Lewiston Dentist

…a short note from Dr. J…

johnson — Fri, 30 Jun 2006 17:26:29 +0000

We have always held fast to the notion that we are the best kept dental secret in the LC Valley. Over the past decade, we have treated thousands of patients like members of our own families, incorporated them into the decision making process, and provided exceptional and predictable care in all aspects of their dental health.

Our office has become increasingly thorough in the collection of pertinent records as they apply to not only your teeth, but to your general health as well. With this, we boast what we believe to be the best Soft Tissue Management Program (gum & bone health) in the area. Contemporary medical-dental researchers are finding disturbing links between your dental and general health, and we take our responsibilities to you, as your dental health providers, very, very seriously (click on our newsletter button and find the article entitled “Turtleneck Sweaters, Systemic Disease, & Your Gums” to find out more).

In a world full of clichés, slogans, and over used promises, it becomes more and more difficult to accurately identify what makes one office different from the next. Knowing this, we can honestly report that our office is not the biggest, not the fastest, and definitely not the most high-tech dental facility in the LC Valley. We have always been into relationship building, though, and believe that once you try us, you’ll want to stay forever.

Newsletters

johnson — Wed, 21 Jun 2006 06:25:01 +0000

In late 2004, our office delivered its first home-spun newsletter. Since then, we have been able to publish four newsletters a year, and have begun to stockpile a collection of articles which we are particularly proud of.

Please note that these articles are not considered to be completely factual, and may in actuality, be only brief overviews of incredibly complex topics. Similarly, several articles include the opinions of Dr. Johnson and may cover topics outside the realm of dentistry.

If you are not on our newsletter mailing lest, but you would like to receive one each “season,” please contact our office and we’d be happy to send you one when the time comes.

Tar Wars at Centennial Elementary School

dentist — Fri, 24 Mar 2006 04:43:22 +0000

     Thanks again Mrs. Harris and Mrs. Kinzer, for extending another invitation to Dr. Johnson to speak to your 5th Graders in February.
     Each year, the Idaho Academy of Family Physicians sponsors TAR WARS, which is a well organized, anti-tobacco program geared toward informing kids of the health risks, social implications, and costs involved with tobacco use. Interestingly enough, national statistics show less than 5% of 5th Graders use tobacco, but by the age of 14, that numbers climbs into the low 20’s.
With this knowledge in hand, it becomes apparent how quickly peer groups can begin playing a major role in a very short period of time. Hopefully, by informing such impressionable kids early on, we can begin knocking these numbers down significantly.
     Advertisers and “friends” don’t always tell us what is the best for us, so it is always wise to “Be Smart….Don’t Start.”
     If you’re interested in becoming a presenter, check out the WEB site at TARWARS.com.

This Five Star Life

dentist — Fri, 24 Mar 2006 04:43:06 +0000

     Funny how your life can change in just twenty years.
     1986. MTV still played real music, and Ronald Reagan was the President. Spring Break movies were all the rage…bikinis, waves, sun, and fun…you watched ’em too…I know you did!! Wow, what a life!!
     Now flash forward…Spring Break 2006. I’m now 40!! MTV…is it still on? George Bush II is President. Disney movies without profanity are now the rage…minivan, sacrificial mule deer on Highway 30, crunched fender and door, waves, Oregon Coast, wind, rain, and the stomach flu X 10. Wow, what a life!!
     About six months prior to Spring Break , my wife began making plans. As it ultimately played out, we rented a house in Brookings, Oregon for a week, shared the house with some friends from Bend, and got to see the Redwood Forest with our children. In addition, we got out of town for some time away from the office and the worries that go along with it.
     What Dealiah did not plan on was the flu, which hit our friends’ children first, crept to our kids, my wife, and then the tag-along kid we brought with us. Out of 11 souls staying in that house, ten of us got sick…and I mean yackity, yack, sick…within six days. Wow, what a life!
     Knowing that I am an early riser and that I would probably be up every day, hours before everyone else, I took some homework with me. Of the tasks I accomplished, I regretted starting the toughest job I have ever had to address…finding a replacement for someone in my office who I’ve always considered irreplaceable.
     Only four weeks earlier, Dena came to me asking for a couple hours off so that she could take her seven month old son to the doctor. “No problem,” I thought. “See you after lunch.”
Little did I know, but that would be Dena’s last request of me as her boss, perhaps forever, for after an assessment by her son’s pediatrician, baby Connor was sent to St. Joseph’s Hospital, and four days later flown to Children’s Hospital in Seattle with a life threatening infection which had settled in his lungs.
     Right after his arrival, he underwent elaborate tests to determine the extent of the viral infection, and was eventually put on a medication which sounded worse than the disease.
