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
Press Release #1 – Cerec
Local Colorado Dentist Utilizes CEREC Technology to Execute Simplistic and Efficient Dental Appointments for all Patients Dr. Jeff Johnston, dentist in Cherry Creek, is pleased to announce that his practice is able to utilize CEREC technology to create crowns, fillings and veneers in just a single visit. This technology allows Dr. Johnston to offer superior dental service to his patients in the Denver and Cherry Creek area. Denver, CO (1888PressRelease) October 09, 2012 – CEREC allows the practice to offer a tremendous level of service to all patients. Instead of taking two or three weeks to create and implement a crown, Ascent Dental is able to do so in a single appointment. The patient will be able to leave the same day with a fully constructed dental crown(s). The practice will continue to use CEREC to successfully treat the patients. Prior to CEREC in Colorado, receiving a dental crown was much more complicated. To do so, a dentist had to take a muddled impression of the tooth and then send it to a dental lab. During the two to three weeks in between appointments, patients would wear a temporary crown before the permanent crown would be attached at times causing it to be uncomfortable or to become dislodged. CEREC is an acronym for Chairside Economical Restorations of Esthetic Ceramic. CEREC uses special imaging technology to get an accurate digital representation of the patient’s tooth. Using specialized software, Dr. Johnston then is able to design a crown that will fit perfectly within the patient’s tooth. An on-site milling machine is then used to physically create the crown, allowing Dr. Johnston to permanently attach to the patient’s tooth. The ceramic material used to create the crown or filling expands and contracts as natural teeth do. Because of this, there is no danger of cracking. Furthermore, they are neither too hard nor too soft. There is no undue wear and the patient will not need to replace them time and again as one might with older crown or filling technology. They also accurately represent the visual aesthetic of natural teeth. The crown is ready for placement in as little as 15 minutes and the results can last years. To schedule an appointment with Dr. Johnson, patients can call (303) 975-6987 or use the online appointment request form www.ascentdental.com . To do this, patients simply have to enter in the date, time and a few words detailing the nature of their appointment into the online form. Shortly after, the practice’s scheduling coordinator will follow up with a confirmation email. About Dr. Jeff Johnston: At the age of 12, Dr. Johnston’s life goal was to be a dentist. Dr. Jeff Johnston, Denver Dentist is a member of several professional organizations, which he chooses on the basis of whether they contribute to the overall wellbeing of patients and the profession. He is currently pursuing the Fellowship Award to the Academy of General Dentistry, which is earned through continuing dental education on the many different fields of dentistry. Other organizations include: American Dental Association, Metro Denver Society, Texas Tech Alumni, Biking Club of Colorado and the NRA. Dr. Johnston is always striving to be the best dentist when it comes to serving the Colorado dental industry. Ascent Dental is a full-service dentist office, providing general dentistry and cosmetic dentistry services to the Denver-area patients. This includes such services as: • Dental hygiene and teeth cleaning • Family dentistry • Dental crowns while you wait • Endodontics (root canal) • Porcelain veneers • Tooth whitening • Dental implants • Porcelain fillings Affordable dental treatments that alleviate any worry or fear of going to the dentist can be completed in one day. The advancement in technology at Ascent Dental is immediately available to all new patients. To learn more about Dr. Johnston, his staff or any of the services that are offered at his practice, patients are encouraged to visit his practice’s comprehensive dental website at www.ascentdental.com .
Omnicam
Sirona Dental Systems, based in Germany, has just released Omnicam. The first intra-oral camera of its kind for CAD CAM sytems. This is a 3D/2D intraoral camera. They have also released thier CAD CAM software to be in color, not just stone looking models. I was at the release in Las Vegas in August. They spend a fortune on the meeting, with over 4,000 dentist. This is a game changer in CAD CAM and patient care. We have a little ways to wait before it can come to Ascent Dental, but looking forward to having this new toy! 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
Dental Education
Around 8yrs ago, I graduated from dental school. I was on top of the world, my brain was chalked full of dentistry, and I was ready to become a dentist. Upon the first month of practicing dentisty, I saw patients and cases I have never seen before and that I didn’t know how to treat or even where to start. I also learned very fast, I was slow and in order to survive in private practice my practice speed had to increase without compromising quality. That first year after dental school, I refused to crack a book or sit in a classroom, after all I had been in school the last 20 years of my life. I just wanted to practice dentistry and earn some extra money, being a student and living very frugally for so long, I wanted nothing more than to have some extra spending money. Little did I know at the time, that my dental degree and license was just a ticket to learn, and thats about it. I have owned my own practice for about 4 years now. I have quickly learned that my dental education is a key to being a great clinican. Every case I see if completely different, and dentist who have been practicing for 30 years still seen new cases and seek new ways to treat them. I am from Texas, and in Texas, the state requires 16 hours of dental continuing education (CE) over anything you want to go learn about related to dentistry. Practicing in Colorado, the state requires 0 hours of CE. I found this to be odd for the state not to require its clinicians to not learn anything new and be able to practice! Dental education is not cheap. Some classes out there can cost as much as 5-10k a weekend plus travel! I find it baffling the cost that is associated with CE. I used to think dental school cost a lot, it is nothing compared to advanced education after school. There are dental courses going on around the world daily from various sources. Picking and choosing who you want to learn from and what you want to learn is that hard part!. I tend to go learn topics that I see frequently come in the practice. Each demographic can see more of a certain type of case than others. In summary, education is a huge part of practicing dentistry. More than ever, todays changes in technology, materials, and equipment make learning an essential part of being a dentist. Jeff Johnston DDS
We Have Achieved Recognized Provder Status
I wanted to share that we have acheived recognized provider status with six month smiles. This means we have done the required amount of cases and six month smiles recognizes us as a top provider! We also recieved the logo.
