Dental Services

Often in the dental office we hear “I have TMJ”. TMJ actually refers to the temporomandibular joint, which is the joint located on both sides of the jaw and attaches the jaw to the rest of the skull, so we hope you have TMJ! However, when a person has a problem with the joint it is called temporomandibular disorder or TMD for short.

It is very common for people to have a popping or clicking of one or both of these joints, as long as there is no pain associated we recommend just monitoring for changes.

However, if you are experiencing pain with regular jaw movement don’t hesitate to have your dentist check the joints. You may also experience frequent earaches, stiffness in the jaw muscles or a change in how your top and bottom teeth fit together. They may recommend having a custom night guard made and seeing a chiropractor or physical therapist to work with the joint and facial muscles.

If all of these options have been tried the next step is to set up an appointment with an oral surgeons who specializes in treating TMD.

Almost anyone who has dental work that needs to be done knows there is a chance that they will be “numbed up” by the dentist. But a common misconception people have is that they will get Novocaine as the numbing agent. Movies, television, and popular culture has Novocaine implanted in our minds as the only thing dentists use to get people numb.

Dentists no longer use Novocaine to numb patients, but rather products like Lidocaine and Septocaine. Novocaine is no longer used due to the increased time it takes to work, how long it is effective and its chances of causing allergic reactions.

Lidocaine and Septocaine are our preferred anesthetics due to their faster onset time, longer acting time and very minimal chance of allergic reactions. Both are clinically safe and provide a level of numbness beneficial to both patients and the dentist. Common side effects of Lidocaine and Septocaine are numbness (could last for a couple hours), drooling and bad taste (very bitter tasting stuff).

A dental crown is a cap or cover that is put over one of your existing teeth. Crowns are used to protect a weak tooth, fix a broken tooth, for cosmetic reasons, hold a bridge in place and to cover a dental implant. A crown does not mean you need a root canal! However, if a tooth has a root canal, it needs a crown. A crown is not a “fake tooth” as your natural tooth is still underneath the crown. The natural tooth has to be trimmed down on the sides and top of your tooth so that the crown can be fabricated by the dental lab to fit properly in your mouth.

Because your natural tooth is still under that crown, cavities can develop where the tooth and crown meet, so it is important to brush and floss ALL your teeth! Crowns have come a long way in terms of aesthetics. They no longer need a metal base and are made to look much more natural, coming in a wide variety of shades. You can even set up to have a custom shade match at the dental lab to get the best match to your natural adjacent teeth.

 

 

If you have silver (amalgam) or gold fillings, you may have considered having them replaced with tooth colored fillings (composite). Dr. Johnson does not recommend replacing this type of filling material if it is just for aesthetic reasons. Often insurance won’t cover the procedure to change to a composite filling if it is for a cosmetic reason.

Some patients have concerns about mercury being present in amalgam material. Many studies have been done showing that the filling material is safe for patients to have in their mouths. There are several metals that make up the amalgam material and when they combine, the mercury is biologically inert.

It is important to remember that anytime Dr. Johnson has to drill on a tooth, it is a type of surgery. If he were to replace a gold or silver filling with a tooth colored filling, he has to remove the tooth structure around where the old filling was to place a new filling. Anytime a tooth is worked on it can cause damage to the tooth, requiring more dental treatment.

Dr. Johnson and our team monitor all teeth for signs of decay, wear and cracks. When the time comes for a filling to be replaced for any of these necessary reasons, we would recommend replacing a silver or gold filling with a tooth colored (composite) filling.

Here is a link from the American Dental Association on what others have to say about amalgam fillings:

https://www.ada.org/en/press-room/press-kits/dental-fillings-press-kit/dental-amalgam-what-others-say

Why does Dr. Johnson have you stick your tongue out during an exam?

One of the most effective ways to diagnose oral cancer at an early stage is for a dentist to perform a quick oral cancer screening during your regular dental exam. Dr. Johnson looks at the lips, inside of the cheeks, gums and roof of the mouth. He also uses a piece of gauze to hold onto the tongue to get a good look at the sides and underneath the tongue during his exam.

If anything looks unusual, Dr. Johnson will have one of our team members take a picture utilizing an intraoral camera. Then we will have you return two weeks later to re-check the area. Typically, if it’s a spot that has had some sort of trauma it will heal in that two-week period. If there is not an improvement, we will help you schedule an appointment with one of the local oral surgeons to do a consult. The oral surgeon will utilize their specialized training to examine the area and complete a biopsy if necessary.

