By M. Kenneth Johnson, DMD, PA
June 03, 2020
Category: Uncategorized
Tags: dental implant  
GettingImplantsCanBeaLongProcess-ButWorthit

Dental implants aren't simply prosthetic teeth, but rather an innovative system that restores both smile appearance and dental function. And while an implant can indeed replace a single tooth, they can do so much more. Integrated with removable dentures or a fixed bridge, they provide a secure solution to multiple missing teeth.

Implants essentially replace a missing tooth's root, the basis for their lifelikeness and functionality. As such, they're also the most sophisticated restoration used today, requiring a high degree of technical and aesthetic skill to place them properly. In reality, implantation is more a process than a procedure.

If you're considering implants, that process begins with a comprehensive dental exam. During the exam, we'll assess the exact condition of your oral and facial structures like the length of remaining teeth, your bite and jaw dimensions. We'll use this information to plan the type and placement of your implants. The exam may also reveal problems like bone loss that might postpone your implants or suggest another form of restoration.

Using digital technology, we then locate the exact positions for your implants on the jaw to ensure the best outcome. This often results in the creation of a surgical guide, a plastic template placed over the jaw that accurately pinpoints the locations for the drilling sequence during implant surgery.

In most cases once the implants are surgically installed, gum tissue may be sutured over the implant to protect it while it integrates with the bone. In some cases, though, a visible crown may be placed immediately, so the patient can enjoy a tooth-filled smile the same day. This immediate crown, though, is temporary and will be replaced with a more durable, permanent one in a few months.

During this interim, the titanium in the implant post will attract bone cell growth, which will build up on the implant surface. This increased bone contact will help secure the implant fully in the jaw, giving the implant its signature durability.

Once the integration is complete, the permanent crown is affixed to the implant (or implants in the case of a fixed or removable dental appliance). It may have been a long road, but you'll have the closest thing to real teeth.

If you would like more information on implant restorations, 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 “New Teeth in One Day.”

YouCanHaveaStraighterSmile-JustLiketheQueenofEngland

The monarchs of the world experience the same health issues as their subjects—but they often tend to be hush-hush about it. Recently, though, the normally reticent Queen Elizabeth II let some young dental patients in on a lesser known fact about Her Majesty's teeth.

While touring a new dental hospital, the queen told some children being fitted for braces that she too “had wires” once upon a time. She also said, “I think it's worth it in the end.”

The queen isn't the only member of the House of Windsor to need help with a poor bite. Both Princes William and Harry have worn braces, as have other members of the royal family. A propensity for overbites, underbites and other malocclusions (poor bites) can indeed pass down through families, whether of noble or common lineage.

Fortunately, there are many ways to correct congenital malocclusions, depending on their type and severity. Here are 3 of them.

Braces and clear aligners. Braces are the tried and true way to straighten misaligned teeth, while the clear aligner method—removable plastic mouth trays—is the relative “new kid on the block.” Braces are indeed effective for a wide range of malocclusions, but their wires and brackets make it difficult to brush and floss, and they're not particularly attractive. Clear aligners solve both of these issues, though they may not handle more complex malocclusions as well as braces.

Palatal expanders. When the upper jaw develops too narrowly, a malocclusion may result from teeth crowding into too small a space. But before the upper jaw bones fuse together in late childhood, orthodontists can fit a device called a palatal expander inside the upper teeth, which exerts gentle outward pressure on the teeth. This encourages more bone growth in the center to widen the jaw and help prevent a difficult malocclusion from forming.

Specialized braces for impacted teeth. An impacted tooth, which remains partially or completely hidden in the gums, can impede dental health, function and appearance. But we may be able to coax some impacted teeth like the front canines into full eruption. This requires a special orthodontic technique in which a bracket is surgically attached to the impacted tooth's crown. A chain connected to the bracket is then looped over other orthodontic hardware to gradually pull the tooth down where it should be.

Although some techniques like palatal expanders are best undertaken in early dental development, people of any age and reasonably good health can have a problem bite corrected with other methods. If you are among those who benefit from orthodontics, you'll have something in common with the Sovereign of the British Isles: a healthy, attractive and straighter smile.

If you would like more information about orthodontic treatment options, please contact us or schedule a consultation. To learn more, read the Dear Doctor magazine article “The Magic of Orthodontics.”

WithOutdoorSportsHopefullyPoisedtoBeginBePreparedforOralInjuries

National Physical Fitness & Sports Month in May, sponsored by the President's Council on Sports, Fitness & Nutrition, is a fitting time to encourage us to play sports. Many of us already feel the Spring itch to get out there and get involved. Unfortunately, an increase in sports or exercise activities also means an increase in potential physical injury risks, including to the face and mouth.

Although COVID-19 protective measures are delaying group sports, there's hope that many leagues will be able to salvage at least part of their season. If so, you should know what to do to keep yourself or a family member safe from oral and dental injuries.

First and foremost, wear a sports mouthguard, a plastic device worn in the mouth to reduce hard impacts from other players or sports equipment. A custom-fitted guard made by a dentist offers the best level of protection and the most comfortable fit.

But even though wearing a mouthguard significantly lowers the chances of mouth injuries, they can still occur. It's a good idea, then, to know what to do in the event of an oral injury.

