Dr Johnson's Blog


Joseph Coupal - Wednesday, April 10, 2013

By Steven Salzberg, Forbes.com Contributor

Mehmet Oz hosts a popular TV show that reaches millions of people. He offers a constant stream of medical advice, and he is popular because he makes his topics sound dramatic, or exciting, or surprising, or all three.

Unfortunately, Dr. Oz sometimes demonstrates a poor understanding of science. At least I hope so, because he promotes so many outrageous treatments, with such enthusiasm, that the only other explanation I can think of is that he is simply a fraud. I don’t think that’s true, so let’s give him the benefit of the doubt and assume that when he makes a mistake, he is simply ignorant of the truth. His latest startling revelation is that the metal fillings in your teeth are very, very bad for you. Or are they?

Last week, Dr. Oz hosted a show called “Toxic Teeth: Are Mercury Fillings Making you Sick?” The show looked at silver amalgam fillings, which contain a small amount of mercury chemically bound within them. Mercury is indeed a toxin. Should you worry?

One problem with taking a skeptical look at a Dr. Oz’s show is that he packs each episode with scientific claims, coming at you thick and fast, and it would take hours to critique them all. Instead, I’ll just pick a few, which illustrate Oz’s lack of concern for accuracy, and his apparent ignorance of the underlying science about dental fillings.

Dr. Oz opens his show with a dramatic claim about mercury:

“This thermometer contains mercury,” he says, holding up a very small thermometer. “If I were to drop it, we would have to evacuate this entire studio immediately!”

Now, this is complete nonsense. If you drop a mercury thermometer, you should carefully clean up the mercury, which beads up into nice little silver-colored balls. No one in the room is in danger, unless perhaps they try to inhale it.*

This opening salvo should set off anyone’s skeptical alarm bells. Here’s a guy who doesn’t seem to mind exaggerating to make a point. Why trust anything he says in the rest of the show? I suspect, though, that after watching this episode, thousands of Oz’s loyal viewers raced to the phone and made appointments to have the silver fillings in their teeth removed.

Dr. Oz continues his introduction by explaining that mercury is contained in silver tooth fillings. No one knew, he claims, that mercury vapor could be released from these fillings, but this news:

“sparked a firestorm 30 years ago [here the show cuts to a graphic of a fireball exploding] when major news reports brought to light the potential TOXICITY of mercury fillings. … Now there’s mounting new evidence showing mercury is released when you eat, and even when you brush your teeth.”

Quick, run to the dentist! Get this toxic mess out of my mouth!

But hang on a minute. Why aren’t people dropping like flies from the fillings in their teeth? With little effort, I determined that, contrary to Dr. Oz’s statements, nothing new has been discovered lately about silver tooth fillings. I found studies going back to the 1970s that shown that we’ve long known for decades that mercury is released from these fillings. But Oz ignores all these. He even announces, a few minutes into the show, that

“for the first time ever, I’m going to show you what happens when you brush your teeth with mercury fillings.”

No, this is not the “first time ever.” As a scientist, I find it worrisome that Oz seems quite comfortable claiming, incorrectly, that he’s the first person ever to tell the world about this.

Perhaps the most outrageous – and unintentionally funny – segment of the show is the “demonstration,” where Oz introduces an Oz-certified expert on mercury vapor, David Wentz, who has a gizmo that looks like it was built by a sideshow huckster. The device is a plexiglass box that looks like it was meant to handle biohazards, with black rubber gloves that let you manipulate its contents. In the box: a set of fake teeth containing… silver fillings! And a toothbrush!

As he walks over to the device, Oz says “I work with Dave Wentz and his Ph.D. dad.” This goes by really fast, so you would be excused for not realizing that Dave Wentz himself doesn’t have a Ph.D., and for not knowing whether he has any credentials at all. Dr. Oz conveniently omits the fact that Wentz and his father run a highly profitable nutritional supplements company, USANA, which happens also to donate money to Oz’s nonprofit corporation, HealthCorps. Hmm.

Dr. Oz then reaches into the box, and while the audience watches in hushed excitement, he brushes the teeth, right on top of those silver fillings! Right on cue, Wentz proclaims that the mercury vapor reading hits 61 in just a few seconds.

