Causes of a Toothache
I found this diagram on the internet and it really helps explain causes of tooth sensitivy or pain. Causes of a toothache can be many different things. I wanted to share this. Dr. Johnston
Bonnie and her Steak
Meet Bonnie- Bonnie came to us for a crown that fell out. Upon the exam, it was discovered the she had multiple teeth that needed to be removed. At the consult, she was surprised at the treatment plan of removing her teeth. She was told we could replace the teeth with dental implants. Again, she was surprised at the cost and considered not doing them and just removing the teeth. We removed 4 very importnat teeth (2 on each side) and put her in a partial denture. We bone grafted the extraction sites, which take 4-6 months to be ready for implants. She did not like that partial dentures and elected not to wear them. 4 months went by and we placed the implants. At this appointment she asked me when she was going to get to eat steak. We then had a few more follow up visits on the implants and again she asked me when she was going to be able to eat steak. The time came for the implants to be restored with teeth on them. I again heard about the steak. The day we placed the teeth, I had aranged a steak dinner in our consult room. We placed the teeth and I led her into the consult room to show her, her steak. This was one of the top rewarding moments in my career. To see the smile on her face and her surprise. I had to return to other patients, but was told she didn’t leave a crumb on that plate! Here’s to Bonnie and her Steak!!! – Dr. Johnston
Deep Cleaning / Dental Scaling
When teeth and gums don’t get cleaned properly, the food particles mix with bacteria in your mouth and develop a soft substance called plaque. This plaque if not removed can turn into a harder substance known as dental tartar or calculus. If tartar is still not removed, it start impinging on the gums and create a seperation between the gums and the tooth. Once this seperation occurs, it allows for more food particles and bacteria to work its way down into the gum. The bacteria secrete waste from eating your microscopic food particles that can destroy gums and bone around the tooth. Once this sequence is established, brushing or flossing will not help remove this. A dental deep cleaning or Scaling and root planing procedure is needed. This is where dental professionals such as a dentist or dental hygienist takes their instruments and goes under the gumline to remove this structure of tartar. Once destruction of the bone has occured, the bone cannot grow back. If enough bone gets destroyed around the tooth, the tooth then loses its support and removal of the tooth is indicated. We commonly find that missing rountine cleanings (depending on one’s dental hygiene) over 1-2 yrs will lead to this. Its very important to see a dentist and have your teeth professionally cleaned so this process does not occur. I have attached a diagram that describes this. – Dr. Johnston
Product Review: Sonicare Diamond Clean
I was out in Las Vegas for a huge Cerec meeting, where they introduced a new camera technology for the Cerec. I happened to win this Sonicare Diamond Clean toothbrush there. For all my career, I have been a huge fan of Oral B electric toothbrushes. Its been a really long time since I have checked out Sonicare. I tried this Sonicare Diamond Clean brush the other night. I thought it was really good. This brush comes with a USB charging case, great for traveling. It has about 5 different modes on it.Its a bit pricey at $219. But its very high tech. https://youtu.be/ZHCHoqsF138 I look forward to brushing with this brush everyday. I can’t say I am a total Sonicare fan at this point, but its making me lean a little in that direction. I have asked multiple colleagues and dental hygienist what brush they recommend, and there is about a 50/50 split on Sonicare vs Oral B. The majority of the consesus was electrics are better than manual no matter what brand you have. I am meeting with Sonicare later this month. I may start carrying both Sonicare and Oral Bbrushes in the office for purchase. Have a great day!Dr. Johnston
Reasons skipping the dentist is bad for you
While most don’t love going to the dentist, we try our hardest to make ourselves do it twice a year. But for some reason, we skip the dentist more than any of our other health-related appointments. According to the Centers for Disease Control, 71.4 percent of women over age 18 had their teeth cleaned in 2008. That means more than a quarter of all women are skipping the dentist! Here are exactly what health benefits you are missing out on when you skip a cleaning.(Motivation to set up an appointment?) Here are some non-tooth-related health conditions that may be spotted or prevented by a dentist (or go undiagnosed if you skip an appointment). 1. Heart disease. A new study from researchers at Berkeley found that women who get dental care may reduce their risk of heart disease by one-third. It’s simple – bacteria in the gums, especially bleeding gums can travel to your heart and set up residence. 2. Oral Cancer.Often times oral cancer are asymptomatic. We all have oral cancer risk factors. Smokers (duh) and anyone who consumes more than one alcoholic beverage on a daily basis. New studies are showing HPV from oral sex are very high oral cancer causing risk factors. 3. Nutritional deficiencies. By looking at your tongue and gums, we can tell if you are lacking in certain vitamins and nutrients. One thing they look for is pale tongue, which may indicate an iron deficiency. While its uncommon in our area in Denver, it can be detected. 4. Diabetes. The condition of your teeth and gums may point to diabetes. Uncontrolled gum bleeding after cleanings and other dental observations can lead to a diabetic diagnosis. Just know that the more you skip out on your dentist, the more damage you can do to the rest of your body. More and more studies are finding systemic links coming from the oral cavity. Take care of those teeth and gums and they will take care of you!
