A Letter From Me to You

Hi, you.

It's me. I'm the person who writes this blog every week for Drs. Johnson and Risbrudt. I'm totally breaking all the rules here, and I'm hoping the fine doctors let me get away with it, because I'm trying to roll with the spirit of the theme this month; gratitude.

First thing I want to say is I'm grateful to Dr. Johnson and his Marketing Specialist, Nicole. They along with their web developer are responsible for putting this blog together, and giving me the opportunity to write the things you see here every month.

It's a pleasure to write, because Drs. Johnson and Risbrudt and the rest of the staff at the office are, every one of them, sparkling. I've heard people say "if you want to be a winner, surround yourself with winners," and I don't know if they did that deliberately, or if it's just a case of like attracting like, but working with them, even as a background character like I am, is a joy.

More than that, I'm grateful to you for reading this blog. This is the end of my first full year writing for Dr. Johnson's office, and every month has been challenging. I'm a writer, not a dentist, and some of these posts have been pretty technical — but I love doing it.

Speaking of which, if you've found any of these posts useful, or overly fluffy, or any such thing, don't be afraid to use the Comments button. I'd love to know more about what you think! You are the ones who make this blog useful to Dr. Johnson, and thus offer me the opportunity to keep writing it.

So thank you. Thank you for reading, thank you for your comments, thank you for visiting Dr. Johnson's office, and thank you for being vigilant about your oral health. Without you, none of us would be here.

Sincerely,

Dr. Johnson's Ghostwriter

Christmastime Is Here! Let's Talk About Pigging Out

At long last, Christmas is once again here! There's a lot of different traditions around the office, but the one thing that it seems everyone can agree with is that Christmastime is a good excuse for a feast. We don't really call them "feasts" anymore, not like in thee olden days, but that's what they are — a vast quantity of food and often an equally vast quantity of desserts waiting to be consumed by people enjoying the holiday.

The question on everyone's mind, because you know this is a dentist's blog, is "I can pig out this one time, right? It's not going to really hurt me in the long run, right?"

To everyone's relief, the answer is yes, you can pig out — if you're already healthy. You can, in fact, 'pig out' on Christmas Eve and/or Christmas Day without doing too much to harm your teeth (or the rest of your body.) Now, if you decide to start pigging out on the 24th and you don't let up until Epiphany, there may be some consequences, but let's look at a single night of pigging out from an overarching scientific perspective.

The human body is kept in equilibrium by a complicated network of counterbalancing forces that are collectively called homeostasis. Homeostasis keeps you at the right temperature, it keeps you at roughly the same weight week-to-week, it makes you sleep when you're tired, and so on.

Homeostatic balance is crucial to the very concept of health, because if your balance is off, you get things like weight gain, sleeplessness, and a weak immune system that can't fight off colds and sickness. Fortunately, homeostatic balance is very good at snapping back from single big pushes. For example, those crazy polar bear swimmers that jump into polar water for a moment or two and then wrap up and get next to a fire.

On the other hand, homeostatic balance is not that good at snapping back from a prolonged imbalance, like getting less than six hours of sleep every night for a week or smoking for years on end.

What this means for you holiday feasters is that, unless your long-term health is already suffering for some other reason, there's absolutely nothing about a single meal — or even 24 consecutive hours — of pigging out that will do any lasting damage to you.

Just be sure that when you're done, you go back to your normal healthy diet-and-exercise routine and give your body oh, say, six days to recover. Then go have a New Years party and do it all over again.

See you next year!

Grinding Your Teeth at Night? A Little Gratitude Might Help

According to some estimates, as many as 95% of Americans will, at some point, have a problem they might never notice — they grind their teeth together at night. Often, the only way someone will notice the problem is if their spouse tells them or if they wake up with an aching jaw.

There are a variety of potential causes that range from the disturbing and highly improbable (parasites in your jaw muscles) to the commonplace and widely accepted (stress in your life). Let's assume in this case that the trigger that makes the most sense to us today — that stress makes you grind your teeth in unconscious frustration at night — is the one that needs the most attention.

What you've just said, essentially, is that reducing stress can improve your dental health by eliminating the grinding problem. Well, there's a lot of advice out there about reducing stress — and almost every modern expert on the subject will tell you that being grateful for the good things in your life is one of the best ways to do it

It doesn't matter if you're grateful to God, grateful to the other people in your life, or simply abstractly counting your blessings, taking a few minutes to consciously acknowledge that you have good things in your life and expressing gratefulness for those things in whatever way best suits you is an amazing way to reduce stress — and thus, if you're a nighttime grinder, reduce the damage you're doing to your teeth as you sleep.

There are several other studies that link a less-stressed, more-grateful life to a systemic boost in overall health, which can in turn improve your oral health, but we wanted to give you at least one cause-and-effect sort of way in which simple gratitude can directly improve your oral health. It's a powerful thing, gratitude — we encourage all of you to use it.

Gratitude Means Giving Back

Drs. Johnson and Risbrudt have always had a strong drive to give back to the community — and to the world. That's why the entire office ran in the Susan G. Korman Run For The Cure, and it's why we strive to do things, small and large, for our community whenever we get the chance.

It's easy, when you're a business, for cynical people to think that anything public you do as a service is some sort of self-centered act. In 2010, when Dr. Johnson gave the world's tallest man, Sultan Kosen, a smile makeover at no cost, several people called it a publicity stunt — but nothing could be further from the truth. There were other specialists, labs and professionals that were involved to make it happen.

The fact is — Dr. Johnson's wife Christa saw a documentary on Kosen and heard that, because of his pituitary disorder, his jaw had literally outgrown his teeth. He needed profound dental work, but he was from a poor village in Turkey and couldn't afford it. Dr. Johnson understood that there was an opportunity to give service to someone who had a profound need and no means, so he stepped up to the plate.

In 2010 Dr. Johnson lead a team of USC students on a mission trip to Honduras. In 2011 he lead them on a mission trip to El Salvador and in 2012 to Guatemala.

Every once in a while we reach out to a patient unexpectedly with a card or another gesture because it is in our hearts to do so. When we receive a response then it confirms why we do what we do. We give from our hearts and our hopes is that our patients know and feel it all the same. But that's hardly the only way that our office works to give back to our community — we also love to go the extra mile for our patients. It's one thing to participate in charitable events or give our services to those in need — but sometimes giving back can be as simple as reaching out to touch the people we meet that need moral support.

Every once in a while, we get a response like this one, and it just redoubles the fuzzy feeling we get when we reach out to someone. Jason's grandmother had just died, and we got together and sent him a condolences card that we all signed — a small enough act, but it sparked something in him that made him write back.

We don't do it for those letters that come back, but we always love it when they do. It's how we know that we're on the right track — giving back to our patients, our community, and our world.

Why We're Promoting Some New Gluten-Free Products

Dr. Johnson's office is promoting some new gluten-free products -- please stop by and ask! And we've gotten some questions about why a dentist, of all people, is interested in gluten intolerance.  The answer is technically complex, but sweetly simple to explain; people with gluten intolerance who eat gluten frequently have horrible dental health.

The Technically Complex Explanation
Gluten causes someone with celiac disease -- the 'technical' name for gluten intolerance -- to have an autoimmune 'tantrum' whenever they eat wheat.  This sudden flurry of autoimmune activity takes places entirely in the intestines, so there are no outward signs, but the results can be devastating.

1. The immune system attacks and kills the villi (the threadlike projections inside your intestines that rummage through your food and extract the nutrients from it) in an attempt to keep the gluten from being absorbed into the body.
2. With no villi, the intestines are unable to extract nutrients from your food properly. No matter how good your diet is, you simply cannot get the nutrients you need from your food.
3. When your body is low on nutrients for an extended period of time, it directs what nutrients it can glean toward the most critical-for-life organs: the heart, brain, lungs, and so forth. The teeth are not on the body's 'critical' list.
4. Over months of not getting any nutrients from the body, the teeth lose their ability to defend themselves from your normal oral bacteria, and you end up with cavities, gum disease, and more.

What Can The Dentist Do?
The nutrient deficiency caused by a person with celiac disease eating gluten for an extended time can be seen in many places other than the teeth -- they often have bad skin, bad hair, emotional or mental imbalances, and so forth -- but rarely can the evidence be seen more powerfully than inside the mouth. That makes your dentist one of the best people to warn you that you may be gluten intolerant -- and by a happy coincidence, the dentist is already prone to dispensing advice about diet and health matters. Drs. Johnson and Risbrudt's decision to carry and promote some gluten-free products is the result.

The Bottom Line: Taking Care of Your Mouth to Take Care of Cancer

From The Journal of Oral Microbiology:

If there is indeed a causal link between oral microbiota and cancer, then the ultimate goal would be to prevent the development of cancer by interfering with the putative carcinogenic potential of the microbiome.
In other words, if the bacteria in your mouth are doing something that increases your risk of getting cancer, then the goal is to find something that we can do to counteract that risk. There are a few different tactics that you can use:

Reduce Overall Cancer Risk

Cancer risk may be affected by what's going on in your mouth, but your mouth really is only one small part of your body. If you're worried about an increase in cancer risk from one place, fight it by decreasing your cancer risk elsewhere. There are plenty of pages online about reducing your overall cancer risks, so we won't get into it here -- it's just one way to address the problem.