“Anything over zero is toxic,” Wentz proclaims. “And we’re at 61.”
“Oh my goodness, 61!” Dr. Oz exclaims.
“That mercury is coming off the fillings, into your mouth, going across the blood-brain barrier, into your brain,” says Wentz dramatically.

Wow. I’ve been brushing my teeth (which have several fillings) for years. How can I not be dead?

As Dr. Oz should know, “the dose makes the poison.” Even water can kill you if you drink too much of it. Wentz is clearly wrong to say that “anything over zero is toxic.”

How much mercury is safe, then?

According to the EPA, 0.1 micrograms of mercury per kilogram of body weight per day is safe. For an adult who weighs around 150 pounds, that’s about 7 micrograms. A 6-ounce can of tuna has about 20 micrograms of mercury, about 3 times the safe amount per day. Scientists do have real concerns that mercury in tuna and other fatty fish might present a health hazard.

Dr. Oz’s device seemed to show that 61 micrograms of mercury were released from brushing teeth, which would be about 9 times the exposure that is considered safe. Is there really a risk here?

Well, no. The EPA has found that “nearly all methylmercury exposures in the U.S. occur through eating fish and shellfish.” (Admittedly, though, this is not mercury vapor.) The precise question that Oz claims to be explaining “for the first time” has been examined in multiple studies, and the evidence is that silver fillings are harmless. (See the FDA summary here.)

A thorough scientific review in 2004 concluded that:

The current data are insufficient to support an association between mercury release from dental amalgam and the various complaints that have been attributed to this restoration material. … Individuals with dental amalgam-attributed complaints had neither elevated HgU nor increased prevalence of hypersensitivity to dental amalgam or mercury when compared with controls. The findings of these studies suggested that individuals with complaints self-attributed to dental amalgam should be screened for underlying dental, physical, and psychiatric conditions.”

So no, there’s no evidence that mercury from silver fillings causes any health problems. None.

But what about that device on Dr. Oz’s show, which showed 61 micrograms being released in just a few seconds of brushing the teeth? My conclusion is that the device in Dr. Oz’s studio was either wildly inaccurate or simply fraudulent. The setup was almost a parody of what real scientific instruments look like, and nothing about it gave me any confidence that it was reliable. I would suggest to Oz that before making a claim like this, he should ask rigorously trained scientists to make the measurements using properly calibrated equipment. A TV studio is no substitute for a real lab.

But wait: Mehmet Oz is a Professor of Surgery at Columbia University – he must know his science! Plus he has an M.D. from the University of Pennsylvania, and he did his undergrad studies at Harvard. By all appearances, he is a very smart guy. If his show were about heart surgery – his specialty – it would no doubt be professional, accurate, and probably far too technical to attract an audience.

Here’s the rub: despite his credentials, Oz is not an expert on mercury amalgam fillings. He probably could have read and understood the science, but he appears to be unaware, or too busy to be bothered by, the many scientific studies on this subject. Had he done his homework, he might not have presented such a spectacularly overblown episode that seems intended to scare people into removing the silver fillings from their teeth.

So there’s no need to go out and get your silver fillings replaced. It’s too bad that a highly educated surgeon like Mehmet Oz, with such a big audience, prefers to present wild exaggerations rather than telling people the truth. Perhaps, though, the truth just isn’t that exciting.

*Note added on followup: Even swallowing is rarely harmful. From J. Dodes: “Acute toxic exposures to elemental mercury are rare but there have been cases of elemental mercury being accidentally released directly into the bloodstream from broken rectal thermometers and when elemental mercury had been swallowed intentionally in an attempt at suicide. In all these cases there was no long-term effects from the mercury.” Dodes, JE. The Amalgam Controversy:an evidence-based analysis. JADA, 132:348-56, 2001.



Joseph Coupal - Tuesday, April 02, 2013

Newton Wellesley Dental Partners is pleased to be recognized as the official dental partner to the Boston Breakers.

