residency, a general practice residency at Cedars-Sinai here in L.A. And that is what brought me out here. So it was quite a few years, but we learned a lot. And here I am.

[Andrew Wilner, MD] (2:28 - 3:31)

OK, well, I'm going to I'm going to pick up a little bit on that story. About 55 years ago, before you were born, I went to Tufts as a patient because I had some strange molar thing wrapped around a nerve and I had to have dental surgery. And apparently mine was a very interesting teaching case, which I didn't really appreciate at the time.

But I was admitted to the hospital and they did this fancy surgery. And then I went back. I grew up about an hour away from Tufts.

So that was the place to go. So we we do have a connection there, although it probably was long before you were born. And but I still I still remember and I think they did a pretty good job.

Now, why? Why dentistry? I mean, you just wake up one morning, you're 12 years old.

I want to be a dentist. How did that happen?

[Anjali Rajpal, DMD1] (3:31 - 6:23)

So I grew up as the daughter of a general surgeon. So my dad obviously was was kind of guiding the way in terms of following a premedical path. But I didn't want to work in a hospital.

And I literally could not find any discipline within medicine that I really was getting drawn to. My mom was very artistic. She painted a lot.

She was just really great with her hands, always super creative, too. So I had a father using his hands a lot and a mother using her hands a lot. So I definitely needed to be using my hands.

But I most of the most of the specialties in medicine really don't allow for that beyond surgery and maybe a couple other specialties. So when I was taking my premedical course, my sister was also she also became a doctor, an oncologist. So I was kind of just following her footsteps.

And and I got to a point where I didn't know why I was doing it because I really wanted to do art. But then I didn't know if I only wanted to do art. I still did want to do something to help people.

So this girl in college ended up telling me that she dropped out of med school and she went into fashion design instead because she wanted to do something creative. But she had a friend who went into dentistry and and she thought that that might be a good idea for me. And honestly, it's been the perfect fit because I'm literally it's literally arts and crafts all day long for me because I'm sculpting teeth.

I'm I'm constantly using my aesthetic eye to see what actually flows with a patient's face. What kind of characterization style of the teeth actually suit their face? And I'm just like they become my art projects.

So it's actually really fun for me every day to be able to continuously make things and actually have them as live works of art that are entering the world because people are showing off their smiles everywhere they go. So it's it's definitely ended up being the perfect fit for me. I'm I've been able to not be in a hospital environment and design a very artistic looking home homey feeling space that I enjoy coming to every day.

And I get to have a great rapport with my patients and and see them on a regular basis, which is something not everything specialty get everything specialty gets to have as well. So being able to see my patients every three or four months and really have like these lifelong relationships is is definitely in line with what I wanted to be doing with a psychology kind of background as well.

[Andrew Wilner, MD] (6:24 - 8:05)

What a heartwarming story. You know, I think some of the people listening to this are trying to figure out where their careers are going in medicine. I had sort of epiphanies along the way as I was studying.

I didn't really know where it was going. And I stumbled into neurology when I was an ER doc. And it was like, whoa, this is really cool.

And that's how I decided. But I think, you know, we had a program just a few weeks ago where I did a program just like this with a plastic surgeon on Park Avenue in Manhattan. And he told a similar story about how he was very aesthetically minded.

He was artistic and liked to work with his hands and was interested in surgery. And so plastic surgery really was a great fit for him. So it sounds like you found, you know, I've always been impressed that, as you say, you know, surgeons, they work with that.

People don't really say work with their hands, you know, every day. And a lot of surgeons have like hobbies where they're working with, you know, they're building model airplanes or, you know, they're doing stuff with their hands all the time because that's that's their gift. You know, that's their talent.

So if you have that talent, you want to be able to use it. Because, frankly, you know, you're working in a small space, right? Somebody's mouth depends on the person, of course, but the mouth is still a relatively small space, even if it's a politician.

And that that's not easy. Right. It's hard to see.

You need the best lighting. You're standing up. Right.

I mean, if that was not your talent, that would be hard, hard work. Right.

[Anjali Rajpal, DMD1] (8:06 - 8:10)

Well, one advantage is I have the tiniest fingers.