Reduce the Risk from Your Oral Bacteria

Cysteine is a non-essential amino acid that is commonplace in several foods. It's also been shown to prevent carcinogens from forming in its immediate environment -- so a regular mouthwash with a drop of cysteine in it could, in theory, reduce the cancer risk without actually doing anything else to improve your oral health. Of course, that seems kind of silly when you could just...

Reduce the Presence of Negative Bacteria in Your Mouth

And the way to do that is stuff you should already be doing every day -- brush, floss, use mouthwash, avoid sugary foods, eat a healthy diet, get decent exercise and get plenty of rest. It's amazing how much just taking care of yourself can keep you well taken care of.

The Theory: How Oral Disease Might Cause Cancer

Science doesn't know how oral disease is related to cancer. But we've seen enough math over the past decade or so of study to know that there's definitely something going on in your mouth that can make you vulnerable to cancer -- even decades later. We're going to lay out the most commonly-accepted theory for you.

The Inflammation Theory

The mouth is a place of almost constant microscopic injuries. For example, something as simple as eating popcorn can cause hundreds of tiny scrapes and cuts on the gums and roof of the mouth. Furthermore, the inside of the mouth is naturally home to hundreds of kinds of bacteria and microbes -- some of which the body considers hostile. When those hostile microbes get into those tiny injuries, it causes a low-grade infection that can literally last for years if you keep re-scraping up the inside of your mouth.

That infection, in turn, leads to a constant low-grade inflammation. Inflamed cells don't respond as well to normal inter-cellular chemical signals, including the signal that tells the cell to die if it starts to act abnormally. If something unusual happens to a cell that causes it to act like a cancer cell, and then the normal self-protection message fails to kill the cell, it can become cancerous. Thus, oral bacteria act as an enabler of carcinogenesis.

The major flaw in this theory is that it doesn't explain why one of the inflamed cells may start to act like a cancer cell. It assumes that, essentially, cells in your body are constantly 'going rogue', starting to act like cancer cells, and then getting killed by your own body. Interestingly, this is another commonly-accepted theory about how cancer works, but when you build one theory on top of another unproven theory, you have to take the whole thing with several grains of salt.

That doesn't mean that there's a flaw in the math -- there's definitely a relationship between oral disease and cancer -- it just means we don't know exactly why.

Getting Into the Data: In Depth On Oral Bacteria and Cancer

Last week we put up several links to studies that show a pretty clear link between oral bacteria and cancer. We couldn't help but think that perhaps it would be helpful to some of you if we translated at least one of them from scientific jargon into layman's English. From The Journal of Oral Microbiology:

"Inflammation caused by infections may be the most important preventable cause of cancer in general. However, in the oral cavity the role of microbiota in carcinogenesis is not known. Microbial populations on mouth mucosa differ between healthy and malignant sites and certain oral bacterial species have been linked with malignancies but the evidence is still weak in this respect. Nevertheless, oral microorganisms inevitably up-regulate cytokines and other inflammatory mediators that affect the complex metabolic pathways and may thus be involved in carcinogenesis. Poor oral health associates statistically with prevalence of many types of cancer, such as pancreatic and gastrointestinal cancer."

What this says, in short, is that many cancers are indirectly caused by infections -- indirectly because it's not the infection itself that causes the cancer, but instead the inflammation caused when your body fights the infection. In addition, this is inflammation that certain bacteria in your mouth can make much, much worse. We haven't figured out exactly how these bacteria cause cancer, so we can't say for certain that they do -- but the statistical correlation between oral health and cancer risk is quite significant.

"Our unpublished results from a cohort study in Sweden with 16 years of follow-up showed that age, female gender, and periodontitis with loss of the first mandibular molars were the principal independent predictors of cancers in general, and breast cancer in particular, as registered in the Swedish Cancer Registry. From the same database, premature death of young individuals was observed to link statistically with periodontitis and missing molars whether the cause of death was because of cancer, cardiovascular, or gastrointestinal disease."

This is the quote we referred to in this months' newsletter. Translated, it says that there are three factors that are the most correlated with breast cancer. The first is the age of the person. The second is their gender. The third is whether or not they had periodontal disease when their first molars were removed.

Why is this considered just as relevant as age and gender? Because it's statistically correlated to an extraordinary degree; if you had periodontal disease when your first molars came out, you were much more likely to get breast cancer. It’s not quite the difference between getting breast cancer as a man and getting breast cancer as a woman, but close to the difference between getting it as a 25 year old and getting it as a 35 year old.

The Hard Science of Soft Sciences

Here at Drs. Eric Johnson and Tom Risbrudt's office, we spend a small but significant portion of our time keeping up on the latest in dental research, from the cutting-edge (no pun intended) pharyngeal surgeries out of Switzerland to the UC Berkeley medical students pumping out research papers about the effects of non-fluoride toothpaste. As mentioned last month, one of the things we see more and more is that there really isn't a distinction between oral health and general health. If your mouth is unhealthy, your body will be too, and vice versa.

But there's a kind of problem with biological sciences. They're referred to by some as 'soft' sciences, because there are just so many variables involved with any form of life that two seemingly identically sets of circumstances can come up with radically different results (ask the scientists studying which diets are best for fat loss!) So a single study that says 'oral bacteria are linked to increased pancreatic cancer risk' is interesting, but until four or five other groups have come up with studies saying the same thing, that's all it is -- interesting.

As it happens, however, the link between breast cancer and oral health isn't just a one-off event. It's been shown in several studies from all over the world:

• The Journal of Oral Microbiology
• Medical News Today
• The Journal of Translational Medicine
• Journal Portal of Shahid Beheshti Medical University

So we at Drs. Eric Johnson and Tom Risbrudt's office are very confident that, when we say that we're doing our part to help fight cancer, we mean it. Not only did our team support the Support G. Komen Walk for the Cure, we also participated in the event last month. We know that the work we do right here every day -- keeping people's mouths healthy -- helps reduce their risk of cancer as well.

 That feels pretty darn good.

Let's All Take PhysEd: The Power of Exercise on Oral Health

We've talked a lot in the past about the importance of nutrition on oral health, and just a couple of weeks ago, we mentioned that getting enough sleep has a profound effect on your body's ability to keep its mouth healthy. Today, we're breaking out the third leg of the 'tripod' of general health: exercise.

According to studies published in the American Journal of Clinical Nutrition and the Journal of Dentistry, exercise and dental health are closely linked. One study divided up people into three groups: inactive, partially active, and extremely active. They discovered that the partially active people had 33% less periodontal disease than the inactive group, and the extremely active group had 52% less than the inactive group.

Another study showed that vitamin D, which is most commonly obtained from exposure to sunlight (which means being outside, which generally means being active), also helps suppress gum disease -- people with the highest levels of vitamin D had 20% less than people with the lowest amounts.

The reasons why this might be are somewhat complex, but they're thought to relate to the body's ability to process blood sugar. Science has proven that gum disease and blood sugar are closely related in ways we haven't discovered -- people who get gum disease also suffer from reduced ability to process blood sugar and people who lose the ability to control their blood sugar (due to pre-diabetes, hormonal imbalance, or other issues) also become more prone to gum disease.

Because getting exercise and getting vitamin D both help the body control its own blood sugar levels, they seem to, through that same undiscovered mechanism, do an excellent job of helping your body fight off periodontal disease.

So in short, get your kids into P.E., after-school sports, or whatever it takes to keep them moving! Along with a good diet and plenty of rest, it's an essential part of keeping up their oral (and their general) health.

Roughhousing at School: What to Do about Injured Teeth

Depending on your child and your school, there may or may not be a bit of roughhousing that goes on during the day. While most such play, as long as it doesn't devolve into bullying, is looked upon as a normal part of growing up, it does carry with it the chance of injury. If something happens to your kids at school and one of their teeth is chipped, cracked, broken, or worst of all, comes out, you need to know what to do.

Let's go from worst to least:

Tooth Comes Out

If a kid's first tooth comes out, it's just a matter of waiting until the adult tooth comes in. If an adult tooth comes out of your kid's mouth, it's panic time. They've got less than an hour before the tooth and the socket die and the tooth cannot be reattached.

Here’s what to do:

• Put the tooth in a glass of milk, or, if milk isn't available, in a glass of salty water.
• Take the tooth and the child directly to a dentist who does surgery; preferably a reconstructive dentist.
• Have the tooth put back immediately.
• Expect the child to take the next day or two off of school while they recover -- oral surgery isn't easy.

Broken Tooth

If a tooth actually breaks off -- not just a chip, but a substantial break -- you need to hurry to the dentist. Depending on the break itself, it may be more effective for the dentist to glue the broken piece back on, or it may be better for him to make a porcelain cap to go over the butt of the tooth.

Cracked Tooth

When a tooth is cracked -- as in, the enamel has a visible, jagged opening in it -- it's still immediately dentist time. The child still shouldn't attempt to eat anything even if they feel OK. The dentist will almost certainly fill in the crack with some sort of enamel-like substance, and your kid should be ready for school the next day.

