Dr Johnson's Blog

MARIJUANA & GUM DISEASE – NEWTON, WELLESLEY, MA

Joseph Coupal - Monday, June 13, 2016

Dr. Ryne Johnson, prosthodontist and managing partner at Newton Wellesley Dental Partners wants his patients to know that, “People who use cannabis for up to 20 years may be more likely to have periodontal disease, according to research published in June in The Journal of the American Medical Association Psychiatry”.

Using self-reported data on cannabis and tobacco use, the longitudinal study compared health outcomes in persistent cannabis users versus tobacco users and found cannabis usage associated with poorer periodontal health at age 38, and within-individual decline in periodontal health from ages 26 to 38 years. Cannabis use was not, however, found to be associated with other physical problems in early midlife, according to the open access article.

The authors conclude that the study results imply that “(1) cannabis use for up to 20 years is not associated with a specific set of physical health problems in early midlife. The sole exception is that cannabis use is associated with periodontal disease; (2) cannabis use for up to 20 years is not associated with net metabolic benefits (i.e., lower rates of metabolic syndrome); and (3) the results should be interpreted in the context of prior research showing that cannabis use is associated with accidents and injuries, bronchitis, acute cardiovascular events, and, possibly, infectious diseases and cancer, as well as poor psychosocial and mental health outcomes.”

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Original article found at, www.ada.org
Artwork: www.herbs.co

GUM DISEASE AND PANCREATIC CANCER – NEWTON, WELLESLEY, MA

Joseph Coupal - Wednesday, June 08, 2016

Gum disease may cause more than just bad breath, according to a new study presented at the 2016 American Association for Cancer Research meeting, which points to a connection between periodontal disease as a potential early marker for pancreatic cancer. According to Dr. Ryne Johnson, prosthodontist and managing partner at Newton Wellesley Dental Partners, “This could pave the way for early detection of pancreatic cancer – one of the most deadly forms of the disease –because of the advanced stage at which it is often diagnosed”.

It is estimated that in 2016, 53,070 new cases of pancreatic cancer will be diagnosed with only 7.7 percent of victims surviving 5 years. Initial findings support a hypothesis and previous research showing that people who have developed pancreatic cancer tended to have poor oral health. The researchers reasoned that periodontitis, which is inflammation of the tissue around the teeth often causing shrinkage of the gums and loosening of the teeth, is due to oral bacteria dysbiosis. Dysbiosis is a term for an unhealthy change in the normal bacterial ecology of a part of the body, such as the mouth.

Many previous studies have shown a strong relationship between associated periodontal disease with pancreatic cancer. Findings from a 2013 European prospective cohort study showed having high levels of P gingivalis antibodies in blood caused a 2-fold increase of developing pancreatic cancer. Another 2007 prospective cohort study looked at over 50,000 male health professionals with a history of periodontitis and found a 64 percent increased risk of pancreatic cancer. Both of these previous studies however, were unable to determine which came first, poor oral health or pancreatic cancer.

A new study from NYU is the first study to determine that periodontal dysbiosis does in fact precede the development of pancreatic cancer and does not develop after the diagnosis. This was determined by looking at the oral samples of saliva collected prior to the onset of pancreatic cancer confirming the positive association with P gingivalis.

Researchers pointed out that this finding does not confirm that the two periodontal disease-causing bacteria cause pancreatic cancer. Rather, they most likely correlate it with systemic inflammation occurring within the body, known to be a precursor for developing cancer. Having periodontal disease-causing bacteria in the mouth may increase the likelihood of inflammation.

Symptoms of pancreatic cancer

The pancreas is located deep within the abdomen sandwiched between the stomach and the spine, with a small portion of it nestled in the curve of the upper portion of the small intestine. It functions as a glandular organ having an essential role in converting the food we eat into fuel for the body’s cells. It has an exocrine function of secreting digestive enzymes into the small intestine helping with digestion, and an endocrine function of releasing the hormone insulin into the bloodstream, a critical controller of blood sugar levels.