Cerec Mentoring
I wanted to take a second and share my weekend with you. This past weekend (Jan 27, 29 2012) I headed out to The Scottsdale Center for dentistry in Scottsdale, Arizona. The Scottsdale Center for dentistry is a world renowned dental teaching facility and is one of the top teaching facilities in the United States. The Scottsdale Center is also a Cerec training capital. As a mentor of Cerecdoctors.com (a online website and forum dedicated to Cerec education) we have the opprotunity to go to the Scottsdale Center and help with classes. These classes usually consist of a lecture and a lab component. While dentists are in the lab, mentors walk around and make sure they are doing ok, answering any questions they may have. This was my first experience teaching postition. Getting asked about 100 questions a day and looking at different situations on the Cerec machine from others really allowed me to display my knowledge of Cerec. I have to say I was impressed with what I knew and have learned, especially in the last year. Dentistry is like peeling an onion, there are many many layers. Great dentist spend their lives learning. Technology today is moving very fast and it can be challenging to keep up with its pace. The future is really bright and I look forward to the challenge of a lifetime of dental education. A wise man once said, once we stop learning, we stop living. Till next time Dr. Jeff 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.
Top 11 Reasons Cerec is Better..
(For those of you who don’t know what a Cerec Machine is….please see our webpage over here here) This past weekend, I attended the Cerec 3rd Annual Symposium, in Scottsdale, AZ at the Scottsdale Center for Dentistry, a premier leader in Cerec Education. Many Topics were covered over the weekend and we even met the software designers from Germany. They presented us the new Cerec software coming out next month, version 4.0, which is one of the best software improvements of Cerec over their 25+ year history. We heard from independent dental material researchers,dental lab technicians, and top clinicians. I took home many things from this meeting, but mainly the confidence that Cerec is the best way of making dental restorations. Here are reasons why Cerec is better than traditional dentistry (presented to us again by top researchers and lap technicians in the world). 1) No Temporaries / One Visit – Temporary restorations can break, fall off, or not last during the 2 weeks needed to fabricate a crown at a lab. Teeth can be sensitive, micro-shift and drift, etc. that can allow the crown from the lab not to fit well or damage to the unprotected tooth. 2) No lab remakes – A lab presenter from a major dental lab stated on average crowns remakes range from 6-10% of the time. This means a crown could take up to 3 maybe even 4 visits! 3) Machine Made Materials – Traditionally porcelain is stacked from a powder liquid technique allowing for weak micro space in the porcelain. Regulated, precise, machine made porcelain is precise and uniform, allowing for a consistent, strong and predictable material. 4) Accurate Impressions – Digital scans are shown to be up to 20-40% more accurate than traditional impression material. Traditionally, a impression is made, sent to the lab and poured up in stone. There are about 20-40 inconsistencies / distortions that can occur in this traditional step. Materials can shrink, expand, get to hot or to cold during shipping, etc. This more accurate scan leads to a more accurate fit and seal with the tooth. 5) Better Bonded Strength- Traditionally, dental crowns are cemented. Cerec crowns are bonded to the tooth vs cemented, using stronger, high sealing, long lasting bonded materials. 6) Every step can be controlled by the dentist – From Start to Finish, the whole CEREC procedure is controlled by the dentist. You can tweek everything about the crown such as bite, tooth contacts, anatomy, width, etc. 7) You can copy– With Cerec, existing Teeth can be copied. This means we can let you keep the exact shape you are used to. This cannot be done with a dental lab. We scan, prepare tooth, copy the scan onto the prepared tooth and give you exactly what you were used to. 8) No 2nd Numbing – many times you need to get numb again to take the temporary off. Not a concern with Cerec single visit porcelain dentistry. 9) In office custom staining and glazing – Traditionally if the crown color we got back from the lab isn’t correct, we had to send it back or you had to go to the dental lab. With Cerec, we can re-stain and glaze the custom color right here in the office. 10) Crown is saved – If you happen to break or fracture a crown make with Cerec, we have the crown stored in the computer. We hit mill and make you a new crown instantly. 11) Environmentally friendly – Instead of delivery trucks to send the case to the lab, we can now email the precise scan to a lab, and the lab can fabricate the crown. You also don’t have to come here twice, so that also saves gas. No need for impression materials, stone, temporaries to go into landfills. Have a great Day
85% don't make it!
Wisdom teeth, or third molars, are the last teeth to erupt in your mouth and are the teeth least needed for good oral health. Most people have four wisdom teeth that usually erupt through the gums in their late teens or early twenties. Sometimes wisdom teeth remain trapped in the jawbone under the gums because there is insufficient room for them to erupt. Wisdom teeth can cause gum disease, crowding or other damage to adjacent teeth, decay (due to the inability of your toothbrush to keep the area clean), and bone destroying cysts. Pain and swelling are the most common symptoms of problem wisdom teeth. Whether you have obvious symptoms or not, it is important to diagnose existing or potential problems caused by your wisdom teeth. Ultimately, at one time or another, its been shown that 85% of all wisdom teeth are removed due to crowding, gum disease and cavities. If they are in, and there is room for them, these usually go on to develop large cavities, as cleaning them is challenging. Waiting to have them removed after your 30’s can go on to become more challenging with longer healing times. We urge you to do this in your teens and 20’s. Removal is the wisest decision for your health and well-being. We can removed them for you, before they cause problems! Make your appointment today! This video can explain it.