Risk factors for oral cancer include tobacco use (both smoking and chewing), frequent and heavy alcohol use, certain types of HPV and prolonged sun exposure. However, a patient with none of these risk factors can still be diagnosed with oral cancer!

If you have noticed anything abnormal in or around your mouth, please call and make an appointment or mention it at your next visit!

With the arrival of spring and warmer weather, comes opening day for Major League Baseball on March 28th! People often only think of mouth guards for full-contact activities like football and hockey. However, accidents happen in any sport and a baseball to the face can cause a lot of damage!

We offer custom sports mouth guards for just $38! A custom fitted mouth guard made in our office helps protect not just the teeth but also the jaw, in case of an accident. Our mouth guards provide a more comfortable, less bulky fit as well as better protection when compared to generic “boil and bite” options available in sporting stores.

We offer a variety of color options and it only requires a quick 10-minute appointment for an impression to be taken! Our team will then fabricate the custom mouth guard within a couple of days. Please call us for any questions you have or to set up an appointment for your custom sports mouth guard!

We invested in a 3Shape Trios scanner last year to assist in making crowns, bridges and other appliances for our patients. The Trios is a digital intraoral scanner that allows us to send detailed images directly to a local dental lab to fabricate crowns and bridges for our patients.

By utilizing the scanner to take digital images, we can get the lab the information they need with patients not having a mouth full of the messy, uncomfortable impression material.

When asked why he prefers to utilize a dental lab to make his crowns and bridges, Dr. Johnson says that the dental lab makes them by hand and the material is stronger than what is available for other options such as in-office “same-day” crowns.

Dr. Johnson reviews x-rays for cavities, signs of infection and other abnormalities that may be present in the bone surrounding the teeth. Even if nothing currently hurts for a patient, x-rays allow Dr. Johnson to catch and treat any issues BEFORE they become a problem. If we wait to take x-rays until something hurts, it is often a more expensive fix and may involve seeing a specialist at another office.

Bitewings, which show the back teeth, are updated every 12-24 months. The panoramic x-ray that goes all the way around the head lets us see a patient’s teeth, supporting structure and upper and lower jaw bones, is typically updated every 5 years. Every patient is different and x-rays may be required more or less frequently depending on dental history. A single x-ray of a tooth may even be needed if there is a problem or something looks suspicious upon a visual exam.

All of our operatories have a special camera, that looks like a wand, designed to take pictures of the inside of the mouth. We may request to take pictures for the following reasons:

– Broken or cracked fillings or teeth
– A suspicious lesion that Dr. Johnson would like to monitor or refer to a specialist
– Before and after pictures of dental treatment

The cameras are a great tool for us to show patients what we see. The photos are saved in patient charts so we can reference them later and there is no additional charge for the photos!

Hygienists use a small periodontal probe to assess the health of your gums, including any signs of gingivitis or periodontal disease, at your regular cleaning appointments.

Gingivitis is gum inflammation. Permanent damage typically hasn’t happened when are first diagnosed with gingivitis and it can be reversed with regular dental visits, brushing twice a day and daily flossing. If gingivitis progresses and goes untreated, it can permanently affect the support around the teeth and cause periodontal (gum) disease.

The probes hygienists use have markings in millimeters (mm) and measure pocket depths around the teeth. Here are what the measurements indicate:

0 – 3 mm & No Bleeding – Healthy gum tissues do not bleed, so just keep up the good work! Your gums look great!

1 – 3 mm & Bleeding – Bleeding gums are an early sign of gingivitis. Better home care, including daily flossing, should get you back on track!

3 – 5 mm – This may be a sign of periodontal disease. We will talk about recommended home care and possibly more frequent dental visits.

5 – 7 mm – This is an indication of bone loss and moderate periodontal disease. More frequent cleanings and additional treatment might be recommended, including a possible referral to a periodontist. Home care will also be discussed.

7 mm + – This shows advanced periodontal disease. A periodontist will be included in your treatment plan to hopefully save any teeth in question.

The measurements are recorded in your patient chart and are reviewed annually. REMEMBER, brushing twice per day and daily flossing can help keep prevent gingivitis and gum disease!

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