Tumors of the pancreas are rarely palpable, which is why most symptoms of pancreatic cancer do not appear until the tumor has grown large enough to interfere with the functioning of the pancreas, or has spread to other nearby organs such as the stomach, liver, or gallbladder. Symptoms of pancreatic cancer may include:

  • Upper abdominal pain spreading to the back
  • Jaundice or yellowing of the skin and whites of the eyes
  • Diminished appetite and unexplained weight loss
  • Fatigue
  • Digestive difficulties
  • Nausea
  • New onset of Type 2 diabetes in people over 50

Risk factors which may increase the risk of pancreatic cancer include:

  • Cigarette smoking
  • Age – over 80 percent of pancreatic cancers develop between the ages of 60 and 80
  • Race – more common in African Americans
  • Gender – more common in men
  • Religious background – more common in Ashkenazi Jews
  • Chronic pancreatitis
  • Diabetes
  • Obesity
  • Diet – diets high in meats, cholesterol, fried foods and nitrosamines
  • Family history

Future additional studies are planned to determine if periodontal disease is a cause of pancreatic cancer. Until then, good oral hygiene including regular brushing and flossing of the teeth and visits to a dentist are recommended. If a person does have periodontal disease, they should be seen regularly by a periodontist for regular cleanings and checkups to get the condition under control.

Anyone who has any of the potential symptoms of pancreatic cancer should make an appointment with their physician for an evaluation and testing as soon as possible.

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Original article: http://www.foxnews.com/health
Artwork: www.medicineworld.org

6 REASONS YOU’RE NOT WAKING REFRESHED – NEWTON, WELLESLEY, MA

Joseph Coupal - Tuesday, May 17, 2016

6 Reasons you’re not waking up refreshed

According to an article in Prevention Magazine, here are the top 6 reasons why you may not be getting adequate REM sleep in order to wake up refreshed. According the Dr. Ryne Johnson, prosthodontist and managing partner at Newton Wellesley Dental Partners, “people are surprised to learn that two dentally-related items are causing them to sleep poorly”. He treats many people with simple oral appliances, worn at night, to combat bad ‘habits’ that are affecting sleep.

You grind your teeth at night

If you wake up with a headache, it’s most likely because you’ve been clenching your jaw or grinding your teeth overnight, said Kathy Gruver, PhD, a massage therapist in Santa Monica, CA. Research shows that massage can help with symptoms, so apply some gentle pressure and/or a warm, damp cloth to the jaw area right before you go to sleep and as soon as you wake up in the AM to help break the cycle. Also consider seeing your dentist for a mouth guard, which keeps your teeth from grinding down.

You have undiagnosed sleep apnea.

Half of all adult women have some type of sleep apnea, according to a 2012 study. (Women between the ages of 20 and 44 have a 25 percent chance of having sleep apnea, which also affects 56 percent of women ages 45 to 54 and 75 percent of women ages 55 to 70.) With this condition, “patients briefly stop breathing multiple times through the night, which leads to poor sleep quality,” explains Dr. Johnson. Sleep apnea is especially common in women as they go through perimenopause, when they mistakenly assume that their frequent night awakenings are a result of hot flashes. As a result, you’ll often wake up exhausted, even if you’ve theoretically gotten plenty of sleep. The best way to diagnose sleep apnea is via a sleep study—at-home devices can pick up only severe cases. Mild cases can often be treated with weight loss and alcohol avoidance before bedtime, but if you’ve got a moderate to severe case, you’ll need to use an oral appliance made by your dentist or in severe cases, a device like a CPAP, an oxygen tube under the nose that emits mild air pressure to keep the airways open.

Other reasons:

You read your Kindle before bed

You sleep in a bad position

Your pillow is of poor quality

You have a nightcap

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Original article: prevention magazine
Artwork: smileydentalgroup.com

GOLD TEETH? – NEWTON, WELLESLEY, MA

Joseph Coupal - Thursday, May 12, 2016

The popularity of a lily-white smile spawned a billion-dollar business for Procter & Gamble. For gold, it’s meant only more bad news.