Chipped Tooth

It's not often that you can find the chip when a tooth gets chipped. If you can, you should head straight to the dentist to get it reattached. If you can't, you could way for a day or three, or not, it's up to you, because whether you do or not, the dentist is going to do the same thing -- fill in the chip with a tiny bit of porcelain and seal it in place.

Back to School Tips: Better Sleeping for Better Teeth -- And Grades

This one is for all the kids, but will help teenagers more than the rest. Did you know that according to one study, kids today get an hour less sleep, on average, than we did when we were young? It's not hard to see why -- it's perfectly normal for a kid these days to have school until 3pm, sports until 5, dinner, prime time TV (aka "family time") until 8 or 9, and then 3 hours of homework on top of that.

Add to that the fact that, around 14 or 15, a teen's internal clock changes to allow (and to a degree require) them to stay up later than they did before. But the times they are required to wake up in the morning don't budge -- and you can see the problem. If kids could sleep in an hour later in the morning, they'd be fine -- but they can't, and over the months and months of school, all those lost hours of sleep add up. So a good night's sleep is good for your kid's health.

So how can you help your child get to sleep a little earlier? Here are a few things you can do:

• Turn off all electronic screens at least an hour before bedtime. No TV, computer, iPod, tablet, smart phone -- nothing with an electronic screen.
• Have a story ready. It doesn't have to be in a book. A recording or someone to tell you a story will work, too, but having something for the brain to focus on that isn't the stress of the next day helps your brain relax and fall asleep.

Keep a regular schedule. Dinner at 6, shower at 9, in bed by 10, every night (assuming they have to be up at 6). Falling asleep should be as regular as waking up in the morning.

Naturally, you should schedule at least 8 hours for them to sleep each night.

Oral Hygiene at School: The Importance of Having Floss on You At All Times

There are some things that are just so useful that once you have them on you for a while, you start to wonder how you ever got by without them. Simple, waxed dental floss is one of those things. Just look at what you can do with dental floss:

• Tie up a shoe whose lace has broken.
• Create a makeshift tourniquet to get a cut finger to stop bleeding so much.
• Cut cheese, modeling clay, or other soft things.
• Put a tripwire up across a bathroom stall.
• Combine it with a paper clip and a pencil to create an in-class zipline.
• Use it to tie your hair back should your scrunchie stop scrunching.

Of course, you can -- and should -- also use it to floss your teeth. Why would you want to do something that lame in the middle of the school day?

There are a couple of good reasons:

Something Hurts

It's not all that often that we can identify exactly why something in our mouth hurts, but when it does, it's more often than not in a place that we can't quite get to. It's a bit vulgar to walk around school trying to get between your teeth with a fingernail -- but floss is completely socially acceptable.

Something is Stuck

Along those same lines, there's very little more distracting than having something annoying stuck between your teeth. Also, as it happens, those bits of food stuck between your teeth are quite bad for your oral hygiene -- each of those bits is a source of food for the bacteria that cause plaque, gingivitis, and other diseases of the teeth and gums. Flossing is the best way to get them out efficiently and without causing a fuss during the school day.

Sleep Apnea's Younger Cousin: Profound Snoring

Sleep apnea can make your life miserable -- but sometimes, when your air passages don't actually close off entirely but still sag a bit, you end up with a problem that makes everyone around you miserable; snoring. About 10% of the population snores, and not all of them do it often or loudly enough to disrupt the sleep of the people they live with. If you are -- or live with -- a profound snorer, Dr. Eric Johnson and Dr. Tom Risbrudt want you to know that help is just a phone call away.

Before you make an appointment for an expensive surgery or other route to address your snoring problems, however, here are some things you can do to address the problem at home:

• Lose weight -- for many people, even just losing 4 or 5 pounds is enough to take the weight off of their soft tissues and allow them to breathe without snoring.
• Avoid sedatives -- alcohol, sleeping pills, and relaxants can all cause snoring by encouraging the soft tissues to over-relax during sleep.
• Sleep on your side -- this keeps the tongue and soft tissues out of the back of your throat, allowing the air through. Even if you have to duct-tape a tennis ball to the back of your pajamas so that you don't roll over onto your back in the middle of the night, learning to sleep on your side is great for killing the snore.
• Prop your head up -- again, gravity can help you keep the flesh out of your airways. Just sleep with an extra pillow, or if necessary get a foam wedge that will keep the top of your body a few degrees above flat.
• Open your nose -- nasal strips, neti pots, and even prescription nasal dilators can help you keep breathing through your nose, which prevents about half of all snoring.

If you've tried these things and your companions still complain about your snoring, it's time to tackle the problem professionally. Call Drs. Johnson and Risbrudt's office to make an appointment to come in and get your snore turned off for good.

How a Dentist Tackles Sleep Apnea

Some people have asked us, why are we taking on obstructive sleep apnea? Isn't that the realm of the otorhinolaryngologist (ear/nose/throat doctor)? The answer is sure -- you could get a referral, see a specialist, pay an excessive amount of money for a cure and watch your insurance rates skyrocket. Or, you can see someone you already know and trust to take care of your smile, pay a lot less money, and end up with the same positive result.

How Do We Fix It?

There are a lot of different kinds of obstructive sleep apnea -- or rather, the obstruction can happen in a lot of different places. Obstructions where the tongue slides backwards to block off the throat have to be treated differently than ones where the throat collapses in on itself, which in turn are different from obstructions where the tonsils and palette fall together to block the air.

Depending on which of the kinds of obstructive sleep apnea you have, there are different approaches that can work to fix it. For the tongue-blocking kind of sleep apnea, there's an oral appliance that you can wear while you sleep that will keep your tongue from sliding backward. If you have the tonsils-and-palette kind of blockage, there's a different appliance you can wear that will force your lower jaw forward, which creates enough space that the air can get around your relaxed palette.

In cases severe enough that the dental appliances don't work, or in cases where the problem is further down the throat, there are two options. The first is surgery by a medical surgeon. The second is a machine called a CPAP (Continuous Positive Airway Pressure) machine. You wear a mask over your face while you sleep, and it continuously pushes air into your moth. Between the pressure from the outside and the suction from your lungs expanding, almost any natural blockage of your airways can be overcome.

How Do You Know if You Have Sleep Apnea?

Sleep apnea can be a tricky thing to diagnose. The lucky ones have a partner who pays attention to them while they're sleeping and can tell when they've stopped breathing. But if you live alone, or your partner is a deep sleeper themselves, determining whether or not you have sleep apnea or if something else is keeping you from sleeping properly can be very difficult.

The major symptom of sleep apnea is simple: you're tired no matter how long you sleep. But there are other things that can cause the same symptom, so you'll have to look for a few additional factors to make the diagnosis of sleep apnea.

Here are some other common symptoms related to this condition:

• Morning headaches
• Waking up with a dry mouth or sore throat
• Going to the bathroom frequently during the night
• Insomnia or frequent nighttime awakenings
• Moodiness, irritability, or depression
• Forgetfulness and difficulty concentrating
• Waking up feeling out of breath

Children with sleep apnea may also exhibit additional symptoms:

• Hyperactivity or inattention
• Decrease in school performance
• Developmental and growth problems
• Breathing through mouth instead of nose
• Irritable, angry, or hostile behavior

If you're still not sure, try keeping a sleep diary. Record each night how long you slept, how many times you woke up, and how sleepy you were the next day. If you fall asleep during normal activities, make a note of that. If you find that you're waking up more than twice each night or that you for more than three days in a row without getting restful sleep, you need to talk to an expert.

Finally, if even the diary leaves you uncertain, there's one definite way to figure out once and for all whether you have sleep apnea; record yourself while you sleep. Record one night all the way through, and then listen to it one hour at a time over the next week. Write down every time you hear your breathing stop for 10 seconds or more at a time. If you get a number above a dozen, you have sleep apnea and you need to seek medical help.

In addition to dental services, Drs. Johnson and Risbrudt offer solutions for sleep apnea and snoring. Stop by our office today and start sleeping well at night.

Let's Talk About Sleep Apnea

As Americans get less fit and more obese, there are a number of things that can and do go wrong with our bodies. Some of them are obvious, some of them less so. Many are things that only a specialist doctor -- like a cardiologist -- can handle, others can be tackled at home. Still others can be addressed in some surprising ways, like obstructive sleep apnea -- a soft tissue disorder of the palate and throat that can have disastrous effects on your physical and mental health. Dr. Eric Johnson's office wants you to know that obstructive sleep apnea may be affecting your life -- about one in a thousand of us have it -- and if it is, he's here to help you.

Obstructive sleep apnea happens when, as you sleep, the muscles that support the soft tissues in your nose, tongue, palate, and throat relax. In most people, that's not a problem, but for some of us, the relaxation allows our throat to close up completely, preventing us from breathing. In others, only the nasal passages close up, forcing us to breathe through our mouth all night long.

In order to keep us alive, our nervous systems panic when we stop breathing, and they send just enough of a jolt to our brain to knock us out of sound sleep. We wake up enough to force our throats open and start breathing again -- and usually, we immediately drift back off to sleep, often without ever realizing that our sleep was interrupted.

