ItTakesArtistryandSkilltoAchievetheRightColorBalanceforYourVeneers

Getting a new smile doesn’t have to be an elaborate affair. If your teeth have minor to moderate chips, stains or tooth gaps, dental veneers could be the answer. These thin wafers of dental porcelain mask tooth imperfections and completely change your smile’s dynamic—and without a huge impact to your wallet.

To achieve that effect, though, your personal set of veneers will require the expertise of both your dentist and a dental lab technician to design and create your veneers. And while there are numerous considerations in achieving a truly life-like appearance with veneers, one of the most important is their color.

We always associate the color white with teeth. And while it is the dominant hue, actual tooth color is more complex. An individual tooth is comprised of multiple shades and tints, that range in variation from its biting edge to the gums. Likewise, tooth color in general can differ from person to person.

Your dentist must take these individual color variations into account while designing your new veneers, especially if you’ll be getting them for some but not for all your teeth. In that case, it’s important for the veneer color to blend seamlessly with the color of your natural teeth without veneers.

Your new smile expectations and desires are also important and should be considered when designing veneer coloring. For instance, do you want a more natural look—or would you prefer a smile with more “dazzle”? This could have an impact on color.

Your dentist takes all of this information (including your input) and communicates it clearly to the dental lab technician creating the veneers. That process is a combination of both science and artistry, using a variety of techniques to achieve an accurate, life-like texture and color result. For example, a technician may paint the edges of the veneers with a ceramic paste that when cured produces a life-like translucency.

This meticulous attention to color detail is necessary to create beautiful veneers that look natural. If the color is right, you’re sure to enjoy the change your veneers bring to your smile for many years to come.

If you would like more information on transforming your smile with dental veneers, 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 “Porcelain Veneers: Your Smile—Better Than Ever.”

By M. Kenneth Johnson, DMD, PA
November 26, 2019
Category: Oral Health
Tags: oral health   hiv  
LivingwithHIVincludesKeepingaCloseWatchonYourOralHealth

We’ve come a long way since the early 1980s when we first identified the HIV virus. Although approximately 35 million people worldwide (including a million Americans) now have the virus, many are living relatively long and normal lives thanks to advanced antiretroviral drugs.

Still, HIV patients must remain vigilant about their health, especially their oral health. ┬áIn fact, problems with the teeth, gums and other oral structures could be a sign the virus has or is moving into the full disease stage, acquired immunodeficiency syndrome (AIDS). That’s why you or a loved one with the virus should maintain regular dental checkups or see your dentist when you notice any oral abnormalities.

One of the most common conditions among HIV-positive patients is a fungal infection called candidiasis (or “thrush”). It may appear first as deep cracks at the corners of the mouth and then appear on the tongue and roof of the mouth as red lesions. The infection may also cause creamy, white patches that leave a reddened or bleeding surface when wiped.

HIV-positive patients may also suffer from reduced salivary flow. Because saliva helps neutralize excess mouth acid after we eat as well as limit bacterial growth, its absence significantly increases the risk of dental disease. One of the most prominent for HIV-positive patients is periodontal (gum) disease, a bacterial infection normally caused by dental plaque.

While gum disease is prevalent among people in general, one particular form is of grave concern to HIV-positive patients. Necrotizing ulcerative periodontitis (NUP) is characterized by spontaneous gum bleeding, ulcerations and a foul odor. The disease itself can cause loosening and eventually loss of teeth, but it’s also notable as a sign of a patient’s deteriorating immune system. The patient should not only undergo dental treatment (including antibiotics), but also see their primary care physician for updates in treating and managing their overall symptoms.

Above all, HIV-positive patients must be extra diligent about oral hygiene, including daily brushing and flossing. Your dentist may also recommend other measures like saliva stimulators or chlorhexidine mouthrinses to reduce the growth of disease-causing bacteria. Together, you should be able to reduce the effects of HIV-induced teeth and gum problems for a healthier mouth and better quality of life.

If you would like more information on oral care for HIV-AIDS patients, 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 “HIV-AIDS & Oral Health.”

By M. Kenneth Johnson, DMD, PA
November 16, 2019
Category: Oral Health
Tags: sensitive teeth  
ToothSensitivityCouldBeaSignofDeeperProblems

If you wince in pain while eating or drinking something hot or cold, you’re not alone: tooth sensitivity afflicts one in three Americans. To understand what’s possibly going on, let’s look first at tooth anatomy.

Teeth are mainly composed of three layers: an outer protective enamel that covers the upper crown, a middle layer called dentin and an inner pulp. The dentin is composed of small tubules that transmit outer temperature and pressure sensations to nerves in the pulp.

The enamel serves as a “muffler,” damping sensations to protect the nerves from overload. In the root area, the gums and a thin material called cementum covering the roots also help muffle sensation.

But sometimes teeth can lose this muffling effect and the nerves encounter the full brunt of the sensations. The most common reason is gum recession, usually caused by periodontal (gum) disease. The gums have shrunk back or “receded,” and after a short while the cementum covering will also be lost, exposing the dentin in the root area.

Another problem is enamel erosion caused by mouth acid. Chronic high acidity, often caused by bacterial growth or acidic foods and beverages, can dissolve the enamel’s mineral content, causing decay and exposure as well of the underlying dentin.

To avoid future tooth sensitivity, it pays to prevent these two dental problems. The most important thing you can do is practice daily brushing and flossing to reduce bacterial plaque and see your dentist regularly for dental cleanings and checkups.

