Posts Tagged ‘johnson’

You Asked: Should I Use Mouthwash? – Newton, Wellesley, MA

“Many people really enjoy the sensation of rinsing after they’re brushed,” says Dr. Ryne Johnson, prosthodontist and managing partner of Newton Wellesley Dental Partners. “They feel like the mouthwash is clearing away all that loose debris.”  And those people are right. Dr. Johnson says mouthwash can help you spit out loosened plaque and other bits of detritus hiding in the cracks and crevices of your mouth. But so can water, he adds.Project1 “I like to say mouthwash is an addition to proper oral hygiene, not a substitute”.  It’s not going to take the place of your morning brush or twice-yearly dentist visit, but it may help freshen your breath, and in most cases it’s not harmful, he says. That last point may raise eyebrows among those who spotted the recent headlines connecting mouthwash to some forms of cancer and heart disease. One recent UK study in the journal Free Radical Biology and Medicine found some mouthwashes could raise your blood pressure by wiping out a kind of helpful mouth bacteria. This bacteria helps your body generate nitric oxide, “which is known to play a critical role in protecting our cardiovascular system, including keeping blood pressure down,” says Dr. Amrita Ahluwalia, a professor of vascular pharmacology at Queen Mary University of London. But Ahluwalia says her study focused on mouthwashes containing a strong antibacterial agent called chlorhexidine, which is usually only available by prescription in the United States. Also, hers was a very small study—just 19 people—and requires more research to support its findings. Since the 1990s, some studies have suggested rinses that contain alcohol could contribute to the development of oral cancers. A 2014 study from Europe reinvigorated the debate. But experts say those studies are not only flawed, but also focus on excessive mouthwash use—three bouts of swishing a day or more. Even if you’re a zealous mouth-rinser, several review studies that dug into the possible associations between alcohol rinses and cancer have failed to find links. However, mouthwashes with alcohol can dry out your mouth, Johnson adds, so choose an alcohol-free version if dry mouth is an issue. When it comes to antiseptic or antibacterial mouth rinses, he says, the picture is more complicated. “If you have periodontal disease or some harmful types of mouth bacteria, an antibacterial rinse could help kill the bacteria that cause the disease,” he says, but you need to speak with your dentist about the benefits and potential risks. But for those with healthy teeth and mouths, a mild mouthwash that doesn’t contain alcohol or strong antibacterial agents is probably your best choice. “Some rinses promote the idea that tingling or discomfort are signs the rinse is working, but that’s really just marketing,” Johnson adds. You don’t need to feel a burn when you rinse for the stuff to do its job. And in the end, its job is mostly about making your mouth “feel” fresh. “You don’t need mouthwash, but if you enjoy it, or you have bad breath and feel it helps, then there’s no substantiated risks to rinsing once or twice a day”. Original article: Artwork:

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Fluoride Treatment for Adults? – Newton, Wellesley, MA

If the high-pitched whir of a dentist's drill as it bores into your molar terrifies you, good news! There could be fewer fillings in your future. According to Dr. Ryne Johnson, prosthodontist and managing partner at Newton Wellesley Dental Partners, “A painless way to prevent cavities in adults is gaining traction”. Project1 Fluoride varnish is standard practice for children's teeth, and is generally done yearly.  According to Dr. Johnson, “many of my older patients are on medications that cause dry mouth, which puts them at high risk for cavities. So for these patients, we use a skinny brush and a little pot of yellowish liquid and paints the varnish on the teeth. We know that saliva helps us wash away bacteria and food in the mouth, and the fluoride varnish will help that.  Sometimes we use a tray to carry the fluoride". One way fluoride helps is by seeping into the enamel and drawing the calcium and phosphate that's naturally present in the saliva. The minerals boost the teeth's natural healing process and make them more resistant to future decay. But there are other theories about how fluoride works. It strengthens the enamel before the tooth erupts, which is why it's so important for children. And it attacks the acid-producing bacteria in the mouth. One study shows fluoride makes it more difficult for these bacteria to stick to the teeth. It takes about a minute, and the fluoride treatment is done. Some patients are also given a prescription for a concentrated fluoride gel that can be used at night. "These preventative approaches work on adults just as well as they do on children," says Norman Tinanoff, a professor of pediatric dentistry at the University of Maryland. He says part of what's making fluoride treatments popular for adults is a move to make dental care personal, with an individual treatment plan for each patient. To do that, you have to weigh a patient's risk of getting cavities. One of the biggest proponents of this approach is John Featherstone, dean of the University of California, San Francisco School of Dentistry. Featherstone came up with a comprehensive way of measuring a person's risk for caries, or tooth decay. It includes testing the level of bacteria in the mouth, and looking at dietary habits, medical conditions, medications, saliva flow and history of tooth decay. When Featherstone put his patients on personal treatment plans, he found the strategy worked. "It really proved that drilling and filling did not fix the disease," Featherstone says. "Putting in a filling fixes that hole in the tooth, but it doesn't deal with the bacteria in the rest of the mouth." Most bacteria are friendly, but a couple of bad actors can cause cavities. These guys feed on sugars and expel acid that eats away at the enamel. Traditionally, dentists were taught that the only way to deal with decay was to drill it out. That's still important in some cases, Featherstone says, but without fixing the underlying problem of bad bacteria, patients just keep coming back for more fillings. Featherstone saw another way. "It's a little bit like your car is starting to rust," he says. "If you can stop the rust before the rust goes right through the body of the car, then you're in good shape." Like rust, tooth decay is a slow process. A full-on cavity is a hole that needs to be fixed. But if you catch decay early, Featherstone says, it can be reversed using fluoride treatments like varnish and concentrated toothpaste and gels. "In the past we believed tooth decay was a rapidly progressive disease. But research shows it's slowly progressive," says Wendell Evans, associate professor of dentistry at the University of Sydney in Australia. He recently published a study that found using these techniques reduced the need for fillings in adults by 30 to 50 percent. Striking as these results seem, the concept isn't new. This shift to a preventive model of dentistry is decades in the making. "Some of the stuff in our study has been known for 50 years," Evans says, referring to the use of fluoride treatments. "Prevention has always been a part of the world of dentistry," says Richard Valachovic, president of the American Dental Education Association. "What we're seeing is a generational shift," Valachovic says. As dentists have come to better understand the microbiology of the mouth, more effective preventive techniques have followed. At this point, Featherstone says, two-thirds of dental schools in the U.S. teach some kind of disease management model based on a thorough risk assessment. And he expects that at some point all dentists will follow a preventive protocol.  "It will happen," Featherstone says. "It's just a matter of time." If you would like additional information  or to see other topic-related blogs, contact Newton Wellesley Dental Partners.   Original article at: Artwork:  