Reasons to Have Your Old Metal Fillings Replaced
Reasons To Have Your Old Amalgam Fillings Replaced With Natural-Looking Composite Fillings If your mouth is still full of those old, metallic fillings that were inserted into your teeth years ago, then you may want to consider making the switch to more natural-looking composite fillings. It’s been shown in studies the average life of a metal filling is 8-15 years. If your fillings are older than 15 years, you may want to consider having them updated. Here are some great reasons to upgrade your old amalgam fillings: 1. Hidden Decay A metal filling can have fractures or weak margins allowing bacteria to enter the tooth beside the filling, ultimately causing decay under or around the filling. This cavity can not be detected in the dental x-ray, as the metal filling will mask it. The only way its detectable is to remove it and look under it. 2. Increased Strength Since composite fillings are actually bonded into the matrix of the tooth structure, they can slightly strengthen your teeth and help hold the tooth together. If an old metal filling is large and little natural tooth structure exists, a crown may be the best way to update and strengthen the tooth. 3. Steady Size Silver fillings expand or contract due to temperature change. If your fillings change size whenever you drink hot or cold beverages, then your teeth may develop cracks. Since composite fillings aren’t made of a metal that expands or contracts in such a manner, you will have less potential for tooth damage. 4. Less Invasive If you are terrified at the thought of somebody drilling holes in your teeth, then you should definitely choose natural-looking composite fillings over amalgam fillings. Although the removal of some of your tooth is necessary because of the cavity, much less of the tooth will need to be removed, which means more conservative drilling is involved. Composite fillings don’t need the same depth, thickness and mechanical retention to be stable, unlike metal fillings. 5. Natural Appearance For most people, this is the biggest benefit of composite fillings. Instead of having a mouthful of silver fillings, your teeth will look all-natural, and after a while, you probably won’t even remember which teeth have fillings! 6. Metallic Taste Some get a metallic taste in their mouths from having metal fillings. By getting rid of them, we can eliminate this metallic taste which can allow foods to taste better. Micro metal wear and fatigue occur during chewing. 7. Potential Health risk While the FDA and the ADA do not claim metal fillings pose health risk, there are studies out there that show different conclusions. While I am not legally able to say metal fillings pose a health risk, I do feel there has to be some small merit in these studies. I let people make their own decisions about this subject, and don’t recommend people to remove metal fillings based on this reason alone. Have a great day.