[Andrew Wilner, MD] (8:11 - 8:11)

There you go.

[Anjali Rajpal, DMD1] (8:12 - 9:03)

So literally, my hands can probably fit in anybody's mouth because just my bone structure is so tiny. But going back to the surgery thing, it was always funny because, yes, my dad was a surgeon, but he would be my mom's sous chef and would always be in charge of cutting all the vegetables and cutting the chicken. And it would just be hilarious watching him because he would incise the fat off the chicken and neatly cut all the pieces into perfect symmetrical shapes.

And it was just so funny because it was literally surgery assisting my mom. So so, yeah, obviously, I think any any surgeon or anybody that's required to use their hands in their specialty, they they have a knack to be doing that. Otherwise, honestly, they probably should be doing something else.

[Andrew Wilner, MD] (9:05 - 9:09)

So who cuts the turkey on Thanksgiving? Is it you or dad?

[Anjali Rajpal, DMD1] (9:10 - 9:21)

We've never been the host, so we've never had to do that. But I think that's a whole other gigantic project using the electric knife.

[Andrew Wilner, MD] (9:23 - 9:45)

Well, well, you do have fancy tools there in dentistry, although I get a shiver up my spine just kind of remembering that that sort of very distinctive drilling sound in my head. Is there anything new that they didn't have 10 years ago that has really sort of changed what you do?

[Anjali Rajpal, DMD1] (9:46 - 15:54)

So going back to the hand pieces now, we have electric hand pieces and that's what I use. So the sound of the air buzzing through the hand piece is not as high as high of a shrill as as the regular hand pieces. So the electric hand pieces are much quieter.

We also give our patients noise cancelling headphones in the event that they just don't want to hear anything. But we play great music, so it's always an option to hear what we're listening to as well. But yeah, AI has definitely become more and more integrated into dentistry.

It was already, I think, I do a lot of Invisalign and Invisalign was one of the first users of 3D printing. So if you look closely at the plastic in the trays, you'll see that there's lines throughout because they're all 3D printed and everything has really become digital now. So I'm 3D scanning all of my patients and they're printing 3D models, the labs to design the veneers and the crowns and all of that.

And it's such a more seamless mode of operation because you're just sending files over. These files can be saved for years. So like if you want to retain the same shape of the patient's teeth 20 years down the road, you have the same file from 20 years ago.

You're not using a stone model. And it just helps eliminate a lot of human error, which is nice because we used to use polyvinyl siloxane putty material, which was flexible. And I would have situations where the room temperature was too hot or cold.

And so it causes a different set time, which then leads to a different pour of the stone model, which then leads to a different restoration. So now we don't have to deal with all of that, the digital impressions. Some people are still using PBS and yes, you can get great results with it.

But I prefer just being digital all the time now. I have the fit of everything I'm doing ends up really being right on all the time. And it's just such an easier process for the patient as well because they're not dealing with this gummy material.

So there's that. And then we have AI simulations for whether any kind of smile makeover case. You can actually just take photos or videos of patients and show them exactly what or a rendering of what they potentially could have if they had a complete smile makeover.

So that's really cool. We also have AI for reading x-rays, which is basically a second set of eyes to catch whatever we might miss and just find different things in the x-rays that we may or may not have picked up on. That just is, like I said, it's a second set of eyes.

So it's great to have that. But it's also all of these are just really beneficial educational tools because I would not be able to back in the day pick up a film that we had dipped in solution. And only we, the doctors and the assistants, would be able to read the films and find the cavities.

But now we have huge computer screens where I'm blowing up the image gigantic onto the screen. And our patients, I can just point out any pathology, any cavities directly on the computer screen. And it's blown up so big that the patient can read it with their own eyes.

And it also helps build trust between the doctor and patient because I'm not just maybe proposing a potential cavity. They can actually see exactly how big it is, where it is, all of that for themselves. And they can also see a 3D scan of all of their teeth inside their mouth.

So we can actually flip the models around so they can see in the back of their head what the top of their wisdom teeth look like. And all of that, just having a 3D model on screen for them to be able to see exactly any other situations like gum recession. All of these things we can monitor so well through the years by being able to have these digital models on file.