Unfortunately, even those non-waking interruptions utterly ruin the quality of our sleep...and they can happen hundreds of times every night. For people with obstructive sleep apnea, it's not uncommon to wake up after ten or even twelve hours of sleep and want nothing more than to go back to bed.

If you consistently wake up feeling tired and unrested, and it's been happening for so long that your behavior is changing for the worse, you need to stop by our office and talk to Dr. Johnson about how he can help you combat obstructive sleep apnea. Call and make an appointment today -- you owe it to yourself to get a good night's sleep.

Wisdom Teeth: Should They Stay Or Should They Go?

Here at San Clemente Dentist Dr. Eric Johnson's office, we start looking at a child's wisdom teeth around the age of 16, to make sure there's enough room for them to come in properly, without causing problems. Wisdom teeth are completely non-vital to a child's health, so if it appears that there may be a problem with them, Dr. Johnson suggests having them removed simply to be on the safe side -- and removing them early on is easier than removing them later in life, as their roots will be shallower.


The Downside of Removal
The downsides of wisdom teeth removal are mostly the same as with any other minor surgery.

• Your child may have an adverse reaction to the anesthetic (very rarely).
• He or she may experience swelling and tenderness in the area of the removed teeth.
• The sutures that are used to close the hole left behind by the removed tooth may open and leave a space that needs to be re-closed.
• A very small number (less than 0.01%) of people who have this procedure have unexplained pain in the jaw that doesn't respond to painkillers and can last for years.

The Upside of Removal The upsides of getting your wisdom teeth pulled are all about the conditions you avoid by having them taken out. With no wisdom teeth crowding their other teeth around, your kids may see the following benefits:

• Their wisdom teeth won't come in at odd angles and be quite so difficult to clean.
• Their other teeth won't get crowded together and require braces to keep straight.
• They won't experience the minor infections common with wisdom teeth eruption.
• They will be able to easily clean the back sides of their rearmost teeth.

There is no cut-and-dried protocol that says your child's wisdom teeth must be removed. It depends on the child and if there is foreseeable problems in the future. Dr. Johnson can inform you and your child of the potential issues or if it is beneficial to keep the wisdom teeth. Check out our Pediatric Patients page of our web site for more information.
 

How To Brush Your Child's Teeth

Dr. Eric Johnson can do a lot for your children's teeth (come in and ask us for a complete breakdown sometime if you're curious) but obviously the parents are the ultimate decider of their children's oral health. But some parents are honestly not sure how to perform basic oral maintenance -- or worse, they think they know, but they're missing a vital step or two. So here's a simple routine for proper tooth-brushing that anyone can follow.

A Simple Guide to Brushing

• The vast majority of damage to the teeth happens while you sleep. It takes a while after the mouth is disturbed for bacteria to settle down and start doing damage, and during the day, we eat often enough that the bacteria doesn't settle down that much. This means that the two most important times to brush your teeth are immediately before going to bed and immediately upon waking up.
• Each tooth has 5 surfaces. Front and back of the tooth. The tongue side or inside of he tooth. The facial side of the tooth or the surface that people can see and then the chewing surface or the incisal edge on the front teeth. There are 20 teeth as a child. Ten teeth on the top and ten teeth on the bottom. There are 32 teeth including the wisdom teeth as an adult. Sixteen teeth on the top and sixteen teeth on the bottom.
• When you brush, you should use a small amount of toothpaste, and you should brush each surface in your mouth for a minimum of 3 seconds. That's a total of 20 seconds worth of brushing.
• Brushing should be done in a circular motion, not just straight back and forth. Going straight back and forth doesn't get the bristles in the cracks between the teeth; a little vertical motion helps get that taken care of.
• If you don't have a tongue scraper, you should brush your tongue for 3 seconds as well.

One final note: Limit highly acidic drinks like Coca-Cola. Ideally eliminating sodas from a child's diet is the best plan. The acid weakens the enamel.

What does a Dentist that sees Children Actually Do?

Dr. Eric Johnson practices several different kinds of dentistry, from restorative to cosmetic, but this month is all about pediatric dentistry -- so what exactly does that entail? The dentist who sees children does a lot more than teeth scrubbing and give free toothbrushes.

Pediatric dentists rarely have to worry about crowns and bridges and fillings, for example -- but it's a lot more than just fluoride scrubs and free floss.

A dentist who sees children...

• Helps to delay and hinder tooth decay, periodontal disease, and other forms of oral disease that can affect a child.
• Follows the growth of baby teeth, tracking them through adolescence when they are lost and replaced with adult teeth.
• Educates the child about the importance of good oral hygiene and the exact techniques the child should use to take care of their mouth at home.
• Educates the parent about tooth-healthy dietary practices, as well as about what to expect next in the child's oral development.
• Addresses a variety of child-specific oral issues such as thumb-sucking or pacifier use.

Dozens of scientific studies have proven that a child's oral health is linked to their social relationships, school performance, self esteem, confidence, and even their long-term cardiovascular health. That's why dentists who see children take their jobs very seriously -- in the long run, it's about a lot more than cavities and plaque.

Dealing With Children's Fear of the Dentist

It doesn't matter if your child is a toddler or about to graduate high school -- almost every young person has some form of fear of the dentist. Whatever it may be, getting the child to the dentist is often the easy part -- actually being treated by a dentist is an entirely different level of challenge.

One of the best things you can do to improve your child's relationship with the dentist is to establish your child's relationship with the dentist. That means taking them in regularly -- at least twice a year -- when they're quite young. Three-year-olds are starting to form long term ideas about the world around them, and learning about the dentist at that age is entirely appropriate even if it it's just to bring them in for a five minute checkup and to become familiar with the dental office and the surroundings.

Another relatively simple step you can take is to arrange to be in the dentist's office with them. Up until about the age when they don't want to be seen getting out of your car at school, they'll be perfectly happy to have you come into the dentist's office and sit next to them while they get their teeth cleaned -- and there's nothing wrong with that.

You can also help by explaining to them exactly what the dentist is doing. It's one thing to say "he keeps your teeth clean" -- and that works quite well for single-digit kids -- but once a child gets into the tweens and teens, they deserve more. Talk to them about oral health in specifics. Ask the dentist to show them some dentures and talk about how to avoid ever needing them. The more they understand how the dentist is helping their future selves keep eating, the more they'll see the dentist as an ally rather than someone to be feared.

Creative Father's Day Gifts -- A Dentist's Take

Like every holiday, Father's Day has become a commercialized affair, with tie companies, coffee cup manufacturers, and office widget producers going berserk with advertising around this time. And while it's always fun to give Dad something fancy and useless for Father's day, Dr. Eric Johnson's office would like to make a more low-key, practical suggestion for a Father's Day gift; a perfect smile.

The over-the-top treatment would be a gift certificate for a full smile makeover. Send Dad in to the clinic for a consultation with Dr. Johnson about how he can make the most of his smile, and get an appointment for an afternoon of smile-perfecting.

If the full shebang isn't quite in-budget, there's nothing like a professional tooth whitening to give Dad's smile that extra wattage. Especially if Pop works in any sort of public business, the value of a smile that pops is hard to overstate. A couple of weeks with Dr. Johnson's customized tooth whitening system, and Dad will be beaming his pearly whites at everyone in sight.

If Dad's afraid that his smile is irreparable, have no fear -- the impossible is what Dr. Johnson is best at. With a set of custom-made white-smile-colored porcelain veneers, even the most Austin Powers-ish smile can be turned into a perfect grin. Send him in for a consult, and Dr. Johnson will custom-make veneers that will turn his teeth into pearly whites faster than Photoshop.

Not every father will be ecstatic about going to the dentist as a 'present' -- but every father will love the results when they get out. There's a lot to be said for the simple pride of knowing that your smile looks great -- it makes you smile more, and smiling more actually makes you happier. So consider giving Dad the gift of happiness: a smile he'll love to use.

Fathers, Children, and the Power of Tone

It may seem odd to some that we're taking time on a dentist's blog to talk about this subject, but it's intensely relevant -- it's time to talk about the power of words. Everyone understands that, to a degree, it's a father's job to be an example for their children, but not everyone understands to what degree your children are actually watching you all the time and how easily they pick up on your cues. We see this quite often right in our waiting room. Two fathers with two children can be sitting right next to each other. One father will say something to his child like "Are you ready to go see the dentist?", and the other will say something like "All right, buddy, let's go." The difference is that the first one sounds excited, and the other sounds like he's about to walk into a much-dreaded seven hour Dora the Explorer marathon.

The first father's child walks in looking around and interested. The second walks in nervously and isn't at all pleased to be there. In all likelihood, the first child will look forward to coming back to the dentist, and the second one will scream and fuss the next time their checkup comes due.

We often underestimate the power that a single phrase can have over our children. One study from Dr. Carol Dweck proved that one single instance of praising a child's work ethic versus praising their intelligence caused as much as a 50% swing in test scores three tests after the praise was given. (Praising work ethic provided higher scores).

When it comes to something with as much 'scare potential' as a visit to the dentist, it's critical that as a father, you're very careful about the words -- and more importantly, the tone of voice -- you use with of your children.