According to Dr. Ryne Johnson, prosthodontist and managing partner at Newton Wellesley Dental Partners, “When I first started in 1986 we used to do a lot of work with gold. Until a decade ago, about 67 metric tons of the yellow metal, worth $2.7 billion today, were filling, capping and crowning teeth worldwide annually. In the last five years, though, demand has plunged almost 60 percent”. The trend accelerated a decline in gold’s allure caused by newer dental cements and ceramics, and soaring bullion prices. “My patients want teeth that look radiantly NATURAL” says Dr. Johnson. “I doubt very much gold would come back into fashion.””Long ago, having a gold tooth was some kind of a status symbol. As time went by, cosmetics took over and, therefore, people began wanting to have crowns with a more tooth-like appearance.”

Used by the Etruscans to make dental bridges as early as 630 BC, gold has been featuring in people’s mouths for millennia. In ancient times, women deliberately removed one or two incisors and replaced them with golden prosthetic ones, according to Marshall Joseph Becker, an emeritus professor of anthropology at the West Chester University of Pennsylvania. Today’s dental patients prefer materials, such as ceramics, that blend, not clash, with their other teeth. And, thanks to lasers and bleach, pearly whites have seldom been whiter. P&G’s Crest Whitestrips, first sold in 2000, was “the largest product introduction in the history of” the 179-year-old multinational company, according to its lead inventor. Americans will this year spend $420.1 million on over-the-counter products to whiten their teeth, market researcher Euromonitor International predicts.

But people tend not to want to show gold, or for that matter silver, fillings these days, even though they are a very good tooth restorative. Gold in dentistry accounts for less than 1 percent of global demand. More than half is fashioned into jewelry, while a fifth is kept as bars or coins as an investment, according to gold council data.

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Original article: Chicago Tribune

Artwork: www.localdentist.pro

CANKER SORES? – NEWTON, WELLESLEY, MA

Joseph Coupal - Thursday, May 05, 2016

Canker sores affect millions of people. According to Dr. Ryne Johnson, managing partner at Newton Wellesley Dental Partners, “Canker sores are an occasional nuisance; while for others, they can be a continuous source of discomfort. If you’ve ever had a canker sore, you know it hurts”.

The actual cause of these annoying mouth ulcers, technically known as aphthous stomatitis, is unknown.

However, in some people, certain factors appear to trigger the onset of a canker sore.

Mouth injury/irritation

Nutritional deficiencies

Food irritation

Toothpaste with SLS (sodium lauryl sulfate)

Stress

Treatment

There are no surefire cures currently available for canker sores; usually, you just have to let them run their course. However, there are several options for relieving canker sore pain. Consult with your dentist regarding which of the following remedies would work best for you:

  • Corticosteroids: These prescription gels or creams reduce the inflammation caused by canker sores.
  • Antibacterial mouthwashes: Only a few mouthwashes on the market have been clinically proven to reduce bacteria including, Listerine® and medicated mouthwashes that contain chlorhexidine gluconate. The latter ingredient can stain teeth, however, so use this only with the advice of your dentist or physician.
  • Pain-relieving (analgesic) gels: These contain the active ingredient benzocaine or diphenhydramine HCL to relieve pain; some even form a protective film over the canker sore. They are available over the counter. Stronger prescription analgesics are also available, especially those medications that contain 2 percent lidocaine.
  • Aphthasol: This medication, approved by the FDA, has been shown to reduce canker sore pain and shorten healing time.
  • Saltwater rinses: While questionable as an effective treatment for canker sores, rinsing with saltwater is completely safe and inexpensive, so give it a try. Just mix a teaspoon of salt in a cup of warm water, and gently swish the solution in your mouth for about a minute before you spit it out.
  • Herbal “tea” rinses: Naturopathic practitioners believe sage and thyme to be natural antiseptics. This has not been proven, but these herbs are safe and inexpensive. Immerse a few spoonfuls in a cup of hot water, allow the mixture to cool to room temperature, then rinse your mouth with it for about a minute and spit it out.
  • Acemannan hydrogel patch: Reports show that this treatment reduces the healing time, as well as the pain, of canker sores. The patch, which contains a form of aloe vera, has received FDA approval and is being sold as the Carrington Patch.
  • ORA5: This is a topical antibacterial compound that uses copper sulfate and iodine to cover the irritated area, greatly reducing the pain. It is relatively inexpensive (around $6) and is available without a prescription.

Why so much pain?