And then we also have robots that are coming in to help. Right now we have robots that help with guided implant surgery. So we have CT scans that help with the whole planning.

And then the robots actually help with precision placement into the patient's bone to help minimize errors there. But they are still controlled by humans, so we're not letting these robots run free. But it's cool that we have some technology that's making some advancements.

And yeah, those are probably some of the major things that have come into dentistry. And then also our materials, our porcelain, our bonding techniques and materials. Everything in terms of that just keeps improving through the years too.

And as the materials and the bonding materials and techniques improve as well, it leads to us not needing to cut down as much tooth structure as we did in the past. So it's much more conservative for the patient because that way I can preserve a lot of their tooth structure for the long term and not have to use un-aesthetic materials like silver fillings or metal underneath crowns that are not so biocompatible. We actually can use very aesthetic, natural-looking restorations that are super strong and that bond to the tooth structure in a very minimally invasive way.

[Andrew Wilner, MD] (15:54 - 16:08)

Wow. I wish they'd had all that stuff 55 years ago when I had my dental surgery. All right.

What about a little Dentistry 101? What is a veneer?

[Anjali Rajpal, DMD1] (16:09 - 17:07)

So a veneer is just a facing made of porcelain. So it's literally just the front and the edge of a tooth. It's almost like if you want to think of a press on nail, it's just a facing that bonds to the front of the tooth.

You usually typically want to take off a tiny bit of tooth structure just from the front and edge so that the porcelain seats and can tuck in under the gums without making something bulky where it might inflame the gums or just make the tooth look bulkier. It just depends on the shape and the position of the original tooth structure. But typically, if you're working with a conservative dentist, it requires such a small amount of removal of tooth structure because the porcelain is so strong now that just having a thin shell of it is concentrated enough that when it's bonded to the tooth, it's actually even stronger than your natural tooth structure.

[Andrew Wilner, MD] (17:07 - 17:11)

And it's probably something you would do on more than one tooth?

[Anjali Rajpal, DMD1] (17:11 - 18:20)

Yeah, we typically, if we're doing a complete smile makeover, then I'll usually look at how wide a patient smiles and you want to go from the corner of their lips to the other corner. But I've had quite a few patients where I just did a round of Invisalign, a round of whitening, and now their teeth were in a great position and they didn't really have too much discoloration or too much disproportion in their tooth structure. So sometimes I would just do the front four and the rest of the teeth just flowed with those four and it ended up working out fine.

So it just depends on the patient's current situation, what the proportion of their teeth is like, what is the color throughout, if it's discolored or just inconsistent, whether you want to use the porcelain veneer to mask all of that and to just change the symmetry, change everything up. So it really is a case-to-case basis depending on what the patient is coming in with.

[Andrew Wilner, MD] (18:20 - 18:23)

You mentioned Invisalign, what is that?

[Anjali Rajpal, DMD1] (18:24 - 20:12)

So when your teeth are misaligned, whether there's spacing or crowding or just misalignment with the way the teeth are meeting each other, I always want to place the patient's teeth into perfect alignment where all the tooth forces are balanced and everything is lined up so that they're the most cleansable possible. Because when teeth are overlapped, they end up trapping bacteria in any areas where your toothbrush is kind of going to miss. And then if there's space, you might be food trapping in there and then again, bacteria are sitting in those areas.

So you really want to be having them in a perfect alignment and not stressing out. You don't want the front teeth to be hitting too aggressively. You want the back teeth to be hitting more when their teeth are close.

So you want to distribute all the forces properly while you're aligning the teeth and just make them into the healthiest, most cleansable position so that they last through the years for the long term. So I do a lot of Invisalign to make sure that everything is in place to last through the years. And then we'll incorporate teeth whitening a lot of the time.

And then I'll either do porcelain veneers, crowns if really necessary, but I kind of try to stay away from doing crowns at this point, unless there's a lot of breakdown of tooth structure. And oftentimes if they just need little touch-ups, little chipping, little minor corrections, then I'll just do some composite bonding on the edges of the teeth just to make them look perfect and to protect them through the years. And then we'll put them into retainers to maintain that shape and to prevent any wear from happening on the teeth if they are teeth grinding.

