Dr Johnson's Blog

SCUBA DIVERS HAVE SPECIAL DENTAL RISKS

Joseph Coupal - Wednesday, July 12, 2017

Scuba divers should consult their dentists periodically to prevent a condition known as “diver’s mouth syndrome,” says Dr. Ryne Johnson, regarded as Boston’s best prosthodontist and managing partner of Newton Wellesley Dental Partners.

Diver’s mouth syndrome, known technically as barodontalgia, can include gum problems, pain in the jaw joint, or a condition known as “tooth squeeze,” in which changing pressure causes pain in the center of a tooth. “Many divers drag the bulky air regulator through the water with their teeth, and this can cause stress or damage to the oral cavity. Divers may bite too hard on the mouthpiece which can lead to pain in the jaw joint and gum lacerations. Complicating this problem is the fact that most standard mouthpieces are too small for most people and only support the very back teeth. Divers really have to work to keep their lips pursed around these small pieces of rubber.”

But the problem, he says, is easily remedied. “If a diver feels pain or soreness in the jaw, he or she should consult with a dentist,” says Dr. Johnson. “A custom-fitted mouthpiece is available in most scuba shops that will support all of the teeth, so these problems can be avoided.”

Tooth squeeze can occur when a cavity, a deteriorated or broken dental filling, a dental abscess or an incomplete root canal has developed an air space and reacts to the changing pressure once the diver is under water. It can occur both in descent and ascent as can other squeeze problems. “It can be very painful, but the irony is that many divers do not feel it because of the exhilarating experience they feel at being in the water. When divers do feel tooth squeeze, they should schedule a dentist visit to get the appropriate dental care.”

Dr. Johnson recommends that divers be in good dental health before diving. Be wary of scuba diving if you have recently undergone dental treatments in which there was a tooth extraction or if a tooth contains a temporary filling. “The change in pressure can cause severe pain and cause healing to take much longer,” says Dr. Johnson. “Be cautious if you have dentures. “Be sure they are well-fitted; have them relined or remade if necessary.”

Go to a dentist where you can be evaluated for joint pain or earaches. “Custom-made mouthpieces are readily available. Yes, they cost more, but you will be amazed at the difference,” says Dr. Johnson. “It’s worth the cost because the dive will be much more comfortable.”

It’s never too late to improve your dental health. Visit www.NewtonWellesleyDentalPartners.com for more blogs or to contact Dr. Johnson

CAN GUM DISEASE AFFECT OVULATION?

Joseph Coupal - Wednesday, June 14, 2017

According to Dr. Ryne Johnson, prosthodontist and managing partner at Newton Wellesley Dental Partners, “Women struggling to get pregnant need to take good care of their gums, a study has found. Bacteria that causes gum infections appears to have a role in making conception take longer”. According to a recent study, “Women with bacteria that causes gum disease in their saliva, P. Gingivalis, took three times longer to get pregnant than women without. And women with the bug as well as symptoms of periodontitis – disease of the gum and underlying bone – took four times longer”.

Researchers believe that infection in the gums and jawbone leads to further inflammation in the body. This inflammation may prevent ovulation or could stop the embryo implanting. Women struggling to get pregnant need to take good care of their gums, a study has found. Researchers think gum disease might be a warning sign of problems elsewhere in the body – particularly type two diabetes and heart disease”.

Additionally, post-menopausal women are more likely to die early if they have gum disease according to this study. Women who lose teeth after the menopause are at a higher risk of an early death, experts have warned. A major study suggests gum disease and tooth loss is a red flag for severe health problems.

Study leader Dr Michael LaMonte, of the University at Buffalo in New York, said no matter the cause of the link, more intensive dental screening in old age could help nip problems in the bud. Other possible effects are inflammation interfering with hormone production, as well as contributing to endometriosis, a condition where tissue that normally grows inside the womb grows elsewhere in the body. Dr Susanna Paju, of the University of Helsinki said: ‘Our study does not answer the question on possible reasons for infertility but it shows that periodontal bacteria may have a systemic effect even in lower amounts, and even before clear clinical signs of gum disease can be seen.

Thus, Dr. Johnson suggests that, “results encourage young women of fertile age to take care of their oral health and attend periodontal evaluations regularly”.

How the study was carried out:

Researchers at the University of Helsinki studied 256 healthy non-pregnant women aged between 19 and 42 who had stopped contraception and were trying to get pregnant. The health of their mouths and gums, as well as their reproductive organs, were examined. Over 12 months they were observed as to whether they became pregnant or not. Researchers believe gum infection leads to further inflammation that may prevent ovulation.

Key findings :

Gingivalis Bacteria was ‘significantly more frequently detected in the saliva among women who did not become pregnant during the one-year follow-up period than among those who did.’

The research found women who either had P. Gingivalis in their saliva – or antibodies indicating they had been infected by P Gingivalis, were three times less likely to get pregnant, while those with the bacteria and signs of gum disease were four times less likely to get pregnant.

