Posts Tagged ‘ryne’

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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Banking Your Child’s Tooth? – Newton, Wellesley, MA

According to Dr. Ryne Johnson, prosthodontist and managing partner at Newton Wellesley Dental Partners, many people are now saving their child’s extracted teeth for stem cell preservation.  While it may be a relatively new process, the development of stem cell therapy holds significant promise and banking this ‘insurance policy’ may ultimately save your child’s life or help correct a major disease later in life”.  Project1 Below are some talking points, but remember, it is important to discuss these matters with your dentist BEFORE the visit is scheduled: What are dental pulp stem cells:  Dental pulp is the soft living tissue inside a tooth. Stem cells are found inside the dental pulp. Dental pulp stem cells retain the ability to renew themselves by dividing and can change into specialized cells. When is the best time to save stem cells: The ideal opportunity to harvest dental stem cells occurs when children and young adults are losing their deciduous (baby) teeth either thorough natural exfoliation or extraction for orthodontia. The teeth that contain the highest quantity and quality of stem cells will be those that maintain a blood supply until they are harvested. Are these cells currently being used for treatments: Dental pulp stem cells, are being used only in laboratory settings at this time. While mesenchymal (MSC) cells are currently used in procedures such as bone marrow transplants, MSC cells from dental pulp are not yet being used for medical treatments. What types of cells can MSC cells become? •    Cardio Myocytes which have the potential to repair damaged cardiac tissue following a heart attack. •    Myocytes which have the potential to repair muscle. •    Osteocytes which have the potential to generate bone. •    Chondrocytes which have the potential to generate cartilage. •    Neuronal which have the potential to generate nerve and brain tissue. •    Adipocytes which have the potential to generate fat tissue. When were dental pulp stem cells first identified:  Stem cells in dental pulp were discovered in 2000 by Dr. Songtao Shi, a dental researcher at the National Institute of Health (NIH). After verification that these cells were in fact viable stem cells, the NIH announced the discovery in 2003. How long can stem cells be stored: We know that stem cells from the late 1980’s are still viable. In fact, most research indicates that stem cells frozen through a slow-rate process and stored with liquid nitrogen are viable for an indefinite period. Why is dental pulp a great source of stem cells: Dental pulp stem cells can be harvested without controversy, in an inexpensive, non-invasive manner, unlike bone marrow and peripheral blood stem cell collection. These methods of stem cell recovery can be both painful and expensive. Umbilical cord blood, another source of stem cells, is a once in a lifetime opportunity at birth. Umbilical cord blood stem cells recovered are typically only used in disease treatment. How is dental pulp collected: Dental pulp collection is simple and poses no risk to the client. The tooth is either extracted or is harvested when it falls our naturally. Next a sterile transport medium is used to ship the tooth to the laboratory. The lab removes the dental pulp from tooth, processes, and then cryogenically preserves and stores the stem cells. Why do I need my dentist to harvest the teeth: It is important to have your dentist or oral surgeon work with you to harvest a healthy tooth for preservation because with their help, you will be able to remove the tooth while a good blood supply is still present. If the tooth is allowed to fall out at home, there is less possibility of finding viable stem cells. What happens if my child’s tooth is falling out early and my dentist has not received the kit: Detailed instructions on collecting dental pulp without a collection kit on hand are available. These instructions can be faxed or e-mailed to your dentist. In an extreme emergency the tooth may be stored in milk in your refrigerator for a BRIEF period of time. How do you prevent the stem cells from damage during the freezing process: The laboratory’s processing technique follows the FDA guidelines of minimal manipulation. The stem cells are prepped for slow-freeze by using a cryoprotectant which prevents damage. The cryoprotectant is washed out of the stem cells in the thawing. Research has shown that this methodology is the most successful in terms of cell recovery. How are the stem cells stored: Stem cells are stored individually in a sealed cryo-container. The cryo-container is designed specifically for long-term cryogenic storage. The container is coded and then placed in a jacketed vapor tank cooled by liquid nitrogen. This type of cooling method prevents all cross contamination. What systems are in place to protect stem cells during long-term storage: The cryogenic facility maintains multiple levels of security. This includes back up alarm systems, 24 hour on-call staff, 24 hour temperature monitoring, and a gravity driven liquid nitrogen system which does not depend on electricity. For additional blogs by Dr. Johnson, Click Here To contact the office, Click Here Original content can be found at:  http://www.toothbank.com/faq/  or  http://www.ndpl.net/faqs.php Original artwork:  www.pellasmiles.com

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Stress & Dental Implications

Stress can cause stomach aches, along with headaches, backaches, and insomnia.  According to Dr. Ryne Johnson, prosthodontist and managing partner at Newton Wellesley Dental Partners, “stress can have a significant detrimental effect on teeth as well.  Bruxism (or teeth grinding) is often seen in my patients who are under stress and it can lead to TMJ issues, periodontal disease or fractured teeth”.Project1 One study of 1,953 men and women found that those experiencing the highest levels of stress were more than three times as likely to have abdominal pain as their more relaxed counterparts. The exact connection is still unclear, but one theory holds that your intestines and your brain share nerve pathways; when your mind reacts to stress, your intestines pick up the same signal. Because of this link, learning to manage stress with the help of a clinical psychologist, meditation, or even exercise can usually help relieve stomach troubles, too. However, if you have frequent stomach aches, see your doc to rule out food allergies, lactose intolerance, irritable bowel syndrome, or an ulcer. Dr. Johnson recommends a hard, acrylic night guard (often with a soft lining) for his patients who grind their teeth.  “It is designed to spread the forces out evenly on the flat surface and the hard plastic, with the softer lining, acts as a shock absorber.” To contact the office or for questions to be addressed by Dr. Johnson, click here For additional blogs, click here.

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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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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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