Dr Johnson's Blog

SEX QUESTIONS FROM YOUR DENTIST?

Joseph Coupal - Tuesday, January 23, 2018

You’ll often hear a plethora of questions at your next dental checkup, like: do you have any toothaches, or pain when you chew? Do you floss every day?

Dr. Ryne Johnson, prosthodontist at Newton Wellesley Dental Partners says that, “there may be another line of questions coming: those about your sex life. Questions about oral sex may be the key to prevention of oropharyngeal cancers of the throat, tonsils and back of the tongue, which can be caused by human papillomavirus (HPV) spread through oral sex”. But lots of dentists are falling short on the practice, a new study in the Journal of the American Dental Association suggests.

That’s what researchers discovered after holding four focus groups with dentists at a regional dental conference. While most dentists screened for oropharyngeal cancers, many fell short on actually talking to their patients about the cancer. In fact, most only talk about the cancer when they see a patient who already has symptoms of it, like a painless lump in the neck or a sore throat that doesn’t go away, according to the statement. That means lots of patients are missing out on important conversations about risk factors and prevention methods.

Barriers against asking these questions include a lack of privacy in most dental offices, plus a fear of embarrassing the patient when bringing up a pretty sensitive topic. “Given the alarming increase of HPV-attributable oropharyngeal cancers, dentists and dental hygienists may be key agents for promoting HPV prevention,” study author Ellen Daly, Ph.D., said in the statement. “However, there’s a serious need for better training and education in the dental community.”

And that’s especially true since HPV-fueled throat cancer is a growing problem: Before 1990, only 21% of Oropharyngeal cancers included the presence of HPV. After 2000, that number grew to nearly two out of every three samples, according to a meta-analysis from the University of Wisconsin School of Medicine and Public Health. HPV can be passed from one person to another during skin-to-skin contact. One way HPV is spread is through sexual activity, including vaginal and anal intercourse and even oral sex.

Most people with HPV infections of the mouth and throat have no symptoms, and only a very small percentage develop oropharyngeal cancer. Oral HPV infection is more common in men than in women. In some studies, the risk of oral HPV infection was linked to certain sexual activities, such as open mouth kissing and oral-genital contact (oral sex). Smoking also increases the risk of oral HPV infection . At this time the US Food and Drug Administration has not approved a test for HPV infection of the mouth and throat.

The number of oropharyngeal cancers linked to HPV has risen dramatically over the past few decades. HPV DNA (a sign of HPV infection) is now found in about 2 out of 3 oropharyngeal cancers and in a much smaller fraction of oral cavity cancers. The reason for the rising rate of HPV-linked cancers is unclear, although some think that it could be because of changes in sexual practices in recent decades, in particular an increase in oral sex.

The researchers believe the study highlights the importance of using the dental visit as a way to educate patients about their own risk factors, what symptoms they should watch for, and what they can do to protect themselves. They hope the results encourage dentists to enhance their own communication efforts with their patients about the disease, which may play a role in reducing their risk.

So don’t be surprised if your next visit includes some questions about your oral sex life. If your dentist doesn’t bring it up, know the symptoms—mentioned above—yourself. And if you experience them, see your dentist or your doctor, stat. As for avoiding it in the first place? The HPV vaccine, which can prevent against cancer-causing strains, is usually given during adolescence, but the Centers for Disease Control and Prevention recommends it through age 26 for men if they meet certain criteria. Using condoms and dental dams correctly can also lower your risk.

For additional blogs by Dr. Johnson, visit: www.NewtonWellesleyDentalPartners.org or if you’d like to contact Dr. Johnson directly, CLICK HERE.

Original article: http://www.msn.com/en-us/health/medical
Artwork: iStock

SQUID INK IN DENTISTRY?

Joseph Coupal - Wednesday, December 20, 2017

Your future dentist visits could become a pleasant pain-free experience, and it’s all thanks to squids. A team of engineers from the University of California San Diego have developed an imaging method using squid ink and ultrasound to check for gum disease.

Dr. Ryne Johnson, prosthodontist and managing partner of Newton Wellesley Dental Partners has been promoting periodontal health for over 30 years.

If you’ve ever had to get your mouth checked for gum issues, you know that the current method to assess gum health involves inserting a periodontal probe’s metal hook in between your gums and teeth. Sometimes, depending on the dentist’s technique your pain tolerance, it hurts. The team’s method eliminates the need for probing — you simply need to gargle some food-grade squid ink mixed with water and cornstarch.

Squid ink is rich in melanin nanoparticles, and those get trapped in the pockets between your teeth and gums. When a dentist shines a laser onto your mouth, the nanoparticles swell and create pressure differences in the gum pockets. That’s where the ultrasound part of the imaging method comes in. Ultrasound can detect those pockets, so dentists can create a full map of your mouth.

The result shows how deep those pockets are, which indicate gum health. That’s why dentists stick a probe in those pockets to begin with — if they’re only one to three millimeters in depth, it means your gums are healthy. Anything deeper than that is a sign of gum disease, and the deeper those pockets are, the worse the issue is.

Problem is, the results of periodontal probing depend on the amount of pressure a dentist uses and the area he’s probing. He could be probing the wrong location or putting too little or too much pressure. Jesse Jokerst, the study’s senior author likened the periodontal probe to “examining a dark room with just a flashlight” wherein “you can only see one area at a time.” He said that their method is more like “flipping on all the light switches so you can see the entire room all at once,” leading to more accurate findings.

The engineers have big plans for their creation, starting with replacing the lasers in the method with more affordable LED lights. Their ultimate goal, however, is to create a mouthpiece that can instantly assess your gum health. They also want to get rid of the the squid ink concoction’s salty and bitter taste, though I’ll take than any day over painful probing.

So until the, Dr. Johnson reminds his patients to have regular, preventative visits with the hygienist. Brush and floss daily…remember, “you only have to clean the teeth you wish to keep”. For more blogs by Dr. Johnson or to contact him directly, visit www.NewtonWellesleyDentalPartners.org

orginal article: https://www.yahoo.com/finance/news/squid-ink-could-dentist-visits-140000793.html

THE AFFECT OF AGGRESSIVE BRUSHING

Joseph Coupal - Thursday, September 28, 2017

Dr. Ryne Johnson, prosthodontist and managing partner of Newton Wellesley Dental Partners came across an interesting article that he wishes to share.

It outlines the long term impact on people who are ‘aggressive’ brushers.

We have been recommending the Braun Oral-B and Sonicare Electric brushes for many years. We also recommend a visit with the hygienist every three, four or six months for routine cleaning and examination.

For additional dental topic discussions, visit:
www.NewtonWellesleyDentalPartners.com

Here is the URL for the article:

http://www.huffingtonpost.com/entry/how-the-traditional-nylon-toothbrush-may-be-causing_us_578fad7ee4b0f529aa07836f?utm_hp_ref=dental-health

NEWTON WELLESLEY DENTAL PARTNERS “TOP DENTIST” IN BOSTON, MA

Joseph Coupal - Thursday, August 10, 2017

Dr. Ryne Jonhson and Newton Wellesley Dental Partners was selected as the “top dentist” for prosthodontics and implant dentistry by Boston Magazine 2017.

http://www.bostonmagazine.com/top-dentists/find/ryne-s-johnson/

SCUBA DIVERS HAVE SPECIAL DENTAL RISKS

Joseph Coupal - Wednesday, July 12, 2017

Scuba divers should consult their dentists periodically to prevent a condition known as “diver’s mouth syndrome,” says Dr. Ryne Johnson, regarded as Boston’s best prosthodontist and managing partner of Newton Wellesley Dental Partners.

Diver’s mouth syndrome, known technically as barodontalgia, can include gum problems, pain in the jaw joint, or a condition known as “tooth squeeze,” in which changing pressure causes pain in the center of a tooth. “Many divers drag the bulky air regulator through the water with their teeth, and this can cause stress or damage to the oral cavity. Divers may bite too hard on the mouthpiece which can lead to pain in the jaw joint and gum lacerations. Complicating this problem is the fact that most standard mouthpieces are too small for most people and only support the very back teeth. Divers really have to work to keep their lips pursed around these small pieces of rubber.”

But the problem, he says, is easily remedied. “If a diver feels pain or soreness in the jaw, he or she should consult with a dentist,” says Dr. Johnson. “A custom-fitted mouthpiece is available in most scuba shops that will support all of the teeth, so these problems can be avoided.”

Tooth squeeze can occur when a cavity, a deteriorated or broken dental filling, a dental abscess or an incomplete root canal has developed an air space and reacts to the changing pressure once the diver is under water. It can occur both in descent and ascent as can other squeeze problems. “It can be very painful, but the irony is that many divers do not feel it because of the exhilarating experience they feel at being in the water. When divers do feel tooth squeeze, they should schedule a dentist visit to get the appropriate dental care.”

Dr. Johnson recommends that divers be in good dental health before diving. Be wary of scuba diving if you have recently undergone dental treatments in which there was a tooth extraction or if a tooth contains a temporary filling. “The change in pressure can cause severe pain and cause healing to take much longer,” says Dr. Johnson. “Be cautious if you have dentures. “Be sure they are well-fitted; have them relined or remade if necessary.”

Go to a dentist where you can be evaluated for joint pain or earaches. “Custom-made mouthpieces are readily available. Yes, they cost more, but you will be amazed at the difference,” says Dr. Johnson. “It’s worth the cost because the dive will be much more comfortable.”

It’s never too late to improve your dental health. Visit www.NewtonWellesleyDentalPartners.com for more blogs or to contact Dr. Johnson

CAN GUM DISEASE AFFECT OVULATION?

Joseph Coupal - Wednesday, June 14, 2017

According to Dr. Ryne Johnson, prosthodontist and managing partner at Newton Wellesley Dental Partners, “Women struggling to get pregnant need to take good care of their gums, a study has found. Bacteria that causes gum infections appears to have a role in making conception take longer”. According to a recent study, “Women with bacteria that causes gum disease in their saliva, P. Gingivalis, took three times longer to get pregnant than women without. And women with the bug as well as symptoms of periodontitis – disease of the gum and underlying bone – took four times longer”.

Researchers believe that infection in the gums and jawbone leads to further inflammation in the body. This inflammation may prevent ovulation or could stop the embryo implanting. Women struggling to get pregnant need to take good care of their gums, a study has found. Researchers think gum disease might be a warning sign of problems elsewhere in the body – particularly type two diabetes and heart disease”.

Additionally, post-menopausal women are more likely to die early if they have gum disease according to this study. Women who lose teeth after the menopause are at a higher risk of an early death, experts have warned. A major study suggests gum disease and tooth loss is a red flag for severe health problems.

Study leader Dr Michael LaMonte, of the University at Buffalo in New York, said no matter the cause of the link, more intensive dental screening in old age could help nip problems in the bud. Other possible effects are inflammation interfering with hormone production, as well as contributing to endometriosis, a condition where tissue that normally grows inside the womb grows elsewhere in the body. Dr Susanna Paju, of the University of Helsinki said: ‘Our study does not answer the question on possible reasons for infertility but it shows that periodontal bacteria may have a systemic effect even in lower amounts, and even before clear clinical signs of gum disease can be seen.

Thus, Dr. Johnson suggests that, “results encourage young women of fertile age to take care of their oral health and attend periodontal evaluations regularly”.

How the study was carried out:

Researchers at the University of Helsinki studied 256 healthy non-pregnant women aged between 19 and 42 who had stopped contraception and were trying to get pregnant. The health of their mouths and gums, as well as their reproductive organs, were examined. Over 12 months they were observed as to whether they became pregnant or not. Researchers believe gum infection leads to further inflammation that may prevent ovulation.

Key findings :

Gingivalis Bacteria was ‘significantly more frequently detected in the saliva among women who did not become pregnant during the one-year follow-up period than among those who did.’

The research found women who either had P. Gingivalis in their saliva – or antibodies indicating they had been infected by P Gingivalis, were three times less likely to get pregnant, while those with the bacteria and signs of gum disease were four times less likely to get pregnant.

The bacteria remained a factor even after other factors that have an effect on getting pregnant such as socioeconomic status, general health and smoking were considered.

Original article: www.dailymail.co.uk/health

Artwork: www.freepik.com

POT MOUTH? – WELLESLEY, NEWTON, MA

Joseph Coupal - Wednesday, April 26, 2017

We recently had a college student return from college in Colorado who came to the office for a general visit. Dr. Ryne Johnson, prosthodontist and managing partner of Newton Wellesley Dental Partners reports that, “Upon reviewing his medical history before a routine cleaning appointment, “John” admitted to “smoking a lot of pot” during his four years away. There was a raised, white area along the cheek”.

Like Colorado, Massachusetts has recently adopted policies that allow for recreational use of Marijuana. There are dispensaries being planned around the state and a likely increase in recreational use of Pot is certainly coming.

Ganja, Hash, Weed, Mary Jane are but a few of the more common names for cannabis which is a plant-derived drug. Commonly abused, about 2.5% of the world’s population uses cannabis. It can be used in several preparations, with dried leaves and flower (marijuana) that are smokes being the most common. Other methods include smoking via water pipe or vaporizer, adding marijuana to food and consuming it, and using concentrated liquid forms.

Dry mouth is a common problem experienced for one to six hours after using cannabis, as well as an increased appetite. Both lead to becoming more vulnerable to an oral attack from foods and sweet drinks. Thermal injury to the tissues is seen in an additional effect by other opportunistic infectious agents.

And our college student? Because it is virtually impossible to distinguish between these benign entities and carcinoma, biopsy is essential. If dysplasia is demonstrated, consider such lesions premalignant. They have the propensity to transform into carcinoma in situ or invasive squamous cell carcinoma. Thus, such leukoplakic growths must be excised completely and the region observed closely for recurrence. … a biopsy report of hyper-keratosis.

Lessen learned!

For other Blogs by Dr. Johnson, click here. To contact the office or Dr. Johnson, click here.

Artwork: www.researchgate.net
Original article: Dr. Gerald Fine

EARLIER DEATH IN OLDER WOMEN RELATED TO GUM DISEASE? -WELLESLEY, NEWTON, MA

Joseph Coupal - Tuesday, April 04, 2017

Dr. Ryne Johnson, prosthodontist and managing partner of Newton Wellesley Dental Partners found an article that resonates with his patient base which he wants to share: Research published in the Journal of the American Heart Association suggests that, “gum disease and tooth loss are connected to a higher risk of early death in women past the age of menopause.” Michael J. LaMonte, lead author of the study and a research associate professor at the University at Buffalo in New York, notes that the findings only suggest an association between oral health and premature death. CNN adds, “The research does not show gum disease or tooth loss cause early death.” However, according to Dr. Johnson, “there are many published findings that correlate gum disease with many medical entities like cardiac issues, pancreatic cancer and poor diets”.

For the study, HealthDay (3/29/17, Preidt) reports that investigators “tracked data on more than 57,000 women aged 55 and older.” The researchers found that “a history of gum disease was associated with a 12 percent higher risk of death from any cause.” In addition, researchers found that loss of natural teeth was associated with “a 17 percent increased risk of death from any cause.” Dr. Johnson recommends a 4x/year regimen with a talented hygienist for many of his periodontally compromised patients. He adds, “it is clearly the best ‘bang for your buck’ in dentistry and can save you many thousands of dollars over one’s lifetime”.

MouthHealthy.org provides oral health information for adults over 40 and adults over 60. MouthHealthy.org also provides additional information for patients on gum disease.

For additional blogs by Dr. Johnson or to contact him directly, visit: www.NewtonWellesleyDentalPartners.com

Original article in CNN.com

Artwork: www.healthline.com

GERIATRIC DENTAL ISSUES – NEWTON, WELLESLEY, MA

Joseph Coupal - Friday, March 24, 2017

There’s a commonly understood recipe for living a healthy life as we get older, and it goes something like this: Exercise, eat healthy food in moderation, don’t smoke, get plenty of sleep, maintain a good social network and engage in mentally challenging activities.

Yet, according to Dr. Ryne Johnson, prosthodontist and managing partner at Newton Wellesley Dental Partners, “there’s another, largely overlooked, ingredient: oral health care”. Because our bodies become more vulnerable as we age, decay, infections and bacteria that occur in teeth, gums and mouth can grow into serious problems that impact overall health. Plus, there are issues seniors have that exacerbate problems and inhibit a senior’s ability to brush, floss or visit the dentist. Medications can create dry mouth. Arthritis limits dexterity and creates transportation and mobility issues. And a lack of dental insurance can halt regular dentist visits.

“Many of older adults are getting used to living in pain,” says Johnson. “They have active infections that have been going on for five, 10, 15 years. Poor oral hygiene is particularly harmful to seniors”.

Poor oral hygiene can increase risks for diabetes, pneumonia, infections elsewhere in the body and strokes, he says. Also, mouth cancers — which can be discovered through regular dental checkups — can go undetected. Many seniors wish they had access to better dental care. But often, after retirement, they lose dental insurance and can’t afford new coverage. Medicare, for instance, doesn’t cover most dental work. In 2012, a survey indicated that being able to afford dental care was the No. 1 health issue for seniors, even more than general medical care (38 percent to 30 percent).

Among the primary oral-health issues older men and women face are:

Dry mouth: Having a drier mouth can be part of the aging & geriatric process. But older people tend to be on more medications, and hundreds of those medications inhibit production of saliva, which protects against tooth decay and controls bacteria. “That creates an environment that is very acidic, because the saliva is not there anymore,” says Johnson, “That leads to more tooth decay, gum disease and an increase in bacteria”. Some studies have shown gum disease can lead to heart disease. And an increase in bacteria has been linked to a higher risk of pneumonia (with bacteria breathed into the lungs) and diabetes. It’s important for seniors to drink more water to battle dry mouth. Also, seniors should provide their dentist a list of medications they are taking.

Oral cancer: Rates increase with age, so if seniors skip regular dental checkups, they run the risk of cancers going undetected early. And even seniors who have no natural teeth and use a full set of dentures should continue regular checkups for mouth cancer.

Caregivers: it’s important for the people who care for seniors to help them with brushing and flossing, and to make certain they see a dentist regularly. “Very often, I have a family member telling me, ‘My mom or dad was scrupulous with their health and took excellent care of their teeth, and now they’re in horrible condition,’” says Johson. “A lot of decay, a lot of periodontal illness because they just lost the capacity to take care of themselves. It takes some active intervention on the part of their families or others.”

“The importance of education can’t be overstated. The baby boomers’ tsunami wave is coming,” says Johnson. “This is a problem that is upon us, whether we want it or not. We have to continue improving the educational process to avoid potential problems.”

The Centers for Disease Control offers a checklist for seniors to maintain good oral health that includes:

  • Drink fluoridated water and use fluoride toothpaste to protect against tooth decay.
  • Brush and floss regularly to reduce dental plaque and prevent periodontal disease.
  • See your dentist regularly, even if you wear dentures and have no natural teeth.
  • Avoid tobacco and limit alcohol to lower risk of oral and throat cancers.
  • Caregivers should provide daily oral hygiene for seniors unable to take care of themselves.
  • If medications produce a dry mouth, ask your doctor if there are alternate medications that can be substituted. If not, drink plenty of water or chew sugarless gum to keep your mouth moist.

For additional information on this topic visit the American Dental Association: www.mouthhealthy.org/en/adults-over-60. For additional blogs by Dr. Johnson or to contact the office, visit: www.NewtonWellesleyDentalPartners.com

Original article: San Diego Union-Tribune
Artwork: yourdentalpartners.com

DENTAL IMPLANTS (KNOCK OFFS & THEIR RISK) – WELLESLEY, NEWTON, MA

Joseph Coupal - Thursday, March 02, 2017

Squeezed between billboards promoting “Free Donuts” and “855-Car-Hit-U”, I recently spotted an ad for $400 dental implants. Radio also has numerous promotions for “teeth-in-a-day”. According to Dr. Ryne Johnson, prosthodontist and managing partner of Newton Wellesley Dental Partners, “This makes for a market that creates confusion for the public. There really is a huge difference between quality and cheap”!

There are dozens of dental implant companies that sell implants in the USA. However many of these companies are copies or “clones” of other successful implants. Since these smaller companies do very little research or development, they are usually 1-2 generations of implant design behind the major companies. In the many implant complication cases referred to us, we have seen a higher rate of problems in the “clone” implants…even though they look very similar to the major implant brands.

An additional concern is that as smaller implant companies come and go there is a risk of not being able to get parts compatible with these numerous implants to make the crowns or bridges that attach to them. I would not put a clone implant into a family member’s mouth (not even my mother-in-law!). Innovative companies that approach implant dentistry responsibly with research and education provide quality and service are doing very well, while implant companies that compete only on price are not a good fit for any practice.

Would you want a discounted hip or knee implant? How would you feel if your dentist was charging you the regular price and giving you a cheap implant knockoff? Do you even ask or know? The consumer needs to know that all implants are not created equal, and they should ask what brand is being used at a particular office.

Here are some implant companies that Dr. Johnson has worked with over his 29 years of clinical practice and have a good track record and lots of data: Biomet 3i, Zimmer Dental, Straumann, Keystone, Astratech and Nobel Biocare.

For more information on Dr. Johnson, click here
To arrange a consultation or contact the office, click here
For additional blogs by Dr. Johnson, click here

Original publication by Dr. Mitchell Josephs on LinkedIn
Artwork: www.oralanswers.com