Boston is one of the biggest sports cities in the world, steeped in historic performances and championship trophies. The Boston Breakers find themselves right in the mix. The longest-running professional women’s soccer team in U.S. history, the Breakers have roots dating back more than a decade. They have been one of the few franchises in Women’s soccer to be profitable and have the long standing support of the greater-Boston community.

The Breakers pride themselves on the work they do both on and off the field. When they’re not competing for a championship, they’re out in the community, making appearances at hospitals, youth camps, clinics, and more. Many of the women work in the business community and hold top-corporate positions.

As a result, the Breakers need to have beautiful smiles and they trust Dr. Ryne Johnson, a recognized and respected prosthodontist at NewtonWellesley Dental Partners. Dr. Johnson has the extra training and clinical expertise for every type of smile as well as aesthetic smile makeovers.

If you seek excellence like the Boston Breakers and would like more information, visit www.NewtonWellesleyDentalPartners.com and Remember, “See a Specialist…The Difference will Make you Smile”.


Joseph Coupal - Friday, March 22, 2013

Thousands of people suffer from chronic pain caused by problematic temporomandibular joints (TMJ). This condition is referred most commonly referred to as TMD which stands for temporomandibular joint disorder. According to Dr. Ryne Johnson, prosthodontist at Newton Wellesley Dental Partners, “TMD may be a result of the joint in your jaw, but it can affect different parts of the body causing neck, ear, head and jaw pain”.

Dr. Johnson, a prosthodontist at Newton Wellesley Dental Partners, tells of many patients who report stiffness in the upper back/shoulders first thing in the morning. Others present after some simple dental work and now have TMD symptoms. “Often grinding at night or some malocclusion can contribute to TMD and the person rarely equates the underlying factors to their oral-facial discomfort”.

Your temporomandibular joints stabilize the upper jaw. A malfunctioning of these joints, which are on both sides of your jaw, is the most common reason people suffer from TMJ disorder. One side of the jaw, will work prematurely during different movements. This is caused by sleeping on it awkwardly. Typically it is caused by night teeth grinding.

TMD can be very painful and causes a lot of discomfort. However, oftentimes patients don’t know that their pain is a result of TMD.

Some symptoms of TMD are:

  • Discomfort in the neck, back and shoulder
  • Headache
  • Pain with chewing and swallowing
  • Clicking of the jaw
  • Dizziness
  • Difficulty opening and closing the mouth
  • Ringing in the ears

Once one side of your jaw joint becomes inflamed, the mouth cannot open symmetrically. Additionally, the inflamed joint can cause pain around the ear. Dr. Johnson can offer solutions to patients suffering from TMD.

TMD symptoms are treated with a mouthpiece, also known as a nightguard, to relax the jaw. The mouthpiece rests on the teeth so you cannot grind them and gradually, the mouthpiece helps heal the joint.

Dr. Johnson also educates his patients about how they can relieve TMD symptoms. For more information on TMD, visit www.NewtonWellesleyDentalPartners.org and remember, “See a Specialist…The Difference Will Make You Smile”.


Joseph Coupal - Friday, March 15, 2013

It is often said that the first thing people notice about you is your shoes. Could be. But in reality, the first thing people notice about you is your smile. Nothing is quite as striking as a beautiful set of white teeth. Not only is a whiter smile more attractive, but it also presents a healthier appearance. And while you may not have been born with it, you can certainly acquire it fairly easily.

While it has never been easier to obtain a radiantly white smile, it is important to do your homework to ensure the option you choose is effective, long lasting and a healthy option for your mouth. There are many products in the marketplace currently claiming to produce teeth-whitening effects, and all have varying degrees of effectiveness. There are plenty of do-it-yourself options available, but none can match the professional whitening services that are offered by a dentist.

Every toothpaste is a basic cleaner and removes mild surface stains, but doesn’t offer much in the way of changing the color of your teeth. It might just be able to keep your teeth their original color. But the natural color of most people’s teeth is impacted by their daily habits. A common remedy and the next step up from regular toothpaste is whitening toothpastes, but, again, these are effective only for surface stains and typically only offer about one tooth-shade improvement. Whiter is always better, but it doesn’t provide a big impact for those who weren’t already born with a nice set of white teeth.

