Posts for: February, 2018

By Joel E. Johnson, DMD, PA
February 27, 2018
Category: Dental Procedures
Tags: braces   oral hygiene   orthodontics  
DontForgetYourOralHygieneWhileWearingBraces

There are a few things you need to do — and not do — while wearing braces: avoid hard or sticky foods, for example, or wear protection during sports to avoid injury. There's one important thing, though, that should be at the top of your list — extra attention to daily brushing and flossing.

The fact is your risk for developing tooth decay or periodontal (gum) disease increases during orthodontic treatment. This is because the braces make it more difficult to reach a number of locations around teeth with a toothbrush or floss. Bacterial plaque, the source for these dental diseases, can subsequently build up in these areas.

Teen-aged orthodontic patients are even more susceptible to dental disease than adults. Because their permanent teeth are relatively young they have less resistance to decay than adults with more mature teeth. Hormonal changes during puberty also contribute to greater gum disease vulnerability.

There are some things you can do while wearing braces to avoid these problems. Be sure you're eating a nutritious diet and avoid sugary snacks or acidic foods and beverages (especially sports or energy drinks).  This will deprive bacteria of one of their favorite food sources, and the minerals in healthy food will contribute to strong enamel.

More importantly, take your time and thoroughly brush and floss all tooth surfaces (above and below the braces wire). To help you do this more efficiently, consider using a specialized toothbrush designed to maneuver around the braces. You might also try a floss threader or a water irrigator to remove plaque between teeth. The latter device uses a pressurized water spray rather than floss to loosen and wash away plaque between teeth.

Even with these efforts, there's still a chance of infection. So, if you notice swollen, red or bleeding gums, or any other problems with your teeth, visit us as soon as possible for an examination. The sooner we detect and treat dental disease while you're wearing braces, the less the impact on your future smile.

If you would like more information on taking care of teeth while wearing braces, please contact us or schedule an appointment for a consultation. You can also learn more about this topic by reading the Dear Doctor magazine article “Caring for Teeth During Orthodontic Treatment.”


By Joel E. Johnson, DMD, PA
February 12, 2018
Category: Oral Health
Tags: gum disease  
PeriodontalProbingIncreasesAccuracyinDiagnosingGumDisease

If you’re over age 30 there’s a fifty percent chance you have periodontal (gum) disease—and you may not even know it. Without treatment this often “silent” bacterial infection could cause you to lose gum coverage, supporting bone volume or eventually your teeth.

That’s not to say there can’t be noticeable symptoms like swollen, red, bleeding or painful gums. But the surest way to know if you have gum disease, as well as how advanced it is, is to have us examine your gums with manual probing below the gum line.

Using a long metal device called a periodontal probe, we can detect if you’ve developed periodontal pockets. These are gaps created when the diseased gum’s attachment to teeth has weakened and begun to pull away. The increased void may become inflamed (swollen) and filled with infection.

During an exam we insert the probe, which has markings indicating depths in millimeters, into the naturally occurring space between tooth and gums called the sulcus. Normally, the sulcus extends only about 1-3 mm deep, so being able to probe deeper is a sign of a periodontal pocket. How deep we can probe can also tell us about the extent of the infection: if we can probe to 5 mm, you may have early to mild gum disease; 5-7 mm indicates moderate gum disease; and anything deeper is a sign of advanced disease.

Knowing periodontal pocket depth helps guide our treatment strategy. Our main goal is to remove bacterial plaque, a thin film of food particles that collects on teeth and is the main cause and continuing fuel for the infection. In mild to moderate cases this may only require the use of hand instruments called scalers to manually remove plaque from tooth surfaces.

If, however, our periodontal probing indicates deeper, advanced gum disease, we may need to include surgical procedures to access these infected areas through the gum tissue. By knowing the depth and extent of any periodontal pockets, we can determine whether or not to use these more invasive techniques.

Like many other health conditions, discovering gum disease early could help you avoid these more advanced procedures and limit the damage caused by the infection. Besides daily brushing and flossing to remove plaque and regular dental checkups, keep watch for signs of swollen or bleeding gums and contact us for an appointment as soon as possible. And be aware that if you smoke, your gums will not likely bleed or swell—that could make diagnosis more difficult.

If you would like more information on treating gum disease, please contact us or schedule an appointment for a consultation. You can also learn more about this topic by reading the Dear Doctor article “Understanding Periodontal Pockets.”


By Joel E. Johnson, DMD, PA
February 04, 2018
Category: Oral Health
Tags: oral health  
CrackedMouthCornerscanbeIrritating-HeresHowtoTreatThem

As dentists, we often see other mouth problems besides those with teeth and gums. One of the most common is cracking around the corners of the mouth. Although usually not serious, it can be irritating and uncomfortable.

Medically known as angular cheilitis (literally “an inflammation of the angles of the lip”), it’s also called perleche, derived from the French lecher, “to lick.” The latter moniker aptly describes the tendency of sufferers to compulsively lick the sores to relieve irritation, which actually can make things worse.

Perleche has a number of possible causes, mostly from in or around the mouth (although systemic diseases or medications can cause it on rare occasions). It’s often found among younger people who drool during sleep or older people with deep wrinkles along the sides of the mouth that increase the chances of dryness and cracking. Long-term wind or cold exposure, ill-fitting dentures or a lack of back teeth (which help support facial structure) may also contribute to the condition.

Patients with perleche can also develop yeast infections from a strain called candida albicans. The infection can spread through the whole mouth, significantly increasing the chances of physical discomfort.

Treating perleche often involves topical ointments with inflammation-reducing steroids and zinc oxide, which has antifungal properties, to provide an environmental barrier during the healing process. If a yeast infection occurs, we may treat it with oral or topical antifungal medication like Nystatin for the whole mouth and chlorhexidine rinses, which has antibacterial properties.

It also helps to adopt a few preventive measures that can minimize the occurrence of perleche. If you wear dentures, for example, cleaning them often (including, if necessary, with chlorhexidine) and leaving them out at night reduces bacterial and fungal growth. We can also see if your dentures are fitting properly. Replacing missing teeth provides better facial support and could minimize wrinkling around the mouth. And, of course, keeping up daily brushing and flossing helps ensure a healthy and disease-free mouth.

If you’re experiencing cracked mouth corners, let us know at your next appointment. With our help and of other medical professionals we may be able to give you relief from this irritating condition.

If you would like more information on gaining relief from angular cheilitis, please contact us or schedule an appointment for a consultation. You can also learn more about this topic by reading the Dear Doctor article “Cracked Corners of the Mouth.”




Columbia, SC Dentist
Joel E Johnson, DMD, PA
9 Office Park Ct.
Columbia, SC 29223
(803) 788-2555
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frontdesk@drjoeljohnson.com

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