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Pot Mouth? – Wellesley, Newton, MA

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

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

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

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

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

Lessen learned!

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

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Earlier Death In Older Women Related to Gum Disease? -Wellesley, Newton, MA

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

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

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

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

Original article in CNN.com

Artwork: www.healthline.com

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Dental Problems Related to Scuba Diving – Newton, Wellesley, MA

A new survey of recreational scuba divers finds that 41 percent report dental problems related to diving. Most of the problems had to do with pain from the increased pressure underwater or from clutching the air regulator too tightly in their mouths, but a few people experienced loosened crowns or cracked fillings.  ryneDr. Ryne Johnson,  prosthodontist and managing partner of Newton Wellesley Dental Partners reports that, “over my 30 years in clinical practice, I have seen numerous patient who presented with broken or shifted teeth induced by long-time use of a regulator”.  He further recommends, “The survey was limited, but suggests that people should make sure their teeth are in good shape before they go deep.  An unhealthy tooth underwater would be much more obvious than on the surface.  One hundred feet underwater is the last place you want to be with a fractured tooth."

Underwater toothache

Barodontalgia is a toothache caused by the increase in pressure felt underwater (it can also happen at high altitudes because of low pressure). The condition, which occurs while the person is in the high- or low-pressure environment, is most common in people who have some sort of underlying dental condition, like a cavity or poorly completed filling.  project1

Forty-one percent of respondents of a recent study said they'd experienced dental symptoms while diving. Of those, 42 percent said they'd had barodontalgia. The second-most common symptom was pain from holding the air regulator too tightly (24 percent of those who'd had a dental symptom), and the third-most common problem was jaw pain (22 percent of those who'd had a dental symptom).

Protecting your teeth

Several people reported that a dental crown — a cap that fits over a broken or damaged tooth — had loosened during a dive. One person reported a broken filling.  The dry air and awkward position of the jaw while clenching down on the regulator is an interesting mix. Dive instructors reported more pain and problems than casual divers.  Instructors spend more time at shallower diving depths, where the changes in pressure are most abrupt.

Divers are required to meet a standard of medical fitness before certification, but there are no dental health prerequisites," according to Dr. Johnson.  In the meantime, divers can protect themselves by visiting the dentist before scuba diving to check for decay and other problems.

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Original article: http://www.livescience.com Artwork: www.scubadiving.com

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Dentistry After Root Canals Impact Tooth Longevity – Newton, Wellesley, MA

“Irynen a recent longitudinal, retrospective analysis, researchers found that what one does AFTER a root canal procedure directly influences the longevity of that tooth” says Dr. Ryne Johnson, prosthodontist and managing partner of Newton Wellesley Dental Partners.  “Teeth with endodontic therapy have been hollowed out and need internal and external protection to prevent fracturing.  This cannot be accomplished with fillings, according to this study” says Dr. Johnson.  “After 30 years of restorative dentistry, I can attest that the best means to improve longevity on a root canaled tooth is with a dental crown”.

Methods

Computerized analysis was performed for all patients who received posterior RCT from 2008 to 2016 in the graduate endodontic department. Data collected included dates of RCT, type of post-endodontic restoration, and time of extraction if extracted. Teeth that received crown after RCT were also divided into 2 groups: receiving crown before 4 months and after 4 months after RCT. Data were analyzed by using Kaplan-Meier log-rank test and Cox regression model (α = 0.05) by using SPPS Statistic 21.

Results

Type of restoration after RCT significantly affected the survival.  Those that received composite/amalgam buildup restorations were 2.29 times more likely to be extracted compared with those that received crown. Time of crown placementproject1 after RCT was also significantly correlated with survival rate. Teeth that received crown 4 months after RCT were almost 3 times more likely to get extracted compared with teeth that received crown within 4 months of RCT.

Thus, according to Boston’s best prosthodontist, “it’s best to protect the tooth as soon as possible to avoid problems”.

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Original article: http://www.ada.org Artwork: www.OswegoSmiles.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.

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

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