Posts Tagged ‘prosthodontist’

The Affect of Aggressive Brushing

Dr. Ryne Johnson, prosthodontist and managing partner of Newton Wellesley Dental Partners came across an interesting article that he wishes to share.
It outlines the long term impact on people who are 'aggressive' brushers. We have been recommending the Braun Oral-B and Sonicare Electric brushes for many years.  We also recommend a visit with the hygienist every three, four or six months for routine cleaning and examination. For additional dental topic discussions, visit: www.NewtonWellesleyDentalPartners.com Here is the URL for the article: http://www.huffingtonpost.com/entry/how-the-traditional-nylon-toothbrush-may-be-causing_us_578fad7ee4b0f529aa07836f?utm_hp_ref=dental-health

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All-on-Four Dental Implants – Newton, Wellesley, MA

Dr. Ryne Johnson, prosthodontist and managing partner of Newton Wellesley Dental Partners rynerecently participated in the American College of Prosthodontics annual meeting in San Diego where he discussed the All-on-4® treatment concept. It provides edentulous and soon-to-be edentulous patients with an efficient and effective restoration using four dental implants to support an immediately-delivered full-arch prosthesis.  Dr. Johnson has been called a pioneer in the synergistic use of computers in implant dentistry. His first case, using a CT scan generated model was performed in 1988.

After the first dental implant patient was treated in the 1980s, a discussion began around the optimal number of implants needed to anchor a fixed dental prosthesis in edentulous patients. Some clinicians tended to install as many implants as possible, often one per tooth. Others argued that biomechanically, only four or even three were needed. Only long-term clinical data could provide answers.

At the forefront

The records of the early patients of P-I Brånemark allowed for an early retrospective study. After a 10-year observation period, the survival rates were demonstrated to be the same for restorations with four and six implants assuming that the bone levels and distribution of implants were ideal. The challenge of advanced resorption remained, however. Because it is not possible in many cases to insert distal implants without grafting and/or nerve lateralization, thproject1e concept of tilting the two distal implants was introduced.

Immediate results

In 2003, the concept of immediate loading (placing a dental prosthesis on implants the same day the implants are placed) of four implants in edentulous lower—and soon after also upper—jaws with two tilted distal implants. This one-stage procedure substantially reduced the costly and time-consuming bone grafting procedures, number of surgeries and healing time.

The success continues

In an early reported a cumulative survival rate of 96.7% for implants and 100% for prostheses at up to 3-year follow up.2 Since then, he and others have repeatedly reproduced high survival rates for both upper and lower jaws.  Today, the All-on-4® treatment concept is used around the world with similar high survival rates and patient satisfaction that is enhanced by limited costs.

Dr. Johnson, with his in-office periodontist, has done hundreds of implant cases with outstanding results.  To arrange a consultation with Dr. Johnson, contact Newton Wellesley Dental Partners.

For additional blogs related to dentistry, click here To contact Dr. Johnson or the office, click here Original article and artwork: www.nobelbiocare.com

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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: http://time.com/4267890/gingivitis-mouthwash-toothpaste/ Artwork: www.lifehacker.com.au

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Big Tonsils & Sleep Apnea – Newton, Wellesley, MA

Dr. Ryne Johnson, prosthodontist & managing partner at Newton Wellesley Dental Partners, came across a new study that found that the size of a person's tonsils may indicate their risk for obstructive sleep apnea, a condition in which blocked upper airways cause breathing to stop and restart repeatedly during sleep. Tongue indentations, or teeth imprints on the tongue that suggest it's too big for the mouth, may also be a sign. Big Tonsils & Sleep Apnea More than 18 million adults in the United States are affected by OSA. Since people with the condition are often suffering from interrupted and reduced sleep, it can lead to fatigue, irritability, and trouble concentrating. In severe cases, the disorder can lead to learning and memory difficulties, heart attack, congestive heart failure, cardiac arrhythmia, stroke or depression, the National Sleep Foundation reports. To reach their conclusions, the researchers examined 200 patients. Patients were screened for known and potential OSA risk factors including neck circumference, body weight, blood pressure and the size of their tongue, tonsils and uvula. Of these 200 participants, researchers concluded that 23 percent were at risk for OSA, with 80 percent of those being male. Obesity, large tonsils and tongue indentations were the most common factors among people who were deemed high risk. The findings are particularly important in the way they lend themselves to dental practice and education. While dentists won't be able to formally diagnose OSA in patients, equipping them with the knowledge to screen for it could potentially save many cases from going undiagnosed. The University at Buffalo points out that a dentist who recognizes an enlarged tongue or tonsils can suggest a patient visit a sleep specialist.  "Dentists see into their patient's mouths more than physicians do and the signs are easy to identify.” Dr. Johnson has been treating sleep apnea cases for many years using a SUADE appliance. For additional information or other blog topics, visit: www.NewtonWellesleyDentalPartners.com Original article: www.Huffingtonpost.com Artwork: www.Speechbuddy.com  

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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:  www.npr.org Artwork: www.slideshare.net  

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