Summer Vacation Is Almost Here -- Get Your Checkups Before the Kids Are Out of School

Dads, it's time to think forward a little bit. Summer vacation starts soon, and it's your job to make sure that your family is having fun in the sun. There are barbeques to be flame-broiled, camping trips to be planned, and Slip-N-Slides to be wetted. The last thing you want hanging over anyone's head during the vacation months is everyone's annual visits to the dentist.

Now is the time to get a hold of Dr. Johnson's office and schedule your checkups. It may actually be too late to get them done before the kids are out of school, but you can at least get them done before the heat makes it preferable to spend your afternoons by the pool rather than in the dentist's chair.

The Sun and Your Teeth
Speaking of spending your afternoons in the sun, recent research has shown that spending at least twenty minutes in the midday sun has a profoundly positive effect on your oral health -- even if you keep your mouth shut the whole time. That's because spending time in the sun helps your body produce its own vitamin D.

Vitamin D does quite a bit for your body. It helps you metabolize calcium, which means better bone health. It also fights inflammation, which means it can help alleviate pain from a wide variety of sources across the body -- including many kinds of gum pain. It's even known to stimulate your body to produce peptides that fight the bad kind of oral bacteria.

The summer has always been the healthiest time of the year, and your oral health is no exception. Come into the office, get your teeth cleaned, and get some sun -- your mouth will thank you.

Dental Care for Moms-To-Be

Over the past few weeks, we've covered the basics of dental care for children 0-30. But what about kids up to -9 months old? You can actually use oral health techniques to the benefit of a child in utero -- by taking care of your own mouth. Studies have shown that poor oral health in mothers has a noticeable negative effect on their babies' health. So what do pregnant women need to do differently than everyone else?

Tell Your Dentist Immediately
Your dentist ought to know the day you know that you're pregnant. (So should your family doctor, of course.) That's because some relatively-common dental routines, such as the use of tetracycline, can negatively affect a baby's growth and should be stopped immediately. Tell your doctor right away so he or she can modify your routine accordingly. Also tell your dentist about any new medicines your doctor has put you on, to avoid any possible counter-indicated drugs or procedures.

When to Avoid the Dentist
There are two very critical periods in the development of any child in which it's wise for the mother to avoid basically any non-critical messing about with her body, including the dentist. The first is the first trimester -- all of it -- and the second is the latter half of the third trimester. The second trimester is safe for most regular dental operations, but any surgery requiring anesthesia or X-rays and any elective procedure should be delayed until after the baby is born unless they threaten your life.

Morning Sickness
Purchase a bland-tasting toothpaste to avoid triggering your morning sickness every time you brush, and a bland mouthwash for rinsing your mouth with should you be unable to avoid vomiting. Always rinse your mouth with something -- even if it's just water -- after you vomit, or the acids from your stomach will sit in your mouth and wreak havoc on your teeth.

Swollen Gums and Other Complications
If you experience swollen gums, pregnancy-related gingivitis, or other oral complications of pregnancy, don't let it keep you from taking care of your mouth. Consider switching to a softer toothbrush, milder toothpaste, and/or waxed floss in order to keep your routine going. Make sure you avoid sugary foods as they only add to the swelling and the sensitivity of your teeth. As soon as you're out of the hospital with your newborn baby, schedule an appointment for you to see your dentist.

For as long as your baby is breastfeeding, your diet directly affects his/her immediate and future oral health -- so stay off the sweets and load up on the fruits and veggies. The little one might not be able to thank you, but you'll thank yourself in a few years when your child's perfect smile begins to show.

The Best Dental Care for Kids Happens At Home

At Dr. Eric Johnson's office, we believe that visits to the dentist are an important part of oral healthcare -- but they're clearly only one small part. Most oral health care happens at home, and it often starts with Mom.

Once your child turns six, it's time to switch to a fluoridated toothpaste. Fluoridated toothpastes go a long way toward preventing cavities, and at six, your child's body is developed enough that fluoride overdose isn't a significant danger. (That said, if you know you have fluoridated water and your child drinks it regularly, you might want to be careful to use small amounts of toothpaste -- it doesn't take much to take effect.)

Proper Nutrition
Between the ages of three and thirty, kids have a tendency to be very vulnerable to the allure of sugar and other highly-processed carbohydrate-laden foods. Candy, muffins, anything made by Hostess or Little Debbie -- you know the stuff. No one is saying they shouldn't enjoy a treat, but part of your responsibility as a parent is making sure that they don't eat too much of the stuff, or too regularly.

From just a dentist's perspective, sugary and floury foods like that are profoundly detrimental to your kid's oral health. Sugars that sit in the mouth encourage bacteria to reproduce exponentially, which in turn leads to plaque, gingivitis, and periodontal disease. (Other health professionals can give you plenty of other reasons to avoid these foods as well).

For best oral health, make certain your child eats at least three different colors of fruit and/or vegetable every day, and not the same three colors day after day. This simple rule will go a long way toward making sure your kid gets a broad spectrum of nutrients, all of which affect his/her oral health directly or indirectly.

Adding To the Routine
As your child grows, you can add a few new elements to their dental routine. At six, add mouthwash. Go straight for the good stuff -- Crest Pro Health which is a great mouth rinse without the alcohol and it won't dry your mouth. Listerine is a classic but it is too strong. As soon as your child starts losing his/her baby teeth, teach them how to floss and enforce flossing each night before bedtime. This will get them well into the habit by the time their adult molars start coming in.

Being a mom is certainly unending hard work -- and taking care of your child's oral health is just one part of the job. But making it part of your daily routine is the key to getting it all under control.

Dental Care for Toddlers -- Mom's Role

Obviously, once a child starts getting teeth in, it's important to bring them to see the dentist at least every six months. The dentist's role in checking up on the toddler's teeth is pretty obvious -- but first-time parents may well ask themselves where their part in their child's dental care is.

The answer is actually pretty simple, too. It's largely a matter of instruction, routine, and observation.

Instruction
The first step in toddler dental care is teaching them how to take care of their own teeth. By the time a child is three, they should be able to at least pretend to brush their teeth. Your job as the mom is to turn that pretend tooth brushing into the real thing. That means teaching them the same basic technique described last week -- but as toddlers who actually have teeth, you want to increase the amount of time they spend on each surface from 2 seconds to 4.

It should take about a minute and a half to brush your teeth -- for second on each of the 24 surfaces inside your mouth. That's 12 on the top (three for each of the two molar surfaces, two for each of the two canine areas, and two for the front teeth), and 12 on the bottom.

Routine
Your second job is to make sure that your toddler brushes their teeth every morning when they wake up and every night right before they go to sleep. If you want to make this easy on yourself, start the routine the day they start eating non-breast-milk foods (see last week's post) and don't vary the routine ever. Kids love routines, and if you get it into their head early, they'll actually remind YOU that they need their teeth brushed.

Observation
The last thing you need to do as the mom is keep track of your child's dental and oral health. Watch to see if they suddenly start favoring one side of their mouth over the other, if they start talking differently (which can be a sign of pain in one part of the mouth), or if they start being distressed at eating particularly hot, cold, or chewy foods. If you catch any of these or any other sign that they may have a problem with their mouths, schedule an appointment with their dentist immediately.

Happy Mother's Day!

Anniversary Party II: Son of Dental Care!

This May is going to be a month of celebration at Dr. Eric Johnson's office. On Thursday, June 7th, we're having an open house in celebration of the second anniversary of Dr. Johnson's arrival, as well as the newly minted merger with Dr. Risbrudt. Details on our web site here. We also think moms deserve more than one day of appreciation, so all May long, we're going to be celebrating the moms out there with flowers -- and we're dedicating our blog this month especially to information about dental care for mothers and babies. To that end, let's talk infants.

Do You Need 'Dental' Care Before You Have Teeth?
The short answer is 'not at first'. In general, a baby that is consuming solely breast milk and water doesn't need much by way of oral care; the breast milk itself acts to protect the baby's mouth and gums. It's only once a baby starts eating other foods that you have to be concerned with oral care.

We all recognize in adults that sugar from any source is problematic for oral health for a variety of reasons. What we don't all realize is that many foods that are designed for toothless babies are sugary (after all, sugar dissolves in their mouths, so it's easy to eat with no teeth.) This includes foods that don't explicitly have sugar, but are made from finely-ground grains (which actually break down into sugars upon exposure to saliva.)

That means that once your child begins eating non-breast-milk foods, whether it's formula, rice cereal, arrowroot cookies, or a nice rare steak, it's up to you to make sure they maintain good oral health. Start brushing their teeth once each day, with a child-sized soft (that's a technical term, look for an "S" or the word "soft" on the package) toothbrush.

Use a tiny (grain-of-rice sized) amount of non-fluoridated toothpaste -- it's hard to find in major shopping chains, but it's not too tough to order online. Brush for two seconds on each surface of the gums (the inside, outside, and top of the molar area, and the inside and outside of the canine area and the front-most gums.)

Do this every day as part of getting ready for bed. Sleeping time is the time when the mouth is left alone for the longest, so it's the time when the bacteria in the mouth have the longest to multiply and become problematic. Brushing right before bed is the best way to keep that time as short as possible and thus minimize the chances of a problem developing.

