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The Latest on Teeth Whitening

Dr. Ryne Johnson, prosthodontist and managing partner of Newton Wellesley Dental Partners was recently interviewed for a national magazine that was developing a synopsis of cosmetic dental procedures.  According to Dr. Johnson, “Tooth whitening has become one of the most frequently requested dental procedures in his office. The public has come to demand whiter, more perfect smiles and in response many choices for tooth whitening have been made available. These include home-based products such as toothpastes, gels, and films, as well as in-office based systems where products containing highly concentrated bleaching agents are applied under professional supervision". The profession and public have been aware of certain risks related to tooth whitening such as increased tooth sensitivity and gingival irritation. New research has shown that there are other risks such as tooth surface roughening and softening, increased potential for demineralization, degradation of dental restorations, and unacceptable color change of dental restorations. The new research is also focused on optimizing whitening procedures to reduce tooth sensitivity and to increase the persistence of the whitening.   Types of Teeth Whitening Systems Whitening systems can be variously categorized. The following approach is in accordance with the American Academy of Cosmetic Dentistry. Whitening Toothpastesproject1 Whitening toothpastes typically contain higher amounts of abrasives and detergents than standard toothpastes, to remove tougher stains. Whitening toothpastes do not contain bleach (sodium hypochlorite) but some contain low concentrations of carbamide peroxide or hydrogen peroxide that help lighten tooth color. Whitening toothpastes typically can lighten tooth color by about one or two shades. OTC Whitening Strips and Gels Whitening strips were introduced into the market in the late 1980’s. They deliver a thin layer of peroxide gel on plastic strips shaped to fit onto the buccal surfaces of the teeth. There are a variety of white strip products on the market with varying instructions. A typical set of instructions are to apply the strips twice daily for 30 minutes for 14 days. project2Tooth lightening can be seen in several days and this method can lighten the teeth by 1 or 2 shades. There are some newer whitening strip products that require only one 30-minute application per day that have the same whitening end point as the two-a-day products. Whitening gels are peroxide-based gels applied with a small brush directly to the surface of the teeth. Manufacturer’s instructions are usually twice a day applications for 14 days. Like the whitening strips, the teeth can usually be lightened by 1 or 2 shades. Whitening Rinses Whitening rinses contain oxygen sources such as hydrogen peroxide to react with the chromogens.project3 Manufacturer’s instructions are for twice a day rinsing for 60 seconds each. It takes up to 3 months to see a 1 or 2 shade improvement in tooth color. Tray-Based Tooth Whiteners Tray-based tooth whitening systems are available both professionally and OTC. This method involves use of a fitted tray containing carbamide peroxide-bleaching gel worn fproject4or 2 to 4 hours a day or overnight. Usually by following the manufacturer instructions tooth whitening is noticeable in a few days, lightening the teeth by 1 or 2 shades. In-Office Whitening Quicker tooth lightening can be achieved through in-office whitening because the products deliver higher concentrations of peroxide than OTC. Consequently, gingival tissues are usually protected before the agent is applied. Some products claim to increase the oxidation of chromogens by exposure to heat or an intense blue light with a wave length between 480 nm and 520 nm to activate the product while on the tooth, causing the chemical reactions to proceed faster. Some professionals use laser systems to increase the rate of the chemical reactions. This use of lasers is considered to be an ‘off-label’ use of laser systems in dentistry by the US Food and Drug Administration. In a systematic review by Buchalla and Attin no added benefit from light-activated systems was found and thus the American Dental Association does not endorse such whitening systems.project5 Tooth lightening results are seen after one 30- to 60-minute treatment. More dramatic results can be obtained with several applications. Risks associated with Tooth Whitening Risks commonly reported with tooth whitening include increased tooth sensitivity and mild gingival irritation. The degree of these side effects is directly related to the concentration of the peroxide bleach component, duration of the treatment, and the non-bleach composition of the product used. Tooth sensitivity usually occurs at the time of treatment and can last several days; gingival irritation begins within a day of the treatment and can also last several days. There are additional risks that have been reported from in vitro studies which include tooth erosion, tooth mineral degradation, increased susceptibility to demineralization, and pulpal damage.4 The ultimate endpoint for tooth whitening is dependent upon the tooth itself, with common wisdom telling us that all treatment regimens will eventually arrive at the same whitening endpoint. This is not exactly true as some very aggressive regimens can damage the tooth through dehydration and demineralization such that the tooth temporarily appears whiter.   Dr. Ryne Johnson, who first lectured on tooth whitening procedures in 1989, has helped thousands of patients achieve a more beautiful smile, often incorporating this proven technique. For other blogs on important dental topics, click here To contact Dr. Johnson, click here. Original article:  https://www.ncbi.nlm.nih.gov Artwork: www.dentalguideaustralia.com , www.askthedentist.com , www.webmd.com , www.parasomnia.tk , www.denmat.com  

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Gum Disease and Pancreatic Cancer – Newton, Wellesley, MA

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”. Project1

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.

For additional dentally related blogs, click here. To contact Dr. Johnson, click here. To get more information on Newton Wellesley Dental Partners, click here.

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

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6 Reasons You’re Not Waking Refreshed – Newton, Wellesley, MA

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.Project1

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

For additional blogs related to dentistry, click here.

To contact the office or Dr. Johnson, click here.

Original article: prevention magazine Artwork: smileydentalgroup.com

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Gold Teeth? – Newton, Wellesley, MA

The popularity of a lily-white smile spawned a billion-dollar business for Procter & Gamble. For gold, it's meant only more bad news.Project1

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.

For more blogs on other dental topics, click here To contact Dr. Johnson or the office, click here

Original article: Chicago Tribune

Artwork: www.localdentist.pro

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