My Blog

Posts for: October, 2017

By Jeffery J. Johnson & Jodi B. Johnson DDS
October 29, 2017
Category: Dental Procedures
Tags: gum disease  
GumInfectionAroundToothRootsCallsforImmediateAction

Many people learn they have periodontal (gum) disease after noticing gum swelling, soreness or bleeding. But what you can see or feel may be only the tip of the iceberg — the damage may extend much deeper.

Gum disease is caused mainly by dental plaque, a thin film of bacteria and food particles built up on teeth due to ineffective brushing and flossing. Infection of the visible gums is only the beginning — left untreated, it can advance well below the gum line and even infect supporting bone.

One critical concern in this regard is the areas where the roots of a tooth separate from each other, known as furcations. Here an infection known as a furcation invasion can cause the bone to weaken and dissolve.

This usually occurs in stages (or classes) we can detect through manual probing and/or with x-rays. In the earliest stage, Class I, we might only notice a slight pocket in the gums with no significant bone loss. In Class II, though, the pocket between the roots has become a horizontal opening of two or more millimeters, indicating definite bone loss with increased pocket depth getting “under” the crown of the tooth. Class III, the last and most serious stage, describes an opening we can probe under the crown all the way to the other side of the tooth; the bone loss now extends “through and through” the furcation.

The basic goal of gum disease treatment is to remove plaque and calculus (tartar) from all tooth and gum surfaces. But removing plaque below the gum line, especially “into” the furcations, can be challenging. We will need instruments called scalers to clean root surfaces, assisted sometimes by ultrasonic equipment to vibrate plaque loose. With furcations we may also need to employ surgery to aid gum or bone tissue regeneration or to make the area easier to access for future cleaning.

Of course, the best way to protect against furcation invasions is to prevent gum disease in the first place. Be sure to brush and floss daily and visit us for thorough dental cleanings and checkups at least every six months.

And don’t delay contacting us if you see any signs of teeth or gum problems. The sooner we can identify gum disease, the more likely we’ll be able to prevent it from doing serious damage to your gums, bone and teeth.

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


By Jeffery J. Johnson & Jodi B. Johnson DDS
October 14, 2017
Category: Oral Health
Tags: thumb sucking  
MonitoringYourChildsThumbSuckingCouldHelpAvoidFutureBiteProblems

Although distressing to many parents, infants and toddlers sucking their thumb is a common if not universal habit. Most children phase out of it by around age 4, usually with no ill effects. But thumb-sucking continuing into late childhood could prove problematic for a child’s bite.

Thumb sucking is related to how young children swallow. All babies are born with what is called an infantile swallowing pattern, in which they thrust their tongues forward while swallowing to ensure their lips seal around a breast or bottle nipple when they nurse. Thumb-sucking mimics this action, which most experts believe serves as a source of comfort when they’re not nursing.

Around 3 or 4, their swallowing transitions to a permanent adult swallowing pattern: the tip of the tongue now positions itself against the back of the top front teeth (you can notice it yourself when you swallow). This is also when thumb sucking normally fades.

If a child, however, has problems transitioning to an adult pattern, they may continue to thrust their tongue forward and/or prolong their thumb-sucking habit. Either can put undue pressure on the front teeth causing them to move and develop too far forward. This can create what’s known as an open bite: a slight gap still remains between the upper and lower teeth when the jaws are shut rather than the normal overlapping of the upper teeth over the lower.

While we can orthodontically treat an open bite, we can minimize the extent of any treatments if we detect the problem early and intervene with therapies to correct an abnormal swallowing pattern or prolonged thumb sucking. For the former we can assist a child in performing certain exercises that help retrain oral and facial muscles to encourage a proper swallowing pattern. This may also help diminish thumb sucking, but we may in addition need to use positive reinforcement techniques to further discourage the habit.

To stay ahead of possible problems with thumb sucking or the swallowing pattern you should begin regularly taking them to the dentist around their first birthday. It’s also a good idea to have an orthodontic evaluation around age 6 for any emerging bite problems. Taking these positive steps could help you avoid undue concern over this common habit.

If you would like more information on managing your child’s thumb-sucking habit, please contact us or schedule an appointment for a consultation. You can also learn more about this topic by reading the Dear Doctor magazine article “How Thumb Sucking Affects the Bite.”


By Jeffery J. Johnson & Jodi B. Johnson DDS
October 03, 2017
Category: Oral Health

Good oral care is part of many people’s daily routine. However, only a fraction of people floss their teeth daily, a task that prevents serious gum diseasedental conditions like periodontal disease. According to the National Institute of Dental and Craniofacial research, periodontal disease is the number one cause of tooth loss, making its prevention crucial in maintaining your smile. Find out more about periodontal disease symptoms and treatments with Dr. Jeffery Johnson and Dr. Jodi Johnson in St. Louis, MO.

What is periodontal disease? 
Periodontal, or gum, disease occurs when the gums become irritated and infected with bacteria. These bacteria begin growing on the teeth, fed by the carbohydrates and sugars in the foods you eat, then harden into a sticky white substance called plaque. Plaque eventually hardens into tartar. The irritation in the gums causes pockets which form between the gum and the tooth, trapping bacteria and plaque, causing further irritation.

Do I have periodontal disease? 
While many people mistakingly believe that bleeding gums while flossing is a sign that they should stop flossing altogether, this is the opposite of the truth. Flossing removes plaque and bacteria from not just between the teeth, but under the gums, too. The process may cause your irritated gums to bleed at first, but will also clear out the bacteria causing the inflammation. Most patients notice that their gums stop bleeding after about two weeks of continued flossing. Other signs of gum disease include:

  • loosened teeth
  • unexplained bad breath
  • swollen or irritated gums
  • gums which pull away from the teeth
  • receding gums
  • sensitive teeth and gums

Treating Periodontal Disease in St. Louis
Most cases of mild to moderate periodontal disease clear up with a professional teeth cleaning and continued flossing. However, other, more serious cases, may require a more in-depth periodontal cleaning. Very serious cases require flap surgery, which cleans the tooth all the way to the tip of its root. Consult with your dentist to determine the best course of treatment for your periodontal disease.

For more information on periodontal disease, please contact Dr. Jeffery Johnson and Dr. Jodi Johnson in St. Louis, MO. Call (314) 427-7400 to schedule your appointment with your dentist today!