So what about kids who have that full set of teeth? Come back next week and find out!

How to Prevent Oral Cancer

Oral cancer, like most cancers, is one of the preponderance of medical conditions where an ounce of prevention really is worth several metric tons of cure. And while Oral Cancer Awareness Month may be rapidly approaching its end, there still may be time for the responsible folks out there to schedule an appointment with Dr. Eric Johnson's office to get a free oral cancer screening.

For those of you who are confident enough to go without, however, we have a bit of parting advice for you -- our best understanding of how to make sure that oral cancer never affects your mouth.

The best bit of advice is to stop aging. Of course, that has its own negative side effects depending on how you go about it. They range from having to drink blood to having a bunch of other immortals try to cut your head off with swords...so that's probably not really a good option. Let's move on with some more realistic steps you can take.

First, avoid tobacco, alcohol, and other drugs. Basically anything that can actually get into your individual cells and mess them up from the inside -- which all of the above really do -- should be on your 'do not' list.

Second, eat a varied diet that includes at least three different colors of fruit and/or veggie with every meal. Different colors mean different beneficial nutrients, so by switching up the spectrum, you're ensuring that your body gets the variety it needs to function properly. Also, most brightly-colored plant life is antioxidant, meaning it fights cancer's earliest stages.

Third, protect yourself from the sun. Oral cancer can spring up inside your mouth because you get too much UVB on the outside of your lips, jaw, and neck -- so get out the sunscreen.

Finally, get yourself screened for oral cancer! Even the best preventative efforts can fail for no apparent reason -- so make sure you don't have oral cancer by letting the professionals check for it. The earlier it's discovered, the easier it is to treat, so get examined at least once a year. And since it's free this month, now's as good a time as any to get it done, don't you think?

April is Oral Cancer Awareness Month! Are You Aware?

Oral cancer doesn't get a lot of play. It's not as lethal as pancreatic cancer, as dramatic as brain cancer, or as commercialized as lung cancer -- but it's pretty nasty stuff nonetheless. Dr. Eric Johnson's office is acknowledging Oral Cancer Awareness Month by offering free oral cancer screenings to anyone willing to make an appointment to see us.

But how do you know if you should come in and get checked?

The obvious answer is "if you have a mouth, you should get checked." But we realize that that won't fly with everyone out there, so here are a dozen other things your body may be telling you that indicate it's particularly worthwhile to schedule a visit.

1. If you're 60 years of age or more, you should definitely get checked.
2. If you smoke(d) or use(d) tobacco for more than a month within the last decade.
3. If you regularly (once a week or more) drink enough alcohol to feel tipsy.
4. If you've been diagnosed with HPV.
5. If you have red and/or white patches on the inside of your lips or cheeks.
6. If you have a lip that's been sore for more than a few days.
7. If you have unexplained bleeding inside your mouth.
8. If one or more of your teeth are inexplicably loose.
9. If you have difficulty or pain when swallowing, especially rough foods.
10. If you have a lump in your neck and you don't know where it came from.
11. If you have a pain that feels like its midway between your ears and your jawbone.
12. If your retainers, dentures or partials have started to feel like they don't fit.

Any of these things can indicate the onset of oral cancer. If you have more than two of them, getting checked for oral cancer should be very high on your list of things to do. Call or come in to Dr. Johnson's office today and make an appointment for your free oral cancer screening -- you've only got until the end of April to get it done for free, so hurry!

What to Expect During an Oral Cancer Exam

Dentists and dental hygienists are quite used to poking around inside people's mouths, and Dr. Johnson and his assistants are no exception. Our vast experience in this area puts us in a unique position to see things going on inside your mouth that few other people can -- things like the beginnings of oral cancer.

An effective oral cancer screening requires a hands-on approach, because some lumps are too small or well-concealed to be visible with the naked eye (and those little mirrors on sticks). Here's what to expect when you come in for an oral cancer check.

• First, we'll ask you to remove any dentures, partials, piercings, grills, or other mouthware you may commonly use.
  
• Next, we'll visually inspect your face, neck, lips, jaw, and mouth for any visible abnormalities. There are lots of things that fall into this category, from obvious lumps to subtle open sores to a simple asymmetry of the mouth.
  
• We'll also listen to your speech for signs of slurring or other indications that perhaps there is a sensitive area or a malformation somewhere along your gum line or tongue.
  
• Then, we'll feel along your neck and your jawline for any bumps that were too small or hidden to see.
  
• And we'll follow that up by feeling along your lips and along the insides of your cheeks.
  
• The tongue comes next. First we'll ask you to stick it out and we'll look at the top and bottom. Then, we'll gently pull your tongue out, squeeze it a little, and then move it around a bit so we can get a clean look at the sides and bottom.
  
• With our mirrors, we'll carefully examine the roof and floor of your mouth.
  
• Finally, we'll feel the roof and floor of your mouth, again looking for any bumps that our visual inspection missed.
  

If we find anything in this examination, we may recommend you get a biopsy so that we know exactly what we're dealing with. It's a simple, 20-minute procedure that we're offering free all this month. So come on in and get 'poked and prodded' — all for a good cause — your own health.

Are You At Risk for Oral Cancer?

Last year, nearly forty thousand cases of oral cancer were reported, and nearly eight thousand people died from oral cancer or the complications thereof. The National Cancer Institute estimates that a minimum of twenty-one thousand men and nine thousand women are diagnosed with oral cancer; most of them are over 60 years of age, although a growing number of younger people are being diagnosed.

Oral cancer appears in the tissues of the mouth or lips or in the back of your throat (technically called the oropharynx). As with most cancers, the tumor found in oral cancer isn't deadly by itself, but if left alone, it will send out cells that will settle in other parts of your body and create new tumors. Should one of those new tumors end up in a vital place like your heart, brain, or another organ, the cancer can become lethal.

The risk factors for oral cancer are several. Age is the biggest one, with people over 60 being the largest risk cohort. Very closely following age is tobacco use -- cigarettes, snuff, and chewing tobacco are all culprits. Less common but still widely prevalent is HPV -- the Human Papilloma Virus, a sexually transmitted viral infection that can take up residence in your tonsils and tongue, where it is believed to cause cancer of the oropharynx.

Less powerful but still influential factors:

* A diet lacking in multicolored fruits and vegetables.
* Overexposure to the sun.
* Chewing of betel nuts (a common substitute for chaw in Asia.)
* Overexposure to alcohol, especially in conjunction with tobacco or betel nuts.

By far the easiest way to deal with oral cancer, as with any cancer, it to find it in its early stages before it starts to spread. That's why we at Dr. Eric Johnson's office encourage everyone to get their mouths checked — and to get the ball rolling, we're offering free oral cancer exams (a $93 value) to anyone making an appointment in the month of April. Come in and get yourself checked — it only takes 5 minutes, and the mouth you save may be your own!

Modern Family-Oriented Dentistry Is Much More Than You Think

The time was fairly recent that you could expect a so-called 'family-oriented' dentist to be able to do about four things well; clean teeth, fill cavities, pull teeth, and make braces. But in recent years, dental techniques have proliferated faster than TV shows making fun of politicians, and many of them have been absorbed into the canon of the general dental practitioner.

A modern-day family dentist like Dr. Eric Johnson can be expected to do everything that a dentist of twenty years ago could do -- and also create stunning veneers, perform gum surgery, do laser cleaning of stained teeth, create and install implants, crowns, and bridges, and more. Check out some of the amazing things that this modern family-oriented dentist can do for you and your loved ones:

Inlay and Onlay Crowns
Sometimes a truly damaged tooth can only be treated by removing the deteriorated part. Dr. Johnson will sculpt a custom-molded porcelain insert that will exactly match the removed area in both size, texture, and color. The result is the closest thing to a brand-new tooth that dentistry can provide.

Dental Implants
If you've lost a tooth or teeth completely, an implant may be the right answer. A titanium post is placed into your jawbone, where it anchors itself, and the implant is then wired to the post exactly like a real tooth is held in place by its root. The result is a new tooth so lifelike that you might not be able to tell the difference, much less your friends.

Whitening
Tooth whitening is all the rage these days, and Dr. Johnson's office offers the best techniques for getting the job done right the first time and for a long time.

Gum Recontouring
If your smile is nearly half-gum and your pearly whites don't shine underneath all that pink, talk to our office. We can bring you in, use a laser to 'peek back' that unwanted gumminess, and have you walking out the same day with a beautiful, "un-begumming" smile.

This is just a taste of the advanced techniques that a modern family-oriented dentist like Dr. Eric Johnson can perform for you and your family. To learn more, call or drop by the office today!

Why a Family-Oriented Dentist Matters

One question that a lot of young couples never ask themselves when they first realize that they're going to be transitioning from couple to family is "what do we do about dental care?" They've already got a lot going on, and oral health at that age isn't often dire enough to be an everyday concern. But they'll realize one day soon that a family-oriented dentist that can handle both spouses (spice?) as well as the children is an invaluable resource.

Why?
First, consider your children. If you choose a young and able dentist, you could potentially be setting up your child with a lasting relationship that will carry them into their adult years. This has several benefits -- not only will your child get to have a dentist that they respect, but also one who knows their oral health inside and out (no pun intended).