Soft tissues. If the lips, cheeks, gums or tongue are cut or bruised, first carefully clean the wound of dirt or debris (be sure to check debris for any tooth pieces). If the wound bleeds, place some clean cotton gauze against it until it stops. If the wound is deep, the person may need stitches and possible antibiotic treatments or a tetanus shot. When in doubt, visit the ER.

Jaws. A hard blow could move the lower jaw out of its socket, or even fracture either jaw. Either type of injury, often accompanied by pain, swelling or deformity, requires medical attention. Treating a dislocation is usually a relatively simple procedure performed by a doctor, but fractures often involve a more extensive, long-term treatment.

Teeth. If a tooth is injured, try to collect and clean off any tooth pieces you can find, and call us immediately. If a tooth is knocked out, pick it up by the crown end, clean it off, and place it back into the empty socket. Have the person gently but firmly clench down on it and call the office or go to the ER as quickly as possible. Prompt attention is also needed for teeth moved out of alignment by a hard blow.

Playing sports has obvious physical, mental and social benefits. Don't let an oral injury rob you or a family member of those benefits. Take precautions and know what to do during a dental emergency.

If you would like more information about, please contact us or schedule a consultation. To learn more, read the Dear Doctor magazine articles “An Introduction to Sports Injuries & Dentistry” and “Dental Injuries: Field-Side Pocket Guide.”

By M. Kenneth Johnson, DMD, PA
May 04, 2020
Category: Oral Health
Tags: oral health  
ThatScaldedFeelingIsntinYourHead-ItCouldBeBurningMouthSyndrome

Most of us have encountered something hot that’s burned or scalded the inside of our mouth—not a pleasant feeling. But what if you have a similar burning sensation without eating or drinking anything to cause it?

It’s not your imagination: It could be a condition called burning mouth syndrome (BMS), the feeling your mouth is burned or scalded without an apparent cause. It’s often accompanied by dryness, numbness, or tingling. You may feel it throughout the mouth, or just in “hot spots” around the lips, tongue or other mouth structures.

Researchers haven’t pinpointed exact causes yet for BMS. It’s most common in women around menopause, connecting it to a possible hormonal imbalance. It’s also been linked to diabetes, nutritional deficiencies, medication, acid reflux, cancer treatment or psychological issues. Because it can persist for years, BMS can contribute to irritability, anxiety or depression.

If you’re experiencing BMS, there are things you can do to diminish its effect. First, though, have your dentist give you a complete oral exam and take a thorough medical history. They can then give you specific treatment recommendations based on what they reveal.

For example, if symptoms seem to increase after brushing your teeth, you might be having a reaction to a toothpaste ingredient, usually the foaming agent sodium lauryl sulfate. Your dentist may recommend experimenting with other toothpaste brands.

Other treatment options include:

  • Alleviating dry mouth symptoms by changing medications (as your doctor advises), drinking more water and using saliva-boosting products;
  • Quitting smoking and reducing your consumption of alcohol, coffee and spicy foods;
  • Chronicling your diet to look for connections between individual foods and BMS flare-ups—you may need to restrict these in your diet.
  • And because it seems to aggravate BMS symptoms, reducing acute stress with relaxation techniques or therapeutic counseling.

If your dentist can’t fully diagnose your condition or the steps you take aren’t reducing your symptoms, you may be referred to an oral pathologist (a dental specialist in mouth diseases). The key is not to give up until you find a workable treatment strategy. Through a little trial and error, you may be able to overcome the discomfort of BMS.

If you would like more information on Burning Mouth Syndrome, 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 “Burning Mouth Syndrome.”

By M. Kenneth Johnson, DMD, PA
April 24, 2020
Category: Dental Procedures
Tags: crowns  
4SituationsWhereaCrownCouldImproveanExistingTooth

Porcelain crowns have been used to restore problem teeth since at least the early 20th Century. Crown technology has gradually progressed from the early use of precious metals like gold or silver to more life-like porcelain crowns, often with a metal interior for added strength. Today, most crowns are all-porcelain, made with newer materials that not only look attractive but can endure under the pressures of daily chewing or biting.

While crowns are often part of restorations for missing teeth, they’re also commonly used to cap or fit over a viable tooth with structural or appearance problems. Here are 4 situations where a crown could improve a tooth’s form and function.

Traumatized teeth. A significant blow to the face or mouth could generate enough force to chip away or fracture a significant amount of structure from a tooth. If the root remains healthy and firmly attached within the jaw, however, a crown can replace the missing structure and restore the tooth’s function and appearance.

Root canal treatments. Root canal treatments remove infected or dead tissue within a tooth’s pulp chamber, its inner core, and the root canals. The procedure rescues the tooth but can in the process significantly alter the tooth’s structure and appearance. A crown not only restores the tooth but also provides added protection against further decay or tooth fracture.

Teeth with multiple fillings. We can effectively treat cavities caused by tooth decay by filling them. But with each filling we must remove more of the decayed structure and shape the cavity to accommodate the filling. After a number of times, a tooth may not have enough structure left to support another filling. If the tooth is still viable, a crown could solve this dilemma.

Abnormally developed teeth. Teeth sometimes don’t erupt in the jaw as they should and may be only partly visible. The tooth not only looks out of place but it can’t fully function like a normal tooth. Capping an abnormally developed tooth with a crown will help normalize it and allow it to blend in with surrounding teeth.

If you would like more information on crown restorations, 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 “Crowns & Bridgework.”





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