Interview detail-oriented esthetic dentistry Kalasho

Iveta Ramonaite, Dental Tribune International

Tue. 11. August 2020

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Dr. Rhonda Kalasho has recently been acclaimed as the most detail-oriented dentist in Hollywood. She works at one of the most innovative dental practices in the U.S., where she offers cosmetic, pediatric, emergency and general dental care and treats dental conditions such as bruxism and sleep apnea. In this interview, Kalasho talks about some of the state-of-the-art tools she uses in her practice and discusses the dangers of do-it-yourself (DIY) dentistry and the influence of social media on smile restoration. She also reveals how COVID-19 has affected her day-to-day work and presents some of the challenges facing cosmetic and restorative dentistry.

Dr. Kalasho, could you tell us a bit about yourself, and how you became a dentist?
I was very young when I came to the U.S. from Baghdad, Iraq. We did not have a lot of money when we arrived, and food and survival were more important than oral hygiene. I found myself in the dental chair a lot when I was young, and I experienced what it was like to have extreme dental pain at a young age. I always wanted to be in the medical field helping people, but I think dentistry spoke to something more than my yearning to bring health and wellness to the public. To me, dentistry is a consolidation of science, art and medicine all in one field.

I love working on patients, and I enjoy every aspect of dentistry—from root canals to veneers. I do it all, and I love it all. Dentistry has come so far, particularly in the last decade with the advancement of 3D printing and scanning technologies, so I always stay up to date with the newest modalities and research and take part in continuing education above and beyond what is required. It is a blessing to be in this field, and I am grateful to be a part of it every day.

GLO Modern Dentistry is considered to be one of the most innovative dental practices in the U.S. What are some of the state-of-the-art tools and techniques that you use in your dental practice?
Our office is fully equipped with the latest and the greatest, including CBCT, intraoral scanners and 3D microscopes. I am not one to buy tools that have no purpose and just look fancy. All the equipment we have in the office is not only state-of-the-art, but also ensures higher-quality dentistry.

Our scanners are incredibly precise, and our implant restorations and implant-retained full-mouth cases are all fully mapped and designed using 3D programs. Patients have full autonomy and are given a vision of what they will look like and what they can expect. Some of the most difficult patients for dentists are those who need molar endodontic therapy or retreatment, and with our 3D microscope by Seiler Medical, the treatment of these difficult molars becomes seamless. I have yet to miss a canal using the microscope, and the coolest thing is that I get to perform root canals wearing 3D glasses, which is beyond fascinating. Patients are always taken aback by the technology we have at the office, and I am constantly searching for the best so that I can bring them the highest-quality dental care.

“I like to think of myself as an old-school dentist using cutting-edge technologies”

What is the primary reason patients come to see you—to fix minor imperfections, such as tooth overcrowding or unevenness, or for more advanced dental treatments?
I like to think of myself as an old-school dentist using cutting-edge technologies. I perform dentistry on a broad spectrum—including fillings, implants and advanced cases of Invisalign treatment. After the completion of my residency at the U.S. Department of Veterans Affairs’ San Diego VA Medical Center, I continued to advance my skill set in multiple specialties to provide my patients with the most comprehensive dentistry at the highest level of care. If I am restoring a Class II cavity or extracting impacted third molars, I immerse myself completely in the procedure, and I love every second of what I do.

It is the quality of the extracurricular studies undertaken and a willingness to learn that will allow even a general dentist to perform high-quality specialty care. At times, I refer some cases to my colleagues in the various dental specialties. However, for the most part, I treat almost any dental condition or issue that my patients come and see me for.

You are known as one of the most stylish and detail-oriented esthetic dentists in Hollywood. Could you elaborate on that and explain how it affects your role as a dentist?
Being in the heart of Hollywood, many patients who see me are on the big screen. They are singers, songwriters, producers and artists, so it was truly a surprise and incredibly humbling to be acclaimed as the most detail-oriented dentist in Hollywood. My staff and I have a motto by which we operate—we treat every patient like we would our own families. If you go into every case thinking this, your mood becomes warmer, your hands become lighter and you end up putting a lot of love into your work.

