My Blog
By George H Johnson, Jr., DDS, FAGD
May 22, 2017
Category: Oral Health
DontletPeriodontalDiseaseCauseYourGumstoRecede

Although your smile wouldn't be the same without them, there's more to your gums than their looks. Besides helping to hold your teeth in place, they're also an important protective barrier for their roots.

Unfortunately, gums aren't immune to disease, especially periodontal (gum) disease. This bacterial infection, triggered by built-up dental plaque on teeth due to insufficient oral hygiene, can cause the gum tissues to detach from teeth and shrink back (recede). This can make your teeth more sensitive to hot or cold foods and beverages, as well as put them at even greater risk for tooth decay.

To treat gum recession, our first priority is to stop any ongoing gum disease through aggressive plaque removal. Depending on severity, this could require clinical procedures like scaling or root planing to remove plaque and tartar (hardened plaque deposits) at or below the gum line. This is especially crucial for improving gum tissue healing and stimulating potential reattachment.

Revitalizing gum tissues this way naturally has a better chance of occurring if we're able to prevent recession before it reaches the roots. If that does happen and we have sufficient gum tissue attachment remaining, we may need to give the gum tissue a helping hand through gum grafting surgery. There are a number of techniques depending on the circumstances, but they all use either tissue from another location in the patient's mouth or prepared tissue from another human donor. This type of surgery requires great skill and expertise, not to mention an aesthetic sense, to achieve a result that's both functional and attractive.

Other than daily brushing and flossing, the most important thing you can do for gum health is to see us as soon as you notice any signs of gum problems like swelling, bleeding or tooth sensitivity. The sooner we can diagnose and begin treating the problem, the less likely any gum recession will have a long-term impact on your health.

If you would like more information on gum health, please contact us or schedule an appointment for a consultation. You can also learn more about this topic by reading the Dear Doctor magazine article “Gum Recession.”

By George H Johnson, Jr., DDS, FAGD
May 14, 2017
Category: Dental Procedures
Tags: celebrity smiles   bonding  
ARoyalFix

So you’re tearing up the dance floor at a friend’s wedding, when all of a sudden one of your pals lands an accidental blow to your face — chipping out part of your front tooth, which lands right on the floorboards! Meanwhile, your wife (who is nine months pregnant) is expecting you home in one piece, and you may have to pose for a picture with the baby at any moment. What will you do now?

Take a tip from Prince William of England. According to the British tabloid The Daily Mail, the future king found himself in just this situation in 2013. His solution: Pay a late-night visit to a discreet dentist and get it fixed up — then stay calm and carry on!

Actually, dental emergencies of this type are fairly common. While nobody at the palace is saying exactly what was done for the damaged tooth, there are several ways to remedy this dental dilemma.

If the broken part is relatively small, chances are the tooth can be repaired by bonding with composite resin. In this process, tooth-colored material is used to replace the damaged, chipped or discolored region. Composite resin is a super-strong mixture of plastic and glass components that not only looks quite natural, but bonds tightly to the natural tooth structure. Best of all, the bonding procedure can usually be accomplished in just one visit to the dental office — there’s no lab work involved. And while it won’t last forever, a bonded tooth should hold up well for at least several years with only routine dental care.

If a larger piece of the tooth is broken off and recovered, it is sometimes possible to reattach it via bonding. However, for more serious damage — like a severely fractured or broken tooth — a crown (cap) may be required. In this restoration process, the entire visible portion of the tooth may be capped with a sturdy covering made of porcelain, gold, or porcelain fused to a gold metal alloy.

A crown restoration is more involved than bonding. It begins with making a 3-D model of the damaged tooth and its neighbors. From this model, a tooth replica will be fabricated by a skilled technician; it will match the existing teeth closely and fit into the bite perfectly. Next, the damaged tooth will be prepared, and the crown will be securely attached to it. Crown restorations are strong, lifelike and permanent.

Was the future king “crowned” — or was his tooth bonded? We may never know for sure. But it’s good to know that even if we’ll never be royals, we still have several options for fixing a damaged tooth. If you would like more information, please contact us or schedule an appointment for a consultation. You can learn more by reading the Dear Doctor magazine articles “Repairing Chipped Teeth” and “Crowns and Bridgework.”

By George H Johnson, Jr., DDS, FAGD
April 29, 2017
Category: Dental Procedures
Tags: orthodontics   braces   oral hygiene  
DontForgetYourOralHygieneWhileWearingBraces

There are a few things you need to do — and not do — while wearing braces: avoid hard or sticky foods, for example, or wear protection during sports to avoid injury. There's one important thing, though, that should be at the top of your list — extra attention to daily brushing and flossing.

The fact is your risk for developing tooth decay or periodontal (gum) disease increases during orthodontic treatment. This is because the braces make it more difficult to reach a number of locations around teeth with a toothbrush or floss. Bacterial plaque, the source for these dental diseases, can subsequently build up in these areas.

Teen-aged orthodontic patients are even more susceptible to dental disease than adults. Because their permanent teeth are relatively young they have less resistance to decay than adults with more mature teeth. Hormonal changes during puberty also contribute to greater gum disease vulnerability.

There are some things you can do while wearing braces to avoid these problems. Be sure you're eating a nutritious diet and avoid sugary snacks or acidic foods and beverages (especially sports or energy drinks).  This will deprive bacteria of one of their favorite food sources, and the minerals in healthy food will contribute to strong enamel.