Taste of My Own Medicine
Today, I went to the dentist to update my fillings. I need to admit, I had a horrible love with candy during my teen years, which led to having many fillings completed in my adolescent years. (Being in the dental office so much interested me in becoming one – so its not all bad!) What got me was braces, braces and candy don’t mix. You can’t floss very easily with braces, so I decided brushing would be enough. In college, some of these metal fillings had cracked and needed to be replaced. So in college, I had another round of metal fillings. After college and into dental school, I became and still am, a dental mutt. I had a filling or two done in dental school by other students and teachers. When I graduated from dental school, I had several other dentists I worked with do fillings on me. Two years ago I had a small laser gum surgery at a laser course as a demonstration! So, in my goal book this year, I wrote down to get my routine dental work updated. So today, I went to a dentist I met in a conference in Scottsdale, AZ, who practices in Lafayette, CO. His name is Dr. Greg Keene of Keene Smiles. Last night (the night before the appointment, I was nervous. I thought about shots, drills, feeling the pain, etc. This morning on the drive to the appointment, I was also nervous. I had to tell myself everything would be ok! However, I was going to a new dentist I have never gone to before, trust is huge, other than knowing Dr. Keene at dental courses, I did not know what he was like as a dentist. This morning he replaced 8 metal fillings on my upper right and lower right side. I replaced them with composite and porcelain onlays. My teeth were not bothering me, I just knew that it had been over 13 years since those fillings were placed. I know that fillings can leak and decay can set up under them and go undetected, even with dental x-rays. I was right, some of my fillings, had decay under them. I have had excellent hygiene, a fairly good diet, and received professional cleanings every 6-8 months the last 10 years of my life too! So, today, I felt the needles, drill sounds and vibrations, was opened for long periods of time, numb lip, bad tastes, etc. Was the work totally comfortable? No, but it wasn’t bad at all. Dr. Keene did a great job! I am so proud of myself today that I took care of this and know my teeth are in much better shape. I have one more round on the left side and my teeth and fillings will be up to date. I now have a thorough understanding and appreciation of the drilling noises, vibrations, needles, taste, numbing feel, etc. During the appointment, I thought about all my future patients and what I can do to make it more comfortable for you all. I want to give a big thanks to Dr. Greg Keene of Keene Smiles in Lafayette, CO for all the work he did on me today. In conclusion, I wanted to share with you, that today – I received a dose of my own medicine.
Cigarette Warning Labels
Cigarette Health Warnings Beginning September 2012, FDA will require larger, more prominent cigarette health warnings on all cigarette packaging and advertisements in the United States. These warnings mark the first change in cigarette warnings in more than 25 years and are a significant advancement in communicating the dangers of smoking. Effects of smoking on your teeth is one of the warnings. Click here to read more and see all the warnings…
Oral B ProfessionalCare SmartSeries 5000 Kit Now Avaliable!
We are now selling Oral B’s best electric toothbrush. Oral-B’s most technologically advanced toothbrush, ProfessionalCare SmartSeries 5000 with SmartGuide provides Oral-B’s most advanced cleaning technology for ultimate plaque removal and also features a wireless SmartGuide. Separate, wireless SmartGuide helps maximize brushing performance Deep Clean mode removes up to 99.7% of plaque from hard-to-reach areas* Pressure sensor stops pulsations when brushing too hard Gentle on teeth and gums Improves gum health better than Sonicare FlexCare Offers outstanding whitening and polishing in 3 weeks** 5 modes: Daily Clean, Sensitive, Whitening, Massage, Deep Clean Oral-B is the #1 dentist-recommended toothbrush brand worldwide Also includes Crest Bag, Toothpaste, Rinse and Floss We are selling these for $125 and it comes with a $15 mail in rebate so your price is $110 total. Compare this to 159.99 at Target.com. We feel this is a great deal and toothbrush. Give your mouth the clean it deserves!
Oral Cancer / Velscope
Most of us are familiar with cancer. Its crossed our path in one way or another during our lifetime. We don’t necessarily know why we get it but unfortunately it happens. We don’t know why we get it but we do know how. Cancer (all forms) is mainly caused by problems with cell replication. Daily our cells which form our tissues undergo death and replication which is all a very complex process involving many stages that have to work precisely. Tissues with higher than normal replication cycles include but are not limited to: skin, breast, GI tract, genital, oral. Lets take this discussion and focus on oral. Oral tissues involve tongue, lips, mucosal lining of mouth (including hard and soft palate), salivary glands, tonsils, beginning of throat. Daily, we eat and drink, most of us three times a day or more. What do we eat or drink? Everything and anything. Sometimes we don’t even know whats in the food we eat or the things we drink. The things we place in our mouth sit on our tongue, our oral tissues, or teeth. Things we place in our mouths can be cold, hot, spicy, salty, sweet, acidic, basic, and even toxic! As you can see the tissue in our mouth undergoes many cycles. Daily we loose and rebuild cells in our oral tissues at a higher rate that other parts of the body. Just like other types of cancer, oral cancer has a good prognosis if detected early. For years dentist have detected oral cancer, but have detected it when they could visibly see it. Once you can visibly see oral cancer its likely to be in a lower prognosis. (stage 3 or 4) Until 5 years ago, there was no other way for dentist to detect oral cancer other that visibly. Gynecologist detect cancer with a pap smear, but dentist never had a pre-visible diagnostic attack on cancer until now. Enter the Velscope. The Velscope is a light that shines on the tissues and fluoresces normal tissue green. If the tissue does not fluoresce green, it needs to be looked at in greater detail. This technology allows dentist to actually look into tissues in greater detail and detect cancer in earlier stages. This technology is also moving to the gynecological circuit as they are hoping to reduce pap smears. (After all a pap smear caused you to rebuild cells that just got scrapped off) Is this light safe? Completely! Its not a laser, its a normal light that is taken at a different spectrum to allow fluorescence. Since the Velscopes introduction, oral cancer is quickly on the rise. I believe this is due to dentists being more aware and easily being able to detect it. We have elected to participate in this brilliant Velscope technology. Everyday we learn something new and things seem to always change. It is my job as a clinician to keep you informed. Till next time…. Have a great day!