Second, consider the benefits of a dentist that is quite well-practiced in the basics. A family-oriented dentist that is accustomed to doing cleaning, fillings, x-rays, and simple extractions can take care of those basic operations more quickly and less expensively than a specialty dentist who spends most of his time working on more complex cases.

Third, consider the impact on your schedule. If you have to arrange for separate appointments for every member of your family at different dentists, you're going to spend a lot of unnecessary time working everyone's schedules around those appointments. Having a single afternoon when everyone can get their teeth taken care of is much more affordable in terms of time.

The Best Reason to Seek Out A Family Dentist
The thing that separates a family-oriented dentist from a run-of-the-mill dentist is a simple change in focus, from the dentistry itself to the people being dentist-ed. If you have a young one or an adult that's afraid to go to the dentist for whatever reason, a family-oriented dentist is the right person to make a beeline for. Family-oriented dentists concentrate on their people skills and on helping people overcome this fear -- and that focus is what makes them perfect for dealing with families of all sizes.

If you've got a frightened child of any age who needs to get in to see a dentist, call Dr. Johnson's office for an appointment today.

Family Dentistry vs. Children's Dentistry

Truth be told, when you get into the technical details, most dentists can handle the typical child's dental needs -- and many dentists advertising themselves as 'children's dentists' will still send your child to a pedodontic specialist if they come up with an oral issue that requires special child-specific treatments.

So what's the difference between a family-oriented dentist and a children's dentist? The answer is that it's almost entirely in the gift-wrapping. If you walk into a dental office and find pastel wallpaper, Sesame Street toys bolted to the walls, and Highlights for Children on every desk, you've found a children's dentist. If you walk in and encounter a light and breezy atmosphere with a nice central table bedecked with Sports Illustrated and Home and Garden, you've probably found a family-oriented dentist.

In short, a family dentist will treat the entire family -- not just in the chair, but from the moment you walk in the door. You'll find that the waiting room is just as pleasant for you as it is for your child, and that the dentist will be just as comfortable talking in adult terms with you as he is explaining things monosyllabically to your toddler.

Similarly, a children's dentist will tend to have a schedule that makes room for school, but doesn't particularly move around your work schedule. A family-oriented doctor will tend to have normal business hours during school time, but will make up for the interruption by transitioning smoothly from your appointment to your child's to your spouse's all in one block so that you can all get back to your lives.

At Dr. Eric Johnson's office, we practice family-oriented dentistry, not children's dentistry. Dr. Johnson can and does work on children on a regular basis, but it's not something he concentrates on exclusively. It's better to be able to serve the entire family in one place than to have a place to take the kid and a different place to get your dental work done.

If you're not certain that your kids would be comfortable in a family-oriented office rather than a children-specific one, we offer you our invitation -- drop by and see for yourself; it's the only way you'll know for sure.

What Does It Mean to be 'Family-Oriented'

There are several different kinds of dentist. Not only do you have the classical medical divisions of oral surgery, orthodontics, periodontics, prosthodontics, endodontics, and pedodontics, but there are also different kinds of simple everyday 'DDS' dentists. You have your dentists that thrive on serving single clients with high-end demands and matching purse strings, your dentists that specialize in Medicare clients with the most basic needs, and you have family-oriented dentists that handle the bulk of American dentistry.

But what does it mean to be family-oriented? Here at Dr. Eric Johnson's office, we have a simple policy: if it makes a family's life easier, it's family-oriented -- and we strive to be family-oriented in all aspects of our work.

Your Time Is the Best Time
The leading challenge faced by the modern family, of course, is time management. Our office is open 7am two days a week, and 8am two days a week so we can take care of most children's dental needs in time to get them off to school in the morning or after school. For extraordinary circumstances, contact Dr. Johnson about an off-time appointment.

Trust and Communication
The foundations of any relationship from true love to that one between a dentist and his client, trust and communication are critical, and these are two things Dr. Johnson's office holds in high regard. Our goal is to ensure that you always know what's going to happen next -- both yours and our responsibilities to each other going forward. And suffice it to say, we pride ourselves on being trustworthy: if we tell you something, unless a true disaster occurs, it will happen.

Handling Your Issues
Of course, you can't be family-oriented if you can't deal with the problems that a typical family is going to bring you. That means more than just typical dentistry, because the 'typical' family needs more than just a yearly scrubbing and the occasional retainer these days. Your son or daughter expects to be able to look perfect for her prom, and there's no reason you should have to go to a special dentist to make it happen. At Dr. Johnson's office, we offer aesthetic, implant, and general dentistry to provide the full range of needs your family is likely to come up with across their lifetimes.

Are we a family-oriented dental office? We're certainly doing everything in our power to make it so. Drop by for a chat and find out for yourself!

38 Years in Orange County and Giving Strong

For the last thirty-eight years, our office has provided the most cutting-edge proven services available to our clients here in Orange County. Dentistry is a frequently-changing field, and there are always a variety of experimental treatments on the horizon. As a doctor of dental surgery, Dr. Eric Johnson keeps his office up to date about the latest options and is constantly training in ultramodern techniques.

Here's a small sampling of the services we offer today that simply didn't exist when this office opened back in 1975:

* Porcelain Veneers: beautiful tooth-colored surfaces that simply bond into place right over your natural teeth, veneers are the instant way to a perfect smile no matter how bad your teeth look.

* Invisible Fillings: by using tooth-colored resin rather than toxic mercury or soft silver, you can take care of your cavities without losing any of your mouth's beauty.

* Gum Recontouring: If you have a smile that's just as much gum as it is tooth, you can benefit from gum recontouring. We take your gums and move them upward (or downward as is necessary) to expose more of your natural teeth, making your smile broader-looking and more beautiful.

* Titanium Implants: No more taking out your dentures at night — or having them fall out by accident. With dental-grade titanium bonding your dentures, bridges, or custom crown to your jawbone, they're sure to stay put perfectly.

* Laser Dentistry: The cutting edge of oral hygiene, laser cleaning is thorough, fast, and effective. Gum disease can be fought using laser light and an antimicrobial solution in combination to have you walking out in no time, with no powdery after-feel in your mouth.

Of course, these are only the beginning of the story. Not only does our office have a 38-year legacy of keeping current with dental techniques, but we maintain an ultramodern office and back office as well. From our assertive and knowledgeable financial coordinator who has no problem talking down a hesitant insurance provider to our extraordinarily competent office manager who keeps everything running like buttered silk around the office. Our specialist team keeps up on the latest developments in their fields as well.

Come visit us and we'll be happy to show you what thirty-eight years of constant improvement and advancement can do for a dental office — and for its patients.

38 Years of Community Service: A Dental Dream Team

You might not generally think of community service as a reason to choose one dentist over another — but when you're in the OC, you have to choose between a few different dental offices that all have good reasons to call themselves "the best". None of them are going to be anything less than amazing when it comes to serving you. You won't find many 'fly-by-night' tooth-crackers in Orange County. But that doesn't mean that they're all the same, either.

Take mine, for example. I'm Dr. Eric Johnson, and I'm quite proud to be the latest dentist to work at our office with a thirty-eight year history of service to the OC community and the world abroad as well.

You can find several dentists in the OC that offer amazing resumes. But you'll only find one with my record of service. Whether it's donating thousands of dollars to the San Clemente Boys and Girls club or taking USC dental students to perform pro-bono dentistry for the populations of El Salvadoran villages, I have always prided myself on my connection to my community and my world.

When my wife first saw the world's tallest man, Sultan Kosen, on a television special, she told me unhesitatingly that she felt for the man. His overactive pituitary gland made his body grow uncontrollably and resulted in crippling problems in many parts of his body — including his teeth. I as well as a small group of specialists and labs provided the man with a full-scale surgical and cosmetic smile makeover. He left smiling — and able to properly chew his food; a first for the eight-foot giant of a man.

There are no words to describe the feeling I get when I'm able to help another human being. I have it written on my website, on the walls of my office, and on the inside of my heart: I believe that I exist to help others have a better life. Being the most recent face of a practice with a 38 year legacy of service has given me plenty of opportunities to prove that maxim over and over again.

The 38 Year Difference: Part II

So, the first part of this duet — The 38 Year Difference Part I — started to describe what it's like to have a dental clinic that has decades of customer service experience under it's belt. Our mental tour had just arrived at the high-tech VIP consultation room, where Dr. Eric Johnson was just asking you what we wanted out of your smile. You tell him you're interested in veneers.

As he listens carefully to your answer, Dr. Johnson takes notes, and starts to sketch. He takes measurements of your face, jaw, and teeth. He takes a mold of your teeth, and starts to make adjustments. Within a surprisingly short time, you are presented with a beautiful wax mold of what your new smile will look like. What's more, that same mold is used to apply a temporary veneer to your smile, so you actually see in the mirror exactly what your new smile is going to look like.

That's what real dental service is like — you know, before you ever commit yourself to the chair, what the results will be when you stand up again. Before you return to the reception area, you express a concern to Dr. Johnson — how much is this going to cost? Can you afford it?