More importantly, take your time and thoroughly brush and floss all tooth surfaces (above and below the braces wire). To help you do this more efficiently, consider using a specialized toothbrush designed to maneuver around the braces. You might also try a floss threader or a water irrigator to remove plaque between teeth. The latter device uses a pressurized water spray rather than floss to loosen and wash away plaque between teeth.

Even with these efforts, there's still a chance of infection. So, if you notice swollen, red or bleeding gums, or any other problems with your teeth, visit us as soon as possible for an examination. The sooner we detect and treat dental disease while you're wearing braces, the less the impact on your future smile.

If you would like more information on taking care of teeth while wearing braces, please contact us or schedule an appointment for a consultation. You can also learn more about this topic by reading the Dear Doctor magazine article “Caring for Teeth During Orthodontic Treatment.”

By George H Johnson, Jr., DDS, FAGD
April 14, 2017
Category: Oral Health
DrTravisStorkDontIgnoreBleedingGums

Are bleeding gums something you should be concerned about? Dear Doctor magazine recently posed that question to Dr. Travis Stork, an emergency room physician and host of the syndicated TV show The Doctors. He answered with two questions of his own: “If you started bleeding from your eyeball, would you seek medical attention?” Needless to say, most everyone would. “So,” he asked, “why is it that when we bleed all the time when we floss that we think it’s no big deal?” As it turns out, that’s an excellent question — and one that’s often misunderstood.

First of all, let’s clarify what we mean by “bleeding all the time.” As many as 90 percent of people occasionally experience bleeding gums when they clean their teeth — particularly if they don’t do it often, or are just starting a flossing routine. But if your gums bleed regularly when you brush or floss, it almost certainly means there’s a problem. Many think bleeding gums is a sign they are brushing too hard; this is possible, but unlikely. It’s much more probable that irritated and bleeding gums are a sign of periodontal (gum) disease.

How common is this malady? According to the U.S. Centers for Disease Control, nearly half of all  Americans over age 30 have mild, moderate or severe gum disease — and that number increases to 70.1 percent for those over 65! Periodontal disease can occur when a bacteria-rich biofilm in the mouth (also called plaque) is allowed to build up on tooth and gum surfaces. Plaque causes the gums to become inflamed, as the immune system responds to the bacteria. Eventually, this can cause gum tissue to pull away from the teeth, forming bacteria-filled “pockets” under the gum surface. If left untreated, it can lead to more serious infection, and even tooth loss.

What should you do if your gums bleed regularly when brushing or flossing? The first step is to come in for a thorough examination. In combination with a regular oral exam (and possibly x-rays or other diagnostic tests), a simple (and painless) instrument called a periodontal probe can be used to determine how far any periodontal disease may have progressed. Armed with this information, we can determine the most effective way to fight the battle against gum disease.

Above all, don’t wait too long to come in for an exam! As Dr. Stork notes, bleeding gums are “a sign that things aren’t quite right.”  If you would like more information about bleeding gums, please contact us or schedule an appointment. You can read more in the Dear Doctor magazine article “Bleeding Gums.” You can read the entire interview with Dr. Travis Stork in Dear Doctor magazine.

By George H Johnson, Jr., DDS, FAGD
March 30, 2017
Category: Oral Health
Tags: sedation dentistry  
SedationAlongwithUnderstandingcanRelieveYourDentalVisitFears

For most people, going to the dentist is as routine as getting their oil changed. But if you're like the one in ten people with severe anxiety, dental visits are anything but routine.

What may have begun as a childhood fear has turned for many people into a lifetime avoidance of dental care.  This absence of dental cleanings, checkups and treatments can have an adverse effect on not only their oral health but their general health too.

But there are ways you can reduce dental visit anxiety, beginning first with finding a compassionate dental provider. A good dentist-patient relationship is important for everyone, but more so for people with anxiety. Building a trust relationship with a dentist who listens and accepts your fears without judging is your first step to overcoming them.

Though finding an understanding provider is important, it may not be enough in the beginning of your return to regular dental care. To help you further relax during visits, we can also provide medicinal therapies known collectively as sedation.

Although it has some similarities, sedation is different from anesthesia. The latter deadens pain sensation; sedation aims to calm your emotions. The most common sedation is taken in oral form, usually a pill (or syrup for children) taken an hour or so before the appointment. Oral sedation is often used in conjunction with gases like nitrous oxide and local anesthesia.

For a more relaxed state (especially during an involved procedure) we may use intravenous (IV) sedation. With this method we deliver the medication through a small needle or catheter inserted into a vein.

IV sedation places you in a reduced state of consciousness. But it isn't a “sleep” state as what's achieved during general anesthesia, but more of a “semi-awake” state. You won't need assistance with breathing or heart function and you can respond to verbal or touch commands. Many drugs used for IV sedation also have an amnesiac affect, so you won't remember many details about the procedure.

Depending on your level of anxiety, we can match the right therapy to induce calm and relaxation. Sedation can help you see dental visits in a more positive light so that it truly does become a life routine.

If you would like more information on sedation therapy during dental visits, please contact us or schedule an appointment for a consultation. You can also learn more about this topic by reading the Dear Doctor magazine article “IV Sedation in Dentistry.”





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