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Antidepressants & Dental Implants

For a lot of people, antidepressants are life-changing, and there's no shame in taking them to take care of yourself. But according to Dr. Ryne Johnson, prosthodontist and managing partner of Newton Wellesley Dental Partners, they might have some unexpected side effects — including messing with your dental implants, new research suggests. Dr. Johnson, who has been called a pioneer in computer-assisted, implant prosthodontics wants patients to know of this correlation. Project1 The study, to be presented at the upcoming conference for the American Association for Dental Research, included 74 participants who all received dental implants during the course of the study. All of the participants were at least 18 years old, and they'd all gotten their implants at the University of Buffalo postdoctoral dental clinic between January and August of 2014. A dental implant is an artificial tooth that your dentist can place into your jaw if you lose a tooth to decay or injury. What's supposed to happen is new bone forms around the implant to secure it in place. But when the researchers went back and looked at the medical information for those 74 people, they found that those who were taking antidepressants — but not necessarily those who were currently suffering from depression symptoms — were more likely to have an implant failure than those who weren't taking the drugs. Among those who did have implant failures, 33% of participants reported taking at least one antidepressant drug. However, among those who didn't have any problems with their implants, only 11% took antidepressants. It's important to note that this is a small preliminary study, but this isn't the first time antidepressants have been linked to problems with bones and teeth. A 2007 study published in the Archives of Internal Medicine found that antidepressants could speed up bone loss in older women. And way back in 2003, another study in the Journal of the American Dental Association found that many dental patients are given medications that may interfere with their antidepressants, possibly creating an environment for tooth problems. Researchers think that because these drugs often act on our serotonin receptors, which are important for both our moods and our bones, they may be doing some damage under the radar. Still, this isn't a reason to start skipping your much-needed meds — but it's always a great idea to touch base with your doctor about side effects.   For more information about implants, Dr. Johnson, or other blog topics, visit:   Original article: Artwork:  

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A Cancer Screening from Saliva?

Project1 According to Dr. Ryne Johnson, prosthodontist and managing partner at Newton Wellesley Dental Partners, “A 10-minute cancer test which can be taken at home using just a drop of may be the wave of the future”. Scientists at California State University says it is possible to detect tumor DNA when is it circulating in bodily fluids – an approach known as a liquid biopsy.  The saliva test is 100 per cent accurate and is so simple that it could be carried out at a pharmacist, the dentist or even in the privacy of someone's own home if they were concerned. Currently scientists can only use blood tests to detect cancer if they have already taken a biopsy and sequenced a tumor, so they know which genetic signature to look for. Although this can be used to monitor cancer spread it cannot be used for an initial test. And it can throw up false positive. Tests have shown that just a single drop of saliva contains enough data to give a definitive diagnosis as soon as a tumor develops, he said. The test is non-invasive and cheap, costing around just $20. It is due to enter full clinical trials in lung cancer patients later this year, and is expecting approval within two years from the Food and Drug Administration in America. “If there is circulating signature of a tumor in a person blood or saliva, this test will find it,” research scientists told the American Association for the Advancement of Science annual meeting in Washington. “We need less than one drop of saliva and we can turn the test around in 10 minutes. It can be done in a doctor’s office while you wait. “Early detection is crucial. Any time you gain in finding out that someone has a life-threatening cancer, the sooner the better. With this capability, it can be implemented by the patient themselves in a home check, or dentist or pharmacy.” The test looks for genetic mutations in blood plasma which are consistent with a tumor. “The advantages of this technology is that it is non-invasive. If you have a credible early screening risk assessment technology that people can use on their own or at dentists’ office or pharmacists - that’s the key, early detection.” For more information or for other blogs of interest, visit:   Original article at:  

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Bad Breath? 10 Ways to Fix it.