Most Dental Problems are Silent
Daily, I get asked from patients, if I am not having pain, why do I have to get a filling? Like cancer and heart disease in the body, most dental problems are silent. Lets look at a few silent dental problems. Cavities When a cavity starts to hurt, that is when it is almost too late to just simply do a filling! Cavities do no hurt until they get close to the nerve in the tooth. The tooth has 2 layers to protect the nerve, the enamel and the dentin. The enamel is one of the hardest elements of the human body, its amazing to think microscopic bacteria can destroy it. Once the bacteria sets up in the dentin of the tooth, the tooth can literally become an eggshell and still look like nothing is wrong. The longer the bacteria sit inside the tooth, the more they destroy by their acid secretion/waste. The bacteria work their way through the dentin to the nerve. This is when pain can start. By then, the nerve has bacteria in it and an infection develops at the root tip of the tooth. The only way to save this tooth now is a root canal and crown, when a filling would have been more simple and cost effective. The assumption is if the tooth doesn’t hurt, it doesn’t need to be fixed Gum Disease Gum Disease is bacteria, plaque and tartar, that develops under the gums. The bacteria also secrete a substance that can kill and destroy bone structure around the teeth. As painful as that sounds, it can present no pain. With destroyed bone around the teeth, teeth can eventually get lose and fall out. Generally, this process can take 5-15 years, but can also happen rapidly, depending on diet, hygiene, bacteria levels in the mouth, etc. Existing Root Canals Once a root canal is completed, there is no more nerve in the tooth. At the bottom of the tooth (the root tip) is where a infection can set up. Bone doesn’t have nerves like tissue does, so therefor if there is an infection underneath a root canal, it can’t be felt. Once this gets to a large level, prognosis of retreating the root can decrease. Implants Dental implants can get gum disease around them and fail as well. Anytime a dental implant becomes loose, its a failure. So, the point of this blog is for me to show you examples of why and how most dental problems are silent. After any dental work is completed it should be checked yearly with an x-ray. The more dental work you have completed, the more work it takes to keep the work lasting. Don’t take chances and see a dentist routinely, so we can get to the problem, before other major problems creep up on you.
Cleanings Only?
Cleanings Only? 11/6/2010 We have had a number of calls to the office asking us if we did cleanings only, as a new patient. When our reply is no, they get upset, say their goodbyes and move on. I want to take a moment and explain why our office doesn’t do cleanings only. If seen as a patient for the first time, total dental care is our responsibility the moment you walk in the office. If we do a cleaning only, its possible an abnormal dental condition could be overlooked. We take dental radiographs to aide in the detection of abnormalities. If dental radiographs are not taken, again an abnormal dental condition could be neglected to be detected. It is in your best interest to have a exam and dental radiographs completed with your first visit with us, as this is the only way we can give you an accurate diagnosis and description of your dental health. We want you to receive the best care possible with us and to know we treat everyone individually as we are all unique. We ask for your understanding. It is for these reasons, our standard of care is set to involve dental radiographs and an exam with our cleanings. If there are further questions on this subject, don’t hesitate to contact us for further information. -Jeff Johnston, DDS