[Andrew Wilner, MD] (20:13 - 20:35)

Dr. Rochefeld, this is very informative. It certainly sounds like it might be worth a trip to Beverly Hills to come to your office. Before we wrap up, I just got to ask, no names, but you're just a stone's throw from Hollywood.

Have you had any celebrities in your dentist chair?

[Anjali Rajpal, DMD1] (20:36 - 21:44)

Yeah, of course. I mean, just being in the area, it naturally ends up drawing in that type of patient. So through the years, we've definitely had our share.

We look forward to seeing more. But every patient, I mean, I've had quite a few patients that I didn't realize that they were celebrities at the time. Or we've had patients that weren't yet, and then they have, through the years, they've landed huge roles over time.

So yeah, just being in this area and hearing all the stories of what everybody's involved in, it's just fun hearing everyone's different projects in every industry that they're involved in. We just have a great patient population with great personalities, and a lot of them are doing those very interesting things. And so that's why I love talking to all of them, because we're always exchanging ideas and educating each other about different things, and it's just an interesting rapport to have.

[Andrew Wilner, MD] (21:45 - 21:56)

Well, maybe some of those successes in the acting industry were in some part due to those magnificent smiles that you gave them.

[Anjali Rajpal, DMD1] (21:57 - 22:43)

I've actually—there are people that have resisted doing things, and then when they finally got around to it and they finally dove into the process, I actually would hear that they landed this huge role on this show, or they got this part that they just didn't expect to get. And even in just any profession, by having a beautiful, professional-looking smile, it makes you more marketable. So it just ups your game, whether it's in your professional life or your personal life.

It just makes you more presentable, it makes you healthier as well, and it just leads to a better first impression.

[Andrew Wilner, MD] (22:44 - 22:50)

Well, I think that's a great way to wrap up, but before we go, is there anything you'd like to add?

[Anjali Rajpal, DMD1] (22:51 - 23:27)

Not really, just I'm here for everybody. We're always here for complimentary consultations if anybody just wants to have me take a quick look at their smile and see what I suggest. But again, I'm here in Beverly Hills.

It's Beverly Hills Dental Arts. My website is bhdentalarts.com. My Instagram is @Beverly Hills Dental Arts.

So is my TikTok, my YouTube. So yeah, I'm not too hard to find. You're all welcome.

And all I want to do is just get everybody in the world to smile more. So that's what I'm here for.

[Andrew Wilner, MD] (23:28 - 23:36)

Sounds terrific, and I'll put all that information in the show notes. Dr. Rajpal, thanks for joining me on The Art of Medicine.

[Anjali Rajpal, DMD1] (23:37 - 23:39)

Of course. Thanks so much for having me.

[Andrew Wilner, MD] (23:40 - 25:54)

And now a final thanks to our sponsor, locumstory.com. Locumstory.com is a free, unbiased educational resource about locum tenens. It's not an agency.

Locumstory exists to answer your questions about the how-tos of locums on their website, podcast, webinars, and videos. They even have a locums 101 crash course. At locumstory.com, you can discover if locum tenens make sense for you and your career goals. What makes locumstory.com unique is that it's a peer-to-peer platform with real physicians sharing their experiences and stories, both the good and bad, about working locum tenens. Hence the name, LocumStory. Locumstory.com is a self-service tool that you can explore at your own pace with no pressure or obligation. It's completely free. Thanks again to LocumStory.com for sponsoring this episode of The Art of Medicine. I'm Dr. Andrew Wilner. See you next time. 

Andrew Wilner, is Associate Professor of Neurology at the University of Tennessee Health Science Center, Memphis, Tennessee. Views, thoughts, and opinions expressed on this program belong solely to Dr. Wilner and his guests, and not necessarily to their employers, organizations, or other group or individual. While this program intends to be informative, it is meant for entertainment purposes only. The Art of Medicine does not offer professional financial, legal, or medical advice. Dr. Wilner and his guests assume no responsibility or liability for any damages, financial or otherwise, that arise in connection with consuming this program's content. Thanks for watching. For more episodes of The Art of Medicine, please subscribe. www.andrewwilner.com