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Geriatric Dental Issues – Newton, Wellesley, MA

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

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Dental Implants (Knock Offs & Their Risk) – Wellesley, Newton, MA

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

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E-Cigarettes as bad the Real Ones? – Newton, Wellesely, MA

Former and would-be smokers who opt for electronic cigarettes may not be doing their teeth a whole lot of good, according to a new study.  Dr. Ryne Johnson, ryneprosthodontist and managing partner of Newton Wellesley Dental Partners has been educating his patients on the harmful effects of smoking on dental tissues for 30 years.  "Many have shifted toward the e-cigarettes thinking that they are a ‘safe’ alternative but new evidence suggests that both may increase the likelihood of gum disease".

However, research published in the journal Oncotarget, which focuses on cancer-related issues, suggests that electronic cigarette smoke may wreak the same type of havoc on teeth and gums that conventional tobacco does. A team of scientists from the University of Rochester and Stony Brook University found that the vapors released in e-cigarettes can cause tissue inflammation and damage comparable to that produces by regular ones.

Furthermore, chemicals used to flavor some e-cigs may cause even more harm to mouth tissue, the researchers say.  project1

Some caveats: This particular experiment was conducted on gum tissue, not live human participants. It’s possible that there are other confounding factors that may contribute to gum disease and in e-cig and regular cigarette users alike.

But it’s the latest example of scientific skepticism surrounding the health benefits of e-cigarettes. Manufacturers claim that they are an obviously superior alternative to conventional products that contain known carcinogens; but the overall public health ramifications of the products remain unclear, including whether or not they may actually be encouraging more kids to smoke.

For additional blogs by Dr. Johnson, click here To contact the office or reach Dr. Johnson, click here

Original article:  http://fortune.com/2016/11/17/e-cigarettes-yellow-teeth-study/ Artwork: www.motherjones.com

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Diabetes…Its Impact on Dental Health – Newton, Wellesley, MA

Dr. Ryne Johnson, prosthodontist and managing partner at Newton Wellesley Dental Partners wants you to know that, “if you have diabetes, you know the disease can harm your eyes, nerves, kidneys, heart and other important systems in the body. Did you know it can also cause problems in your mouth? People with diabetes have a higher than normal risk of periodontal diseases”. Project1

Periodontal diseases are infections of the gum and bone that hold the teeth in place. In advanced stages, they lead to painful chewing problems and even tooth loss. Like any infection, gum disease can make it hard to keep your blood sugar under control.

What Is the Link Between Diabetes and Periodontal Disease?

Diabetic Control. Like other complications of diabetes, gum disease is linked to diabetic control. People with poor blood sugar control get gum disease more often and more severely, and they lose more teeth than do persons with good control. In fact, people whose diabetes is well controlled have no more periodontal disease than persons without diabetes. Children with IDDM (insulin-dependent diabetes mellitus) are also at risk for gum problems. Good diabetic control is the best protection against periodontal disease.

Studies show that controlling blood sugar levels lowers the risk of some complications of diabetes, such as eye and heart disease and nerve damage. Scientists believe many complications, including gum disease, can be prevented with good diabetic control.

Blood Vessel Changes. Thickening of blood vessels is a complication of diabetes that may increase risk for gum disease. Blood vessels deliver oxygen and nourishment to body tissues, including the mouth, and carry away the tissues' waste products. Diabetes causes blood vessels to thicken, which slows the flow of nutrients and the removal of harmful wastes. This can weaken the resistance of gum and bone tissue to infection.

Bacteria. Many kinds of bacteria (germs) thrive on sugars, including glucose -- the sugar linked to diabetes. When diabetes is poorly controlled, high glucose levels in mouth fluids may help germs grow and set the stage for gum disease.

Smoking. The harmful effects of smoking, particularly heart disease and cancer, are well known. Studies show that smoking also increases the chances of developing gum disease. In fact, smokers are five times more likely than nonsmokers to have gum disease. For smokers with diabetes, the risk is even greater. If you are a smoker with diabetes, age 45 or older, you are 20 times more likely than a person without these risk factors to get severe gum disease.

For additional blogs by Dr. Johnson, click here To contact the office, click here

Original article at http://www.webmd.com/diabetes/periodontal-disease Original artwork: www.deltadentalco.com

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Tongue Scraping and Oral Health – Newton, Wellesley, MA

It’s been hammered into our heads to brush twice a day, floss once (though that's up for debate) and maybe rinse with a fluoride mouthwash. Dr. Ryne Johnson, managing partner of Newton Wellesley Dental Partners suggests that,  “in addition to your current dental routine: tongue scraping should be considered”. But is this ayurvedic practice that dates back to ancient India really worth your while? Project1

Dr. Johnson, recommends the practice to all of his patients.  “Most of my clients don't realize the effectiveness of tongue scraping until they actually do it and see all the gunk that comes off their tongue,” he says. “The tongue is the perfect breeding ground for bacteria, but although we take care of our teeth and our gums regularly, we don't pay nearly as much attention to our tongue. The bacteria on your tongue is one of the main causes of bad breath, so scraping it regularly can significantly improve your breath over time".  In fact, a recent study showed about 85 percent of all bad breath cases begin in the mouth and half are caused by bacteria residue on the tongue. Brushing your tongue is "the best way to ensure that your breath stays fresh throughout the day,” Williamson says.

However Kimberly Harms, DDS,  a spokesperson for the American Dental Association, says "your taste buds in the back are made for bacteria to hide." And when your mouth has a lot of bacteria in it, you can taste it. “That sour taste is often due to bacteria," she says.  If you often suffer from dry mouth, this quick health routine can help that, too. “If you’re not producing enough saliva when you chew, you may have digestive issues,” Harms says. “Scraping can help.”

How to do it

“A scraper is an efficient way to remove all that’s coating your tongue,” Harms says. Here are four things to keep in mind as you scrape: 1. Buy a dedicated tongue scraper (they cost as little as $6) that comes in plastic or metal and is usually shaped like the letter U. 2. Always be gentle — scraping your tongue should never hurt. 3. Scrape only five to 10 times, Harms suggests. 4. Don't go too deep. "Since we have a gag reflex, be sure not to put the scraper too far back in your mouth,” she adds.

“It’s a wonderful thing,” Harms says. “We don’t like to praise things without research but tongue scraping makes sense. If you’re successful at brushing twice a day and flossing daily, great. Do that first. Consider tongue scraping a great adjunct to good oral hygiene.”

For additional Blog Topics by Dr. Johnson, click here To contact Dr. Johnson or the office, click here

original article: www.mnn.com/health artwork: www.wisdomsofhealth.com

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