By M. Kenneth Johnson, DMD, PA
January 15, 2020
Category: Dental Procedures
Tags: crown  
CustomizedTemporaryCrownsletyouRehearseYourFutureSmile

Modern restorations for severely damaged or missing teeth are truly remarkable. Although the type of restoration may differ — dental implant, bridge, or veneer — the end result is a life-like facsimile that matches the shape and color of your natural teeth.

To achieve this result, though, the new crown or veneer requires fabrication in a dental laboratory, a meticulous process that may take a few weeks. In the interim, we often install temporary crowns. These help in a number of ways: because we’ve prepared the teeth for final restoration by removing some of the tooth structure, the temporary crown protects and stabilizes the teeth, reduces sensitivity and helps maintain gum health. Temporary crowns also enable the patient to present a more natural smile while waiting for the permanent restoration.

Temporary crowns are typically manufactured to fit a wide range of patients, similar to an “off-the-rack” suit from a clothing store. In recent years, though, customized “tailored” temporary crowns designed specifically for an individual patient have grown in popularity among dental professionals as well as patients.

In creating a customized temporary crown, we first perform a smile analysis similar to one used for a permanent restoration. After a careful assessment of your mouth, we would then make recommendations about the elements to include in the temporary crown, including shape and color. We would also factor in your desires and concerns into the final design. Working together with the dental laboratory, we would then have the temporary crowns produced and ready to apply as soon as we complete the preparatory work.

Customized temporary crowns also serve another important purpose as a kind of “dress rehearsal” for the permanent restoration. This gives you an opportunity to “try out” the smile you’ll have with the permanent restoration in your daily life. We can then use your experience to make adjustments to the permanent crowns before final production.

While customized temporary crowns involve more effort and expense than the traditional, the benefits are worth the added cost, especially if you’re involved with an extensive “smile makeover” procedure. Not only will you look better while your permanent restoration is under construction, your temporary look will give you added confidence that your future smile is right for you.

If you would like more information on temporary and permanent dental 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 “Concepts of Temporary Restorations.”

By M. Kenneth Johnson, DMD, PA
January 05, 2020
Category: Oral Health
Tags: dental exam  
YouMayNeedSomethingOtherThanOintmenttoClearupThisFacialRash

During your latest dental cleaning and checkup, your dentist notices a skin rash around your mouth. You sigh—it’s been going on for some time. And every ointment you’ve tried doesn’t help.

You may have peri-oral dermatitis, a type of skin rash dentists sometime notice during dental treatment. It doesn’t occur often—usually in only 1% of the population—but when it does, it can be resistant to common over-the-counter ointments.

That’s because peri-oral dermatitis is somewhat different from other facial rashes. Often mistaken as acne, the rash can appear as small red bumps, blisters or pus-filled pimples most often around the mouth (but not on the lips), nostrils or even the eyes. Sometimes the rash can sting, itch or burn.

People with peri-oral dermatitis often try medicated ointments to treat it. Many of these contain steroids that work well on other skin conditions; however, they can have an opposite effect on peri-oral dermatitis.

Because the steroids cause a constriction in the tiny blood vessels of the skin, the rash may first appear to be fading. This is short-lived, though, as the rash soon returns with a vengeance. Prolonged steroid applications can also thin the affected skin, making it more susceptible to infection and resistant to healing.

Peri-oral dermatitis requires a different treatment approach. The first step is to stop using any kind of steroidal cream, as well as moisturizers, ointments and both prescription and non-prescription medications. Instead, you should only use a mild soap to wash your face.

You may find the rash looking worse for a few days but be patient and continue to avoid ointments or creams. Your healthcare provider may also prescribe oral antibiotics, usually of the tetracycline family. It may take several weeks of antibiotic treatment until the skin noticeably clears up.

For most people, this approach puts their rash into permanent remission. Some, though, may see a reoccurrence, in which case it’s usually best to repeat treatment. With a little patience and care, though, you’ll finally see this persistent rash fade away.

If you would like more information on peri-oral dermatitis, please contact us or schedule an appointment for a consultation.

