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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!

For other Blogs by Dr. Johnson, click here.  To contact the office or Dr. Johnson, click here.

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

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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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Dental Implants: You Have Options – Newton, Wellesley, MA

If you’re missing a tooth, Dr. Ryne Johnson, prosthodontist and managing partner of Newton Wellesley Dental Partners rsj-10-10-16wants you to know, “you’ve got several options. The least advisable is to do nothing! It’s not just about aesthetics…Replacing a lost tooth is important to restoring maximum function, maintaining the alignment of surrounding teeth, and preserving facial contours”.  Dr. Johnson has been involved in implant dentistry since 1988 and is regarded as a pioneer in the synergistic use of CT Scans, CAD/CAM and placement ‘jigs’ to create implant supported reconstructions with stunning results.

Your pearly whites don’t just look pretty, they are important place holders for each other. Over time, those adjacent to a toothless gap can drift to fill the space and move out of alignment.  Additionally, tooth roots below the gums provide stimulation that the underlying jawbone needs to maintain its form and density.

Following are common approaches to replacing a lost tooth. The most appropriate for you will depend on a variety of factors that you should discuss with your dentist.

Dental Implantsproject1

Today’s gold standard for tooth replacement is the dental implant. This is actually a tooth root replacement to which a separately fashioned crown is attached. For successful implantation, there must be a sufficient amount of healthy jawbone to anchor the implant and the adjacent gums and teeth must be healthy. Certain systemic health conditions may preclude implantation as well.

PROS: Aesthetic, functional, reliable Stimulates the jaw bone to remodel and rebuild Does not compromise the integrity of adjacent teeth Decreased risk of periodontal (gum) disease compared with a bridge

CONS More expensive than a bridge (but more durable so it could be more cost effective long term) Requires minor surgery and healing time before placement of  a permanent crown

Bridges project2

Prior to implants, the three-unit fixed partial denture (FPD), or fixed bridge, was the standard approach for tooth replacement. In this scenario, the two teeth on either side of the gap (the “abutment” teeth) are crowned and the crowns support a “pontic” — a false tooth — between them like pickets in a fence.

PROS: Provides normal  function and aesthetics Less wait time than with implants Less expensive than implants

CONS: Damage to abutting teeth (must be shaped to accommodate the crown) Greater susceptibility to tooth decay Jawbone beneath the ‘fake tooth’ may deteriorate over time

Removable Partial Denture (RPD)project3

A removable denture is made of an artificial tooth anchored in plastic that mimics gum tissue. It is attached to metal clasps that hook onto adjacent natural teeth. It can be removed for cleaning.

PROS: Aesthetic, functional Least expensive option

CONS: Greater susceptibility for periodontal (gum) disease and tooth decay Usually results in teeth becoming loose May have stability and comfort issues May not fit right over time Jawbone underneath may deteriorate over time

For more information on your options for replacing missing teeth, contact Newton Wellesely Dental Partners.

For more information and access to additional blogs by Dr. Johnson, click here

original article:  www.deardoctor.com artwork: www.samdental.com, www.dentalcrest.com

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      447 Centre Street
      Newton, MA - 02458
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      Wellesley, MA 02481
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