Dr. Ryne Johnson, prosthodontist at Newton Wellesley Dental Partners finds that, “While good oral hygiene and fresh breath are important for everyone, a recent study shows that for couples, it matters a lot. In fact, 60 percent of U.S. adults with partners say that their partner's oral health — the state of their teeth, gums and breath — plays a big role in their level of intimacy”. Project1 While for some folks, chronic bad breath is a symptom of a larger health problem, the rest of us who simply experience a little morning dragon breath, or the occasional post-dinner stinkiness, can usually freshen things up pretty quickly. Of course, there are scores of commercially available toothpastes, mouthwashes and dental floss we can use to keep our teeth, gums, and tongues in tip-top shape. But there are a number of other ways to make our mouths smell nice. Here are 10 ways to improve your oral health and lessen your bad breath: 1. Brush and floss correctly. For starters, make sure you're nailing the basics of brushing and flossing. You don't want bacteria, or worse, plaque and tartar in your mouth. "We tell our patients to brush two or three times a day, with a thorough brushing and flossing at least once, but preferably twice a day," says Dr. Johnson. Though he says recommendations for each patient differ, he tells most to use a soft, ADA-approved toothbrush and toothpaste with fluoride.  Mechanical brushes (Oral B or Sonicare) are good options for many people. Flossing, too, is crucial.  Dr. Johnson, quips, “Only floss the teeth you wish to keep”. "A toothbrush will cover all the areas around the teeth except for where the teeth actually contact each other so you have to floss in between to break up the plaque and food debris, which can cause bad breath.   2. Use a tongue scraper. You should scrape your tongue every day. Tongue scrapers play a role in eliminating plaque and food debris, Wall says, and can be found in most drug stores and health food stores.   3. See your dentist twice a year. Keep up with dental cleanings and be sure to get annual X-rays of your teeth. "Bad breath can be caused by gum disease, cavities, root absorptions, and lots of other conditions that are found in the mouth," says Dr. Johnson. "There's no way to know what's going on in there unless a professional looks in your mouth and takes X-rays."   4. Drink more water. A number of the culprits that cause bad breath can be dealt with by simply bumping up your water intake, says Dr. Gigi Meinecke, spokesperson of the Academy of General Dentistry. One is acid-reflux, which a 2012 Tufts University study suggests can be alleviated by drinking more water. Another is post-nasal drip, says Meinecke, which she says is a more common cause of halitosis than most people know. Increasing water, she says, helps loosen up secretions in the back of the throat, thereby freshening up the area. A dry mouth also contributes to bad breath. Dry mouth happens when there isn't enough saliva in the mouth. It's why we get morning breath. It's especially common in people who take certain medications. "There are over 400 prescription and over-the-counter medications that list dry mouth as a side effect," says Meinecke. Drinking more water moistens the mouth and helps things run smoothly.   5. Eat more crunchy, raw foods. "Crunchy vegetables have a low-water content, so if you're eating them, you have to produce more saliva in order to get it down your throat," says Meinecke. "Increasing saliva in your mouth and having more salivary flow is good."   6. Consider a saltwater gargle. Meinecke says gargling with saltwater could benefit anyone who has crypts, or pockets, in their tonsil area. "Those crypts get junk in them and they get schtunky," says Meinecke. Gargling with saltwater could help dislodge anything that's become stuck, she says. But don't go overboard with the salt.  Use one teaspoon of salt in six ounces of water.   7. Chew gum. Chewing sugarless gum can help freshen breath and not only because gum comes in fresh minty flavors. "Chewing gum increases salivary production," Meinecke says, which moistens the mouth.   8. Be mindful of stinky foods. Onions, garlic, spicy dishes — even coffee — all have smells that linger in our mouths up to 72 hours after we ingest them, experts say. If you're going to partake, just know your mouth may let others know you have.   9. Don't smoke! There's a reason they call it "smoker's breath." That nasty sour smell is partly from smoke particles that get stuck in the mouth, throat, and lungs after smoking cigarettes. The smell of just one cigarette can linger in your lungs for hours. Additionally, chemicals found in tobacco add to the stink. As if that's not enough, tobacco also dries out the mouth, which contributes to the unpleasantness.   Original article found on Today

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