By M. Kenneth Johnson, DMD, PA
December 26, 2019
Category: Dental Procedures
Tags: dental implants  
AlthoughRareAllergicReactionstotheMetalinImplantsCouldbeaConcern

You’re considering dental implants and you’ve done your homework: you know they’re considered the best tooth replacements available prized for durability and life-likeness. But you do have one concern — you have a metal allergy and you’re not sure how your body will react to the implant’s titanium and other trace metals.

An allergy is the body’s defensive response against any substance (living or non-living) perceived as a threat. Allergic reactions can range from a mild rash to rare instances of death due to multiple organ system shutdowns.

A person can become allergic to anything, including metals. An estimated 17% of women and 3% of men are allergic to nickel, while 1-3% of the general population to cobalt and chromium. While most allergic reactions occur in contact with consumer products (like jewelry) or metal-based manufacturing, some occur with metal medical devices or prosthetics, including certain cardiac stents and hip or knee replacements.

There are also rare cases of swelling or rashes in reaction to metal fillings, commonly known as dental amalgam. A mix of metals — mainly mercury with traces of silver, copper and tin — dental amalgam has been used for decades with the vast majority of patients experiencing no reactions. Further, amalgam has steadily declined in use in recent years as tooth-colored composite resins have become more popular.

Which brings us to dental implants: the vast majority are made of titanium alloy. Titanium is preferred in implants not only because it’s biocompatible (it “gets along” well with the body’s immune system), but also because it’s osteophilic, having an affinity with living bone tissue that encourages bone growth around and attached to the titanium. Both of these qualities make titanium a rare trigger for allergies even for people with a known metal allergy.

Still, implant allergic reactions do occur, although in only 0.6% of all cases, or six out of a thousand patients. The best course, then, is to let us know about any metal allergies you may have (or other systemic conditions, for that matter) during our initial consultation for implants. Along with that and other information, we'll be better able to advise you on whether implants are right for you.

If you would like more information on the effects of metal allergies on dental implants, 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 “Metal Allergies to Dental Implants.”

By M. Kenneth Johnson, DMD, PA
December 16, 2019
Category: Oral Health
PopStarDemiLovatoPopsOutJayGlazersTooth

Singer and actor Demi Lovato has a new claim to fame: formidable martial artist. When she is not in the recording studio, on stage or in front of the camera, Lovato can often be found keeping in shape at Jay Glazer's Hollywood (California) gym. Glazer, who is best known as a sports journalist, also runs conditioning programs for professional athletes and celebrities based on mixed martial arts. On March 6, Glazer got more than he bargained for when 5'3" Lovato stepped into the ring and knocked out his front tooth.

Glazer reportedly used super glue to put his tooth back together. Not a good idea! While it may not be convenient to drop everything and get to the dental office, it takes an expert to safely treat a damaged tooth. If you glue a broken tooth, you risk having to undergo major work to correct your temporary fix—it's no easy task to "unglue" a tooth, and the chemicals in the glue may damage living tooth tissue as well as the surrounding gum and bone.

Would you know what to do in a dental emergency? Here are some guidelines:

  • If you chip a tooth, save the missing piece if possible. We may be able to reattach it.
  • If your tooth is cracked, rinse your mouth with warm water, but don't wiggle the tooth around or bite down on it. If it's bleeding, hold clean gauze to the area and call our office.
  • If your tooth is knocked loose or is pushed deeper into the socket, don't force the tooth back into position on your own. Immediate attention is very important.
  • If your tooth is knocked out, there's a chance it can be reattached. Pick up the tooth while being careful not to touch the root. Then rinse it off and have either someone place into its socket, or place it against the inside of your cheek or in a glass of milk. Please call the office immediately or go to a hospital.

What's the best thing to do in an emergency? Call us right away, and DON'T super glue your tooth! You can prevent worse problems by letting a professional handle any dental issues.¬†And if you've been living with a chipped, broken or missing tooth, call us to schedule an appointment for a consultation—there are several perfectly safe ways to restore your smile. Meanwhile, if you practice martial arts to keep in shape, think twice before getting into the ring with Demi Lovato!

To learn more, read the Dear Doctor articles “Trauma & Nerve Damage to Teeth” and “Saving New Permanent Teeth After Injury.”

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.”





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