A sore on your mouth’s lining reacts differently than a sore on your skin. Because your mouth is a moist environment, the sore doesn’t dry out and scab over. This causes sensitive nerve endings to constantly be exposed to friction, foods, and beverages. Most canker sores heal within two weeks. If yours takes longer than that, or if it prevents you from eating or drinking, consult with your dentist.

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Original article at massdental.org
Artwork: vividmagazine.net

ARE YOU FLOSSING?

Joseph Coupal - Tuesday, May 03, 2016

According to Dr. Ryne Johnson, prosthodontist and managing partner at Newton Wellesley Dental Partners, “People can now be scientifically divided into three categories: Those who floss daily, those who never floss and those who fall somewhere in between”.

The first nationally representative analysis designed to determine how many people floss their teeth found that those who floss daily amount to 30 percent of the population. Just over 37 percent report less than daily flossing; slightly over 32 percent say they never floss.

Lead author of a study, Duong T. Nguyen, a medical epidemiologist, said the idea for the study hit him one day when he was rummaging through his house looking for dental floss. A little checking revealed that “nobody had ever looked at this before,” at least in a rigorous, scientifically valid analysis, he says.

Nguyen was in an ideal position to tackle the question. A member of the CDC’s Epidemic Intelligence Service (EIS) – the agency’s training program for disease detectives – he was assigned to the National Health and Nutrition Examination Survey (NHANES), a representative look at the nation’s health habits based on interviews and physical examinations of 5,000 people a year. One section of the survey asked about flossing.

Done properly, flossing removes food particles that stick to teeth creating colonies of bacteria that promote inflammation and gum disease. Over time, these colonies, called plaque, harden into tarter and wear away at gums and bone, eventually causing tooth loss.

The researchers examined NHANES data from 9,056 US adults, age 30 and up, who participated from 2009 to 2012. Nguyen and his colleagues parsed their answers by age, sex, race and a ratio of family income and poverty level.

Among the findings:

  • Males (39 percent) were more like to report never flossing than females (27 percent).
  • People 75 or older (45 percent) were more likely to report never flossing than those age 30 to 44 (31 percent).
  • Non-Hispanic blacks (40 percent) and Hispanics (38 percent) were more likely to report never flossing than non-Hispanic white adults (30 percent).
  • Low-income participants (49 percent) were more likely to report never flossing than those in higher income brackets (28 percent).

Even better news is that there’s now sufficient data on flossing practices to inform discussions about prevention and education. “It’s never been looked at to this extent, it’s nice to have a study that actually looks at [flossing] and gives us a big enough sample to work with.” “What it tells me, as a medical provider, is that we need to increase education,” says author Nguyen, who reported the findings Monday in Atlanta at the agency’s 65th EIS Conference. “Something as simple as flossing is, to a lot of people, a bane,” he says. “They don’t want to do it. Yet, in the long run it can be so beneficial – it can prevent tooth loss and everything that comes with it.”

So Dr. Johnson says, “only floss the teeth you wish to keep and remember to visit your hygienist for regular cleanings; especially if you are not flossing often enough”.

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TEETH WHITENING VIDEO: WORTH WATCHING – NEWTON, WELLESLEY, MA

Joseph Coupal - Wednesday, April 27, 2016

Dr. Ryne Johnson, prosthodontist and managing partner of Newton Wellesley Dental Partners has been performing tooth whitening procedures since 1986. As an early pioneer and lecturer of these techniques, he is often asked, “what is teeth bleaching and what are the different techniques used to whiten teeth”.

There are basically three modalities used in dentistry to lighten teeth: over the counter, prescription-strength material in custom trays and in-office teeth whitening. Each has its advantages and benefits. For a good overview visit: http://www.mouthhealthy.org/en/az-topics/w/whitening

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YOU’RE BRUSHING TOO HARD! – NEWTON, WELLESLEY, MA

Joseph Coupal - Thursday, April 14, 2016

8 Ways You’ve Been Brushing Your Teeth All Wrong

As far as difficult tasks go, brushing your teeth doesn’t seem like one of them. After all, you’ve been doing it since you were little (we hope). According to Dr. Ryne Johnson, prosthodontist & managing partner at Newton Wellesley Dental Partners, “it’s easier than you think to make tooth brushing mistakes, putting your oral hygiene and your smile at risk”.