The major difference between at-home products and in-office teeth whitening at a dentist’s office is the strength of the solutions with the at-home solutions being much weaker. The obvious reason for this is that a stronger product would require much more care and attention than a weaker solution, which necessitates a professional be involved. In office whitening solutions are anywhere from five to 15 times as strong. Simply put, a dentist is going to be able to make your teeth whiter, do it quicker and make it last longer.

A dentist offers teeth-whitening methods and options that are not available to the general public and that are safer and more effective. In particular, they are careful to protect your gums from the impacts of bleaching agents. Your gums are very sensitive, and using an improperly fitting mouthpiece like you get from the one-size-fits-all store kits is asking for discomfort. A dentist can build you a custom-made mouthpiece and provide you the home kit to ensure that if you choose an at-home solution, you reduce contact of the solution with your gums.

You get what you pay for. At the top and best end of the scale in effectiveness is the in-office teeth-whitening procedure followed-up by periodic take-home touch-ups.

For more information on in-office teeth whitening, visit, www.NewtonWellesleyDentalPartners.com and Remember, ”See a Specialist…The Difference will Make you Smile”.



Joseph Coupal - Monday, March 11, 2013

Lou Merloni, current radio personality and former Major League Baseball with the Red Sox, wants you to know about Dr. Johnson of Newton Wellesley Dental Partners. As Mr. Merloni is doing more TV appearances, he wished to improve his smile and he did not want to settle for mediocrity where his dental work was concerned. According to the retired infielder, “I set the bar very high in everything I do and I entrusted Dr. Johnson to do some sophisticated dental work…and couldn’t be happier.” He went on to say that he wanted to see Dr. Johnson, a prosthodontist because, “Prosthodontists have the extra training and clinical expertise to handle challenging cases. They often do aesthetic makeovers and complex CAD/ CAM dentistry and implant reconstructions” . If you seek excellence, visit, www.NewtonWellesleyDentalPartners.com.

Here is what Lou Merloni has to say about Dr. Johnson:

“As a locally born and raised retired Red Sox player, I do many public appearances for the radio station (WEEI), on TV and at philanthropic events. I entrusted Dr. Johnson to enrich my smile and couldn’t be happier with the results. Dr. Johnson’s work turned out great. I now know what the hands of an Ivy-League catcher can accomplish. His experience, passion and CAD/DAM expertise enable him to be “at the top of his profession“.


Joseph Coupal - Monday, March 04, 2013

Our teeth tend to shift over time, with the end result being spaces, gaps, crookedness and misalignment. According to Dr. Ryne Johnson, prosthodontist at Newton Wellesley Dental Partners, this can happen a number of ways, through continually sleeping on one side, which can push teeth out of alignment; dental decay, which eats away at enamel and affects how your teeth fit together; or filling a cavity that requires the bite to be reworked. All of this can be fixed.

There are a range of cosmetic dentistry options that can straighten your teeth. Depending on what you need, some can be accomplished the same day, and some require more visits and a little more work. But regardless of how your teeth have aged, you can have a straight and sexy smile if you want one.

Teeth whitening allows your teeth to look whiter and brighter but still natural. Just whitening teeth takes years off your appearance because teeth yellow with age.

Also over time, as a result of gravity, upper lips droop and lower lips fall. This makes for shorter looking teeth on the top and gummy looking teeth on the bottom. Neuromuscular dentistry can be used to give you a non invasive facelift.

Veneers are used to bring the shine and luminescence back to your teeth which dull overtime. Because our teeth become less porous, they lose their shine, veneers bring this back.

For more information on non-invasive ways to that sexy smile, visit www.NewtonWellesleyDentalPartners.org and remember to, “See a Specialist…The Difference Will Make You Smile.”


Joseph Coupal - Tuesday, February 19, 2013

LeAnn Rimes is suing her dentist over gum inflammation. She is claiming negligence of her dentist.

LeAnn says her dentist placed 8 faulty crowns that are affecting her singing as well as her daily life. The crowns procedures were done 2 years ago. Recently, she has undergone extensive dental treatments to remove the crowns, including root canals and having multiple teeth pulled. She blames her dental issues for stalling her singing career.