But if you’re already experiencing symptoms, you’ll first need an accurate diagnosis of the cause. If it’s related to gum disease, immediate treatment could help stop or even reverse any gum recession. To address enamel erosion, your dentist may be able to protect and strengthen your teeth with sealants and topical fluoride.

There are also things you and your dentist can do to reduce your symptoms. One is for you to use hygiene products with fluoride, which can take the edge off of sensitivity, or potassium, which helps reduce nerve activity. Your dentist can further reduce nerve sensitivity by blocking the tubules with sealants and bonding agents.

Tooth sensitivity is an irritating problem in itself; more importantly, though, it’s often a warning of something else seriously wrong that needs attention. If you’re feeling a little sensitive in the teeth, see your dentist as soon as possible.

If you would like more information on tooth sensitivity, 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 “Treatment of Tooth Sensitivity: Understanding Your Options.”

By M. Kenneth Johnson, DMD, PA
November 06, 2019
Category: Oral Health
Tags: celebrity smiles   retainer  
MargotRobbieKnowsAGreatSmileIsWorthProtecting

On the big screen, Australian-born actress Margot Robbie may be best known for playing devil-may-care anti-heroes—like Suicide Squad member Harley Quinn and notorious figure skater Tonya Harding. But recently, a discussion of her role in Peter Rabbit proved that in real life, she’s making healthier choices. When asked whether it was hard to voice a character with a speech impediment, she revealed that she wears retainers in her mouth at night, which gives her a noticeable lisp.

“I actually have two retainers,” she explained, “one for my bottom teeth which is for grinding my teeth, and one for my top teeth which is just so my teeth don't move.”

Clearly Robbie is serious about protecting her dazzling smile. And she has good reasons for wearing both of those retainers. So first, let’s talk about retainers for teeth grinding.

Also called bruxism, teeth grinding affects around 10 percent of adults at one time or another, and is often associated with stress. If you wake up with headaches, sore teeth or irritated gums, or your sleeping partner complains of grinding noises at night, you may be suffering from nighttime teeth grinding without even being aware of it.

A type of retainer called an occlusal guard is frequently recommended to alleviate the symptoms of bruxism. Typically made of plastic, this appliance fits comfortably over your teeth and prevents them from being damaged when they rub against each other. In combination with stress reduction techniques and other conservative treatments, it’s often the best way to manage teeth grinding.

Orthodontic retainers are also well-established treatment devices. While appliances like braces or aligners cause teeth to move into better positions, retainers are designed to keep teeth from moving—helping them to stay in those positions. After active orthodontic treatment, a period of retention is needed to allow the bite to stabilize. Otherwise, the teeth can drift right back to their old locations, undoing the time and effort of orthodontic treatment.

So Robbie has the right idea there too. However, for those who don’t relish the idea of wearing a plastic appliance, it’s often possible to bond a wire retainer to the back surfaces of the teeth, where it’s invisible. No matter which kind you choose, wearing a retainer can help keep your smile looking great for many years to come.

If you have questions about teeth grinding or orthodontic retainers, please contact our office or schedule a consultation. You can read more in the Dear Doctor magazine articles “Teeth Grinding” and “The Importance of Orthodontic Retainers.”

By M. Kenneth Johnson, DMD, PA
October 27, 2019
Category: Oral Health
Tags: tooth decay  
LimitingRefinedSugarinYourDietcanReduceRiskofToothDecay

“Cut down on sweets, especially between meals” is perhaps one of the least popular words of advice we dentists regularly give. We’re not trying to be killjoys, but the facts are undeniable: both the amount and frequency of sugar consumption contributes to tooth decay. Our concern isn’t the naturally occurring sugars in fruits, vegetables, grains or dairy products, but rather refined or “free” sugars added to foods to sweeten them.

The World Health Organization and the U.S. Food and Drug Administration both advise consuming no more than 50 grams (about ten teaspoons) of sugar a day. Unfortunately, our nation’s average per person is much higher: we annually consume around 140 pounds per capita of refined sugars like table sugar or high fructose corn syrup, more than three times the recommended amount. Soft drinks are the single largest source of these in our diets — Americans drink an average of 52 gallons every year.

The connection between sugar and tooth decay begins with bacteria that ferments sugar present in the mouth after eating. This creates high levels of acid, which causes the mineral content of tooth enamel to soften and erode (a process called demineralization) and makes the teeth more susceptible to decay. Saliva naturally neutralizes acid, but it takes about thirty minutes to bring the mouth’s pH to a normal level. Saliva can’t keep up if sugars are continually present from constant snacking or sipping on soft drinks for long periods.

You can reduce the sugar-decay connection with a few dietary changes: limit your intake of sugar-added foods and beverages to no more than recommended levels; consume sweets and soft drinks only at meal times; replace sugar-added foods with fresh fruits and vegetables and foods that inhibit the fermentation process (like cheese or black and green teas); and consider using mint or chewing gum products sweetened with xylitol, a natural alcohol-based sugar that inhibits bacterial growth.

Last but not least, practice good oral hygiene with daily brushing and flossing, along with regular office cleanings and checkups. These practices, along with limits on refined sugar in your diet, will go a long way toward keeping your teeth and mouth healthy and cavity-free.

If you would like more information on the relationship of sugar and dental disease, 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 “Nutrition & Oral Health.”





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