You’re not brushing your teeth for long enough

The American Dental Association recommends brushing for two minutes, but many people fall woefully short—and don’t even realize it. “Different studies have timed people brushing their teeth and asked them how long they thought they did it for,” says Ed Hewlett, DDS, professor of restorative dentistry and associate dean for outreach and diversity at UCLA School of Dentistry. “Some people thought they’d brushed for a couple of minutes, but it can be less than half a minute. Our perception of how long we’re brushing is not very accurate.” To take out the guesswork, use an electric toothbrush that beeps when you’ve reached two minutes, or use a timer on your phone or an egg timer. Here are 10 secrets for keeping your teeth white and healthy.

You’re brushing too hard

If you brush your teeth like you would scour a pan with baked-on food, you’re doing more harm than good. “When you press hard against your teeth and gums, you get a satisfying sensation that you’re really getting the teeth clean,” says Dr. Hewlett. “But it’s not making your teeth cleaner, and it can do harm.” The point of brushing is to remove plaque—a bacterial film—which is sticky but also soft, so you don’t need to go to town on your teeth to remove it. “Pushing too hard can overstress the gum tissue and cause it to recede, exposing part of the tooth’s root,” says Dr. Hewlett. “That area can become sensitive to hot and cold. The root is also more susceptible to cavities than the hard enamel part of the tooth.” Try one of these home remedies for a toothache.

Your angle is off

Brushing straight across like you’re playing the violin isn’t the best way to brush your pearly whites. You want to hold the toothbrush at a 45-degree angle—upward for your top teeth and downward for your bottom teeth—so the bristles can sweep and clean under the gum line where plaque can hide. Gently brush your teeth in small circles, as if you’re drawing tiny “O’s” on them. The exception: If you have an electric sonic toothbrush, you don’t need to angle the brush to 45 degrees. “They’re designed to go straight on the tooth and you just hold it there for a few seconds,” says Sally Cram, DDS, a periodontist in Washington, D.C., and spokesperson for the American Dental Association. “You don’t have to make O’s or circles with a sonic brush.”

Your toothbrush bristles are too firm

If you’ve noticed on drug store runs that it’s getting harder to find “firm” and “medium” bristles, you’re not imagining things. Those bristles are often too harsh for your teeth and gums, so most dentists don’t recommend them. Instead, choose soft or ultra-soft bristles that can gently get down under the gum line. “Your gum is like a little turtleneck collar, and you need to get under that collar,” explains Dr. Cram. “Hard and medium brushes don’t do that and can actually abrade the gum.”

Your toothbrush head is too big

Your toothbrush should fit your mouth comfortably—and in most cases, smaller is the way to go. Unless you have a large mouth, compact brush heads do a better job of helping you access those hard-to-reach and hard-to-see molars, notes Dr. Cram.

You’ve had the same toothbrush since last year

Over time, bristles become splayed out, bent, and curved so when you angle your brush to 45 degrees, they no longer point in the right direction. The bristles become even softer and stop working as effectively. “Every three months, treat yourself to a new toothbrush,” says Dr. Hewlett.

You don’t consider flossing mandatory

That lonely container of dental floss that’s collecting dust in your medicine cabinet? You’re not alone if you’ve forgotten about it (or purposely avoid it). A 2014 Delta Dental survey found that only 41 percent of Americans manage to floss their teeth at least once a day, while 20 percent never break out the dental floss. “Brushing alone is not enough,” says Dr. Hewlett. “Toothbrushes reach a little between teeth, but they don’t remove all of the plaque there. That’s where flossing and other products come in.” Not a fan of flossing? Try an interdental cleaner, such as an electric flosser, a bristled dental pick, or wooden dental sticks, which are just as effective as flossing, according to Dr. Hewlett. “When you brush and floss together, even though it seems inconvenient or cumbersome, it’s the best return on investment because of the enormous amount of disease you can prevent,” says Hewlett.