Dr. Johnson directs you to the Business Team. They will listen carefully to your concerns. They will work with you to come up with an option that you are comfortable with. You will know what your financial responsibility is before any dental treatment is performed.

Once the financial side is set to go, the Business Team will confirm your next appointment. If you are scheduled to see our dental hygienist, Marlena, she will greet you and take you back for your dental hygiene appointment. When your hygiene appointment is complete then it is a short wait for your veneer appointment and your smile to be as perfect as it can be.

Do you see what 38 years in the business can do for a dental practice? If you think that's impressive, wait until you see what it can do for you.

The 38 Year Difference: Part I

One of the things that separates a truly quality dentist from just another oral surgeon down the street is detail. Not just attention to detail, but even more fundamentally than that, an understanding of the details that form the basics of a dental experience.

For example, when you come in to Dr. Eric Johnson's treatment room, we don't put you in a beat up old pleather chair and come at you with a giant third-degree-interrogation light. We give you a neck pillow. We put on a soothing aromatherapy scent. We give you an iPod equipped with relaxing music and Bose acoustic noise-canceling headphones. And the chair — is real leather.

You're probably imagining what that's like right now — and you should be. We've spent nearly four decades perfecting our routine with the goal of making you look forward to coming to the dentist. That's what we refer to as the '38 year difference' — the effects of a long legacy of deeply attenuated customer service.

Of Course, it doesn't start and stop with the chair, either. Every aspect of our office, from the wide-open and calming reception area to our modern and inviting VIP consultation room, is designed to show you that you are in good hands. Our six person team includes a full time Registered Dental Hygienist, two Registered Dental Assistants, a Financial Coordinator, and an Office Manager, as well as Dr. Johnson himself. Each one is an absolute professional in their field and has performed minor miracles of dentistry and/or administration in their time with us.

So, imagine again: you walk into a beautiful earth-toned reception room. Brightly colored fresh seasonal flowers greet you atop a glass table that marks the centerpiece of several soft, comfortable chairs. Modern art and a flat-screen television hang on the walls, providing no shortage of captivating visuals. Centered in the reception area there is no glass partition which gives you clear access to the Business Team, Stephanie and Tracey.

Stephanie or Tracey will give you details of your appointment. When Dr. Johnson is ready for you one of his Registered Dental Assistants will take you to the VIP consultation room, where he asks you what you want from your smile.

What happens next? Read The 38 Year Difference: Part II next week to find out!

Three Effective Options of Teeth Whitening for Wedding Pictures

There are lots of ways to get your teeth whitened for wedding pictures, but all three of the most effective share one common attribute: a dentist. There's not that much that you can do at home that has the same effectiveness as professional teeth whitening. For wedding pictures, you want the best, so talk to a dentist as soon as you've set a date for the nuptials.

Traditional Teeth Bleaching
A traditional whitening procedure can take a few visits, and they have to be somewhat separated — but it's very thorough, whitening every part of your teeth. You have to make certain that you get the process started with enough time to get the last session complete a few days before the wedding, but other than that, this is probably one of the least bothersome ways of getting your teeth whitened. For weddings, it's probably the best overall option.

Veneers
If your teeth are really bad — if you're a coffee-swilling, cigarette-smoking, blueberry-and-vegemite eating type of gal — you can opt to get veneers. These thin porcelain facings that bond to your natural teeth give you a beautiful perfect smile. You have the veneers for life, so as long as you take care of them your smile will be beautiful for any occasion.

Laser Teeth Whitening
For wedding parties — the bridesmaids, father of the bride, and so on — it might not be as important to get the extraordinarily thorough whitening of a full-on traditional bleaching. For these folks, a lightning-fast, single-visit Laser teeth whitening can be the answer. Generally done in an hour or less, in a single visit, this kind of 'less important' scenario is exactly what laser teeth whitening is for. Wedding parties that don't want to spend a lot of time getting their teeth whitened can take this option for a quick and effective whitening session.

One final note, make sure to schedule the teeth whitening for your wedding pictures well in advance so you can make sure there is available time in your dentist's schedule. Also, when it comes to scheduling, make sure to have your whitening session about 30 days in advance of the groom's dinner. This will insure your teeth will not lose any of its shine by your wedding day, and allow ample time to correct any problems should they occur.

Teeth Whitening for Weddings: Home vs. Professional

There are literally hundreds of products and services out there designed to get your teeth white for important and well-photographed times in your life. Figuring out which one is the best depends a lot on what you expect from your teeth whitening. For weddings, you want the best possible results, because you never know when someone is going to snap an extreme close-up of your face, and you don't want any flaws in your smile.

The Problems with Home Teeth Whitening
For wedding parties—and especially the bride and groom—it's an absolute necessity that you be as photogenic as possible at the wedding and at the reception. While you could certainly trust your smile to some form of gel-based or strip-based home teeth whitening system, it's not a good idea.

Strips leave significant gaps along the inward-curving surfaces of your teeth that don't get white, and it shows up clear as day in professional close-ups. The whitening substance just doesn't get where the strip doesn't go, and that includes every single surface between any two teeth.

Gels contain humectants like propylene glycol and many also have harsh bleaching agents so that they work quickly. The problem here is that these ingredients can severely irritate the gums, leaving them red and raw—which will show up in the pictures you have taken.

Gums, Toothpastes, and Home Remedies like "mix charcoal dust with peanut butter and brush your teeth with it" all have the same basic problem — they don't do crap. They might whiten your teeth a shade or two if you use them regularly for a few months, but they won't ever work as proper teeth whitening for weddings. You need WHITE teeth, not merely "not yellow" teeth.

The Answer is Professional Teeth Whitening
For weddings, there is simply no substitute for professional teeth whitening. Talk to your dentist and schedule your appointment for at least 30 days before the rehearsal dinner. That will give you as few chances as possible to stain your teeth in the interim, but also enough time to make sure, if there's a problem, that you have time to fix it before the critical moment. There's no good reason to use any other methods of teeth whitening for wedding pictures.

Teeth Whitening for Weddings: Pre-Nuptial Smile Care

So, you're going to get married, and you know that you want to get your teeth whitened. For wedding parties, it's usually suggested that every one of the bridesmaids and groomsmen get their teeth whitened so that they look their best for wedding pictures. But it's not a good idea to get it done the day before the ceremony, because even the most professional dentist can't give you a 100% guarantee that nothing will go wrong.

Why Smile Care?
It's important that you understand exactly what you are whitening your teeth. Wedding pictures and videos are memories that you're going to be looking back on fondly in years — possibly decades — and the better you look in those pictures, the more you'll enjoy the memories. No one wants to look back and get distracted because their teeth are yellow or stained in their wedding pictures. That's why it's critical that you not only get your teeth professionally whitened, but you engage in a few days of intensive smile care to make sure that those pearly whites stay both pearly and white.

Things to Avoid

• Drinking coffee, black or red 'rooibos' tea (green, white, and herbal are fine), and other dark drinks, including any form of cola.
  
• Red wine, cranberry juice, and other dark red drinks are also no-nos.
  
• Smoking anything, but particularly cigarettes.
  
• Popsicles and other frozen desserts that have bright artificial colors.
  
• Balsamic vinegar, unless you eat it with lettuce or spinach. Green leafy veggies form a protective barrier over your teeth, so eating salads with balsamic dressing is still safe.
  
• Similarly, dark Asian sauces from tamari to hoisin are best avoided.
  
• Tomato sauce, especially in the form of spaghetti sauces with artificial colors.
  
• Any highly acidic foods like citrus foods won't necessarily stain your teeth themselves, but they can cause minor enamel damage that will make your teeth more prone to staining.
  

Things to Do

• Brush and floss regularly, even if you're not usually in the habit — it's a good idea in general, but especially when you're trying to keep your teeth clean for your big day.
  
• Eat the aforementioned green leafy vegetables, and if possible, a small salad with each meal.
  
• Finally, green and white teas are great for your dental health, strengthening your enamel.
  

Make a Shining Impression on the New Family with Teeth Whitening for Weddings

One of the most nerve-wracking parts of a wedding is seeing your spouse's extended family for the first time. If everything goes well, you still have to remember that, for many of these people, you're making a first impression that they'll never forget.

That's not the only reason that you need to look and feel your best at your wedding — but it's a pretty big one. There are a lot of steps you ought to take in order to look your best for your wedding. You may want to get a manicure and a haircut, and it's probably best to get a facial as well. But perhaps one of the most important things you can do to prepare for your nuptials is make an appointment with your dentist to get your teeth whitened. For weddings, there's nothing quite as impacting as teeth that compliment your dress — it's a first impression that the in-laws will remember for years.

You might want to talk to your dentist a month or so before the ceremony is planned so that you can find the best time for your teeth whitening appointment. Depending on which techniques the dentist is going to use to whiten your teeth, you may need more than one appointment. You definitely want to leave an extra few days between the last appointment and the ceremony just in case the process doesn't go quite perfectly.

Attention to detail is the measure of success for any wedding, and getting your look perfect so that your new family sees you at your absolute best is a critical detail to attend to. There are very few wedding planners that will think to care for your pearly whites as part of the preparation, so take control of your own teeth whitening.