The bacteria remained a factor even after other factors that have an effect on getting pregnant such as socioeconomic status, general health and smoking were considered.

Original article: www.dailymail.co.uk/health

Artwork: www.freepik.com

POT MOUTH? – WELLESLEY, NEWTON, MA

Joseph Coupal - Wednesday, April 26, 2017

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

EARLIER DEATH IN OLDER WOMEN RELATED TO GUM DISEASE? -WELLESLEY, NEWTON, MA

Joseph Coupal - Tuesday, April 04, 2017

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

GERIATRIC DENTAL ISSUES – NEWTON, WELLESLEY, MA

Joseph Coupal - Friday, March 24, 2017

There’s a commonly understood recipe for living a healthy life as we get older, and it goes something like this: Exercise, eat healthy food in moderation, don’t smoke, get plenty of sleep, maintain a good social network and engage in mentally challenging activities.

Yet, according to Dr. Ryne Johnson, prosthodontist and managing partner at Newton Wellesley Dental Partners, “there’s another, largely overlooked, ingredient: oral health care”. Because our bodies become more vulnerable as we age, decay, infections and bacteria that occur in teeth, gums and mouth can grow into serious problems that impact overall health. Plus, there are issues seniors have that exacerbate problems and inhibit a senior’s ability to brush, floss or visit the dentist. Medications can create dry mouth. Arthritis limits dexterity and creates transportation and mobility issues. And a lack of dental insurance can halt regular dentist visits.

“Many of older adults are getting used to living in pain,” says Johnson. “They have active infections that have been going on for five, 10, 15 years. Poor oral hygiene is particularly harmful to seniors”.

Poor oral hygiene can increase risks for diabetes, pneumonia, infections elsewhere in the body and strokes, he says. Also, mouth cancers — which can be discovered through regular dental checkups — can go undetected. Many seniors wish they had access to better dental care. But often, after retirement, they lose dental insurance and can’t afford new coverage. Medicare, for instance, doesn’t cover most dental work. In 2012, a survey indicated that being able to afford dental care was the No. 1 health issue for seniors, even more than general medical care (38 percent to 30 percent).

Among the primary oral-health issues older men and women face are:

Dry mouth: Having a drier mouth can be part of the aging & geriatric process. But older people tend to be on more medications, and hundreds of those medications inhibit production of saliva, which protects against tooth decay and controls bacteria. “That creates an environment that is very acidic, because the saliva is not there anymore,” says Johnson, “That leads to more tooth decay, gum disease and an increase in bacteria”. Some studies have shown gum disease can lead to heart disease. And an increase in bacteria has been linked to a higher risk of pneumonia (with bacteria breathed into the lungs) and diabetes. It’s important for seniors to drink more water to battle dry mouth. Also, seniors should provide their dentist a list of medications they are taking.

Oral cancer: Rates increase with age, so if seniors skip regular dental checkups, they run the risk of cancers going undetected early. And even seniors who have no natural teeth and use a full set of dentures should continue regular checkups for mouth cancer.

Caregivers: it’s important for the people who care for seniors to help them with brushing and flossing, and to make certain they see a dentist regularly. “Very often, I have a family member telling me, ‘My mom or dad was scrupulous with their health and took excellent care of their teeth, and now they’re in horrible condition,’” says Johson. “A lot of decay, a lot of periodontal illness because they just lost the capacity to take care of themselves. It takes some active intervention on the part of their families or others.”

“The importance of education can’t be overstated. The baby boomers’ tsunami wave is coming,” says Johnson. “This is a problem that is upon us, whether we want it or not. We have to continue improving the educational process to avoid potential problems.”

The Centers for Disease Control offers a checklist for seniors to maintain good oral health that includes:

  • Drink fluoridated water and use fluoride toothpaste to protect against tooth decay.
  • Brush and floss regularly to reduce dental plaque and prevent periodontal disease.
  • See your dentist regularly, even if you wear dentures and have no natural teeth.
  • Avoid tobacco and limit alcohol to lower risk of oral and throat cancers.
  • Caregivers should provide daily oral hygiene for seniors unable to take care of themselves.
  • If medications produce a dry mouth, ask your doctor if there are alternate medications that can be substituted. If not, drink plenty of water or chew sugarless gum to keep your mouth moist.

For additional information on this topic visit the American Dental Association: www.mouthhealthy.org/en/adults-over-60. For additional blogs by Dr. Johnson or to contact the office, visit: www.NewtonWellesleyDentalPartners.com

Original article: San Diego Union-Tribune
Artwork: yourdentalpartners.com

DENTAL IMPLANTS (KNOCK OFFS & THEIR RISK) – WELLESLEY, NEWTON, MA

Joseph Coupal - Thursday, March 02, 2017

Squeezed between billboards promoting “Free Donuts” and “855-Car-Hit-U”, I recently spotted an ad for $400 dental implants. Radio also has numerous promotions for “teeth-in-a-day”. According to Dr. Ryne Johnson, prosthodontist and managing partner of Newton Wellesley Dental Partners, “This makes for a market that creates confusion for the public. There really is a huge difference between quality and cheap”!