You think it’s no big deal to skip brushing your teeth before bed now and then

Turns out, it is a big deal. Ninety-eight percent of all dental disease can be avoiding by brushing twice daily with fluoride toothpaste and flossing once per day, along with having regular check-ups with your dentist. And a study published in BMJ found a link with poor oral hygiene (read: people who rarely/never brushed their teeth) and an increased risk of developing heart disease.”Dental disease is totally preventable,” says Dr. Cram, “and a lot of it can be avoided by stepping up your home brushing program and having check-ups.”

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Original article by: Rachel Grumman Bender at www.rd.com
Artwork: www.vibrantsmilesga.com

HABITUAL TEETH GRINDER? – NEWTON, WELLESLEY, MA

Joseph Coupal - Wednesday, April 06, 2016

According to Dr. Ryne Johnson, prosthodontist & managing partner at Newton Wellesley Dental Partners, “You may have to look inward to solve the problem”. Grinding your teeth (bruxism) is widely thought of as a sleep-related disorder. Many bruxers who clench or grind their teeth during the night have other sleep disorders, such as snoring and pauses in breathing (sleep apnea).

But there could be another reason for your teeth grinding — be it during the day or night. Doctors still don’t completely understand the causes, says Mayo Clinic, but intense emotions such as anxiety, stress, anger, frustration or tension could be at the root of the problem. Meaning the more stressed you are, the more likely you are to start bruxing. “Nervous tension, anger and frustration can cause people to start showing the signs of bruxism without even knowing it,” says Dr. Johnson.

Last week, writer Hale Goetz revealed how her own anger management issues were “destroying” her teeth. During a visit to her dentist, he revealed her canines were flat and told her she would need a mouth guard if she wanted to prevent nerve damage. As a lifelong bruxer, the impact of extreme habitual grinding was “inevitable” to Goetz. When it was pointed out to her by her dentist, using a pair of false teeth to show just how out of line her jaw had been moving to flatten her teeth, she began to notice just how much of a grinder she was and how it was more extreme when she was in a state of emotional conflict.

A mouth guard is typically the first step a dentist will recommend toward preventing or correcting damage to the teeth, as it keeps the teeth separated to soften the impact of any clenching or grinding. Goetz says her mouth guard has two roles: It does its job by protecting her teeth, but also (and perhaps more importantly) it serves as a useful self-care gauge. The deeper the notches in her mouth guard, the more attention she needs to pay to her emotional well-being.

“Bruxism is often associated with anxiety and stress as are some anger management issues,” says Fredrick Wade from Addiction Medicine. “When one is treating anger management, learning stress management techniques is essential as it can be for those who suffer with bruxism.” “If stress is the cause [of bruxism], you need to find a way to relax,” says the American Dental Association. “Meditation, counseling and exercise can all help reduce stress and anxiety.”

Other self-care tips for bruxism are listening to music, taking a warm bath and exercising. Stay away from stimulating substances (including alcohol, caffeine and nicotine) in the evening, and try to say goodnight to technology at least 30 minutes before you go to bed.

Above all, don’t forget those regular dental exams. For additional dental topics by Dr. Johnson, click here. To contact him, click here.

Original article: www.sheknows.com
Artwork: www.happytoothnc.com

SMILE MAKE-OVER: NEWTON, WELLESLEY, BROOKLINE, MA

Joseph Coupal - Wednesday, March 30, 2016

Dr. Ryne Johnson, prosthodontist & managing partner of Newton Wellesley Dental Partners has been regarded as, “The go-to dentist for Boston’s most demanding & discriminating people” since 1986. His patient reviews offer insight into his extraordinary skills in cosmetic dentistry. He’s discussing veneers and showing before and afters of many of Hollywood’s more notable smile corrections. Is your smile ready for a makeover?

Veneers are routinely used to fix:

Teeth that are discolored — either because of root canal treatment; stains from tetracycline or other drugs, excessive fluoride or other causes; or the presence of large resin fillings that have discolored the tooth
Teeth that are worn down
Teeth that are chipped or broken
Teeth that are misaligned, uneven, or irregularly shaped (for example, have craters or bulges in them)
Teeth with gaps between them (to close the space between these teeth)

What’s the Procedure for Getting Dental Veneers?

Getting a dental veneer usually requires three trips to the dentist – one for a consultation and two to make and apply the veneers. One tooth or many teeth can simultaneously undergo the veneering process described below.