For the right dentist and the right results, contact Dr. Ryne Johnson at Newton Wellesley Dental Partners. Remember, “See a Specialist…The Difference Will Make You Smile“.

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Joseph Coupal - Thursday, February 14, 2013

It’s Valentine’s Day, which most likely means you will have some chocolate or other sweet treats in your future. Be sure to take care of your teeth while you are indulging! Here are some dental tips recommended by Dr. Ryne Johnson, prosthodontist at Newton Wellesley Dental Partners.

To ensure that your teeth remain strong and healthy and to avoid periodontal disease and gingivitis, here are some simple and easy tips:

  1. Brush Twice a Day: Brushing your teeth twice a day is the first step to good oral hygiene. Bacteria in your mouth converts food deposits that collect between teeth into acids. The mixing of these acids and your natural saliva results in plaque which leads to tooth decay and cavities. Plaque development starts immediately after eating. So brushing at least twice a day can minimize plaque accumulation.
  2. Use Fluoride Toothpaste: Since you are brushing anyway, use toothpastes that contains fluoride. Fluoride fights bacteria and helps prevent tooth decay.
  3. Floss Daily: Flossing allows you to remove plaque between your teeth. Between your teeth is the main area where plaque and tooth decay begin. You can counter this by flossing daily.
  4. Visit the Dentist: It is recommended that you visit the dentist at least 2 times a year. Seeing the dentist helps you find and fix cavities, tooth decay or any gum problems as soon as they start, preventing bigger problems later on.
  5. Eat a Diet Rich in Calcium: A healthy diet rich in calcium is one of the most basic tips for healthy and strong teeth. Drinking milk daily ensures healthy, strong, white teeth. Avoiding foods that have high sugar like candy, pretzels and chips is good for your teeth as well.

For more information on dental and oral health, visit www.NewtonWellesleyDentalPartners.org and remember, “See a Specialist…The Difference will make you Smile.”


Joseph Coupal - Wednesday, February 06, 2013

Carrying a precious life is generally considered one of the greatest experiences a woman can have during her lifetime. However, according to Dr. Ryne Johnson, Prosthodontist at Newton Wellesley Dental Partners, it also produces challenges that will impact one’s dental health. Understanding the dental implications of a pregnancy can assist in being pro-active and avoiding significant problems after delivery.

Keeping Your Oral Health On Top Of Your Mind

As you already know, your lifestyle and habits during pregnancy can affect your health as well as the health of your unborn baby. With all the things you need to be prepared for, your oral health may not exactly be top-of-mind. But maintaining the healthy teeth and gums is necessary to avoid the risk of developing pregnancy gingivitis and to establish good oral health long-term.

Postpone Dental Care During Your First Trimester

The first trimester of your pregnancy (the first 13 weeks) is the time in which most of the baby’s major organs develop. If you go to the dentist during your first trimester, tell your dentist that you’re pregnant and have only a checkup and routine cleaning. If possible, postpone any major dental work until after the first trimester. However, if you have a dental emergency, don’t wait! Infections in the mouth can be harmful to you and your baby. See your dentist immediately, and make sure that all dental professionals who examine you are aware you’re pregnant.

Know About Your Increased Risk of Gingivitis

During pregnancy, 50 to 70% of all women experience a condition called pregnancy gingivitis. This is why it’s vital to pay more careful attention to your daily brushing and flossing routine to keep plaque under control. Here’s how:

  • Use a rechargeable electric toothbrush. Many remove more plaque than regular manual toothbrushes, and by investing in one, you can begin to take the steps to reduce the amount of plaque in your mouth and help prevent and reverse gingivitis.
  • Brush with an anti-gingivitis toothpaste. Be sure to read packaging carefully to make sure the toothpaste contains gingivitis-fighting ingredients.
  • Floss regularly. Even if gingivitis causes your gums to swell and bleed, but you still need to floss. By flossing daily, you can eliminate more plaque than brushing alone and help reduce your risk of developing pregnancy gingivitis.
  • Rinse with anti-gingivitis mouthwash. Rinsing with an alcohol-free, anti-gingivitis mouthwash is the final step to killing germs and improving your oral hygiene during pregnancy.