There are dozens of dental implant companies that sell implants in the USA. However many of these companies are copies or “clones” of other successful implants. Since these smaller companies do very little research or development, they are usually 1-2 generations of implant design behind the major companies. In the many implant complication cases referred to us, we have seen a higher rate of problems in the “clone” implants…even though they look very similar to the major implant brands.

An additional concern is that as smaller implant companies come and go there is a risk of not being able to get parts compatible with these numerous implants to make the crowns or bridges that attach to them. I would not put a clone implant into a family member’s mouth (not even my mother-in-law!). Innovative companies that approach implant dentistry responsibly with research and education provide quality and service are doing very well, while implant companies that compete only on price are not a good fit for any practice.

Would you want a discounted hip or knee implant? How would you feel if your dentist was charging you the regular price and giving you a cheap implant knockoff? Do you even ask or know? The consumer needs to know that all implants are not created equal, and they should ask what brand is being used at a particular office.

Here are some implant companies that Dr. Johnson has worked with over his 29 years of clinical practice and have a good track record and lots of data: Biomet 3i, Zimmer Dental, Straumann, Keystone, Astratech and Nobel Biocare.

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Original publication by Dr. Mitchell Josephs on LinkedIn
Artwork: www.oralanswers.com

DENTISTRY: A HEALTHY LIFESTYLE – NEWTON, WELLESLEY, MA

Joseph Coupal - Wednesday, February 08, 2017

Dr. Ryne Johnson, prosthodontist and managing director of Newton Wellesley Dental Partners wants his patients to lead a healthy lifestyle and have outstanding oral health. A recent article in Bicycling Magazine outlined the top ways to stay healthy and a regular visit to your dentist is critical. According to Dr. Johnson, “A visit to the dentist can make your pearly whites shine—and keep your ticker on track, as well”. In a recent Taiwanese study people who had their teeth cleaned at least twice a year for 2 years had a 24% lower risk of heart attack and a 13% lower risk of stroke compared with people who never went to the dentist. Professional teeth cleaning appears to reduce inflammation-causing bacterial growth, which can lead to dangerous inflammation, say the study authors.

Here’s the list:

  1. Eat Calcium Rich Foods
  2. Fill up on Anti-oxidants
  3. Go to the Dentist
  4. Cook with Herbs and Spices
  5. Load up on Potassium
  6. Take Blood Pressure Medicine at Night
  7. Treat High Blood Pressure
  8. Stay Active
  9. Run a Mile
  10. Eat Walnuts
  11. Feast on Fish
  12. Sprinkle Flax Seed on your Cereal
  13. Eat Dark Chocolate…in Moderation
  14. Start your Day with Oatmeal
  15. Snack on Nuts
  16. Switch to a Better Cooking Oil

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Artwork: adobe stock photos

DENTAL PROBLEMS RELATED TO SCUBA DIVING – NEWTON, WELLESLEY, MA

Joseph Coupal - Wednesday, January 04, 2017

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. Dr. 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.

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

TEETH GRINDING & STRESS – NEWTON, WELLESLEY, MA

Joseph Coupal - Tuesday, January 03, 2017

Research has found a link between stress and teeth grinding, which 70 percent have reported. Known as bruxism, teeth grinding can go undetected as the most common symptom is a headache, usually concentrated at the temples of the head. Other symptoms include sleep disorders, ear ache, and stiff muscles in the jaw, shoulders and neck. The teeth will also show signs of wear, cracks and tooth loss can result.

Dr. Ryne Johnson, prosthodontist and managing partner at Newton Wellesley Dental Partners has been treating teeth grinding and TMJ therapy for over thirty years. “Many people grind their teeth at night and we used custom-made, hard appliances (with a softer, resilient liner) to lessen the impact of this significant force” says Johnson. “The night guard is designed to absorb the impact and spread the force out over all the teeth instead of allowing it to wear away the enamel”.

What the doctor says: ‘If you suspect that you are suffering from Bruxism, it is important to see your dentist who can provide a proper diagnosis”.

“Grinding your teeth can be triggered by several factors including an underlying sleep disorder, stress and anxiety or a result of dietary intakes such as alcohol and caffeine”.

“Your dentist will recommend a guard specially made for your teeth to create a protective barrier from friction to prevent increased tooth wear and reduce discomfort of the jaw muscles.”

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original article: http://www.dailymail.co.uk

artwork: http://www.arizonafamilydental.com/

DENTISTRY AFTER ROOT CANALS IMPACT TOOTH LONGEVITY – NEWTON, WELLESLEY, MA

Joseph Coupal - Friday, December 16, 2016

“In 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 placement 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