  • Diagnosis and treatment planning: This first step involves your active participation. Explain to your dentist the result that you are trying to achieve. During this appointment, your dentist will examine your teeth to make sure dental veneers are appropriate for you and discuss what the procedure will involve and some of its limitations. He or she also may take X-rays and possibly make impressions of your mouth and teeth.
  • Preparation: To prepare a tooth for a veneer, your dentist will remove about 1/2 millimeter of enamel from the tooth surface, which is an amount nearly equal to the thickness of the veneer to be added to the tooth surface. Before trimming off the enamel, you and your dentist will decide the need for a local anesthetic to numb the area. Next, your dentist will make a model or impression of your tooth. This model is sent out to a dental laboratory, which in turn constructs your veneer. It usually takes 1-2 weeks for your dentist to receive the veneers back from the laboratory. For very unsightly teeth, temporary dental veneers can be placed for an additional cost.
  • Bonding: Before the dental veneer is permanently cemented to your tooth, your dentist will temporarily place it on your tooth to examine its fit and color. He or she will repeatedly remove and trim the veneer as needed to achieve the proper fit; the veneer color can be adjusted with the shade of cement to be used. Next, to prepare your tooth to receive the veneer, your tooth will be cleaned, polished, and etched — which roughens the tooth to allow for a strong bonding process. A special cement is applied to the veneer and the veneer is then placed on your tooth. Once properly position on the tooth, your dentist will apply a special light beam to the dental veneer, which activates chemicals in the cement, causing it to harden or cure very quickly. The final steps involve removing any excess cement, evaluating your bite and making any final adjustments in the veneer as necessary. Your dentist may ask you to return for a follow-up visit in a couple of weeks to check how your gums are responding to the presence of your veneer and to once again examine the veneer’s placement.

What Are the Advantages of Dental Veneers?

Veneers offer the following advantages:

  • They provide a natural tooth appearance.
  • Gum tissue tolerates porcelain well.
  • Porcelain veneers are stain resistant.
  • The color of a porcelain veneer can be selected such that it makes dark teeth appear whiter.
  • Veneers offer a conservative approach to changing a tooth’s color and shape; veneers generally don’t require the extensive shaping prior to the procedure that crowns do, yet offer a stronger, more aesthetic alternative.

What Are the Disadvantages of Dental Veneers?

The downside to dental veneers include:

  • The process is not reversible.
  • Veneers are more costly than composite resin bonding.
  • Veneers are usually not repairable should they chip or crack.
  • Because enamel has been removed, your tooth may become more sensitive to hot and cold foods and beverages.
  • Veneers may not exactly match the color of your other teeth. Also, the veneer’s color cannot be altered once in place. If you plan on whitening your teeth, you need to do so before getting veneers.
  • Though not likely, veneers can dislodge and fall off. To minimize the chance of this occurring, do not bite your nails; chew on pencils, ice, or other hard objects; or otherwise put excessive pressure on your teeth.
  • Teeth with veneers can still experience decay, possibly necessitating full coverage of the tooth with a crown.
  • Veneers are not a good choice for individuals with unhealthy teeth (for example, those with decay or active gum disease), weakened teeth (as a result of decay, fracture, large dental fillings), or for those who have an inadequate amount of existing enamel on the tooth surface.
  • Individuals who clench and grind their teeth are poor candidates for porcelain veneers, as these activities can cause the veneers to crack or chip.

How Long Do Dental Veneers Last?

Veneers generally last between 5 and 10 years. After this time, the veneers would need to be replaced.

Do Dental Veneers Require Special Care?

Dental veneers do not require any special care. Continue to follow good oral hygiene practices, including brushing, flossing, and rinsing with an antiseptic mouthwash as you normally would.

Even though porcelain veneers resist stains, your dentist may recommend that you avoid stain-causing foods and beverages (for example, coffee, tea, or red wine).

Are There Alternatives to Dental Veneers?

Yes, alternatives to veneers include bondings and crowns. Veneers offer a nice intermediate option. Veneers may be best suited for individuals who want to change the shape of their teeth more than just a little bit — as is done with bonding — but not enough to require a crown.

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original article in www.webmd.com