I strive for perfection, and yes, perfection is not always attainable. However, you can get pretty close to it if you concentrate your energy and use your skill set for doing the best work possible. When I look at a patient’s smile, I am not only looking at the size and shape of his or her teeth. You can take a perfect set of teeth and put it in someone’s mouth and he or she will suddenly look off. A smile depends on the harmony with the face shape, lip shape, lip line, nose and chin position. A beautiful smile depends on so many different things, and I look at all aspects when I am restoring a smile.

Dr. Rhonda Kalasho believes that a smile should not overpower a person’s face. Therefore, she recommends that her patients stick to natural smile enhancement treatments. (Image: Rhonda Kalasho)

Many patients have resorted to DIY dentistry during the lockdown. What is your opinion about attempting to perfect a smile at home?
I was recently asked by the magazine Allure about whitening solutions made at home. My advice is to remain cautious about doing any home remedy type of treatments, be it buying mail-in aligners, using a nail file to help fix a chipped tooth, moving teeth or treating teeth, since these are all delicate procedures. DIY dentistry has gone wrong too many times for me to condone it. I have seen an excessive use of baking soda and acids to whiten teeth that eventually lead to tooth erosion and enamel demineralization. More recently, with the surge of the mail-in clear aligners that are being vigorously promoted on social media and in some podcasts, I have seen some devastating malocclusion as a result of patients moving their teeth without being under the care of a dentist.

Moving teeth is not as simple as shoving teeth into a straight line—you need to look at the root morphology, the periodontal status, the bone quality, existing restorations, and evaluate the patient’s cephalometric parameters in order to deliver the most esthetic, long-lasting results within the available standard of care. I have seen patients no longer able to close on their posterior teeth because they purchased clear aligners without being under the direct care of a dentist. They then had to pay so much for additional dental treatments just to regain their functionality, which defeated the purpose of trying to save money by going the cheaper route in the first place. Leave dentistry to the professionals.

COVID-19 has had a major impact on dental practices worldwide. How has it changed your day-to-day work and the way you treat your patients?
Since I perform extractions and root canals, I treated a lot of emergencies during the shutdown. I was part of the Los Angeles Dental Society task force for reopening, and I managed to acquire all the necessary personal protective equipment (PPE) in order to perform emergency dental services safely. We cut our patient load during that time by over 70%. However, it was more exhausting having to treat patients under the stress and fear of contracting the virus while wearing such heavy gear.

We have taken extensive precautions at the office, not only in wearing the proper PPE, but also in using extraoral suction with every patient during treatment and making sure that only one patient is in the waiting room at a time. The sterilization technique is increasingly extensive and thorough, and we test our staff at a certified laboratory for COVID-19 every two weeks. We still provide the same great quality of care we always have done, just with some more gear.

“Social media often influence people into thinking that they can all do cosmetic dentistry”

In your opinion, what will be some of the biggest challenges facing cosmetic and restorative dentistry over the next five years?
One of the challenges is convincing people who want to look like their favorite social media filter that super-white square boxy teeth are not esthetic. As more and more dentists who have not studied the art of symmetry and ceramics are performing low-quality veneers or crowns, you will see more of these low-quality ceramics that are bulky and too opaque. These bulky crowns generally lead to periodontal disease and recurrent caries.

Social media often influence people into thinking that they can all do cosmetic dentistry. However, my strongest suggestion is that everyone who is treating in the cosmetic arena must be trained in the periodontal maintenance of the patient and the dental materials involved in high-quality ceramics. The challenge rests mainly on the education that so many dentists are not willing to embark on. Continuing education is incredibly important if you want to deliver the highest-quality service to patients.

What is the best advice you can give to your patients seeking to enhance their smiles?
Every smile is beautiful. If you have a gap, small teeth or gingival hyperplasia or if you have some crowding, keep in mind a smile is not one-size-fits-all. Stick to what looks natural. Chiclet teeth or those overly white veneers or crowns that look so incredibly unnatural will never be in style. I always tell patients to think of the most beautiful person they know, and every time I ask them to name the person, every time, without fail, that person’s smile is natural and not overwhelming. Enhancing your smile means just elevating what you have and getting a color that matches your skin and hair and creating teeth shaped to match your face and lips in order to achieve an overall harmonic appearance that will not overpower your face.