Take About 1200mg of Calcium Daily

Your teeth are made of minerals similar to bone, and the calcium you take in aids in bone development in your baby. The right amount of calcium will help keep your bones strong and contribute to the development of strong teeth and bones in your baby.

Learn About the Medications You’re Taking

Some antibiotics and pain medications are okay to take during pregnancy and may be necessary. However, one group of antibiotics, tetracycline and related antibiotics may cause hypoplasia (underdevelopment) of tooth enamel and/or discoloration of the permanent teeth in children. Be sure to tell your doctor you’re pregnant if he or she prescribes this medication for you.

Be Prepared for Morning Sickness

Morning sickness is nausea and vomiting that often occurs during pregnancy. It can happen at any time of day. If you suffer from morning sickness, having your own emergency travel bag is a good plan. In a small, sturdy bag, pack the following:

  • Opaque plastic bags without holes (Plastic grocery bags are a good choice)
  • Wet wipes, tissues or napkins to wipe your face and mouth
  • A small bottle of water to rinse your teeth and mouth
  • A travel-sized mouthwash, toothpaste and toothbrush to brush away stomach acids
  • Breath spray or mints

Deal with Changes in Your Mouth

During pregnancy, you may experience symptoms of dysgeusia (changing tastebuds or a bad taste in your mouth) or ptyalism (too much saliva). To help cope with a bad taste in your mouth:

  • Brush often, and gargle with a mixture of baking soda and water (1/4 teaspoon of baking soda in one cup of water) to help neutralize pH levels
  • Add lemon to water, drink lemonade or suck on citrus drops
  • Use plastic dinnerware and utensils to help decrease metallic taste

To help cope with an increase in saliva, drink plenty of fluid to increase swallowing. Sucking on SUGAR-FREE candies may also offer relief.

Ask a Professional Before Using Fluoride

While many prenatal vitamins contain fluoride, the value of fluoride and fluoride supplementation in pregnant women is unclear, and not everyone agrees on it. Be sure to consult your doctor if you’re curious about it.

Speak with your OB/GYN regarding these issues and for additional information, visit www.NewtonWellesleyDentalPartners.org and remember to, “See a specialist…The difference will make you smile”.

Original article produced by Oral B


Joseph Coupal - Monday, January 28, 2013

In 1987 computed tomography (CT) was introduced into dentistry which added another dimension to dental implant treatment planning. Prior to this technology, dental diagnosis and treatment planning relied on a two dimensional image which, in some instances, led to a false impression of available bone. According to Dr. Ryne Johnson, Prosthodontist at Newton Wellesley Dental Partners, “This new technology allows clinicians for the first time to evaluate anatomic structures with a higher level of accuracy”.

In 1999 dental implant planning applications were developed, allowing interactive planning of virtual implants in 2-D and 3-D. The use of radiopaque templates/scanning appliances at the time of the CT scan made it possible for the prosthetic outcome to be incorporated into interactive pre-surgical planning. This advancement paved the way for an association between radiographic anatomic interpretation, prosthetic treatment planning, and precise surgical execution. Through the use of stereolithography and CAD/CAM technology, surgical templates can be fabricated, prior to surgery which helps clinicians place implants in a well-planned preoperative/prosthetic manner, rather than a ‘seat of the pants’ intraoperative planning, which is often surgical-driven.

The use of surgical templates can benefit the patient as well as the dental team (restorative dentist, surgical specialist, and laboratory technician). The work performed is generally more accurate and less invasive than in traditional cases. The ability to transfer the desired three-dimensional position of implants from the virtual model to the mouth has made this a more efficient outcome with far fewer risks and better outcomes.

The surgical template essentially has two functions: one for the surgical phase and one for the laboratory phase. It is used as a laboratory template to fabricate a master model, which is used to create the premanufactured implant-supported prosthesis.

To visualize this process, visit www.NewtonWellesleyDentalPartners.org for more information. Remember to, “See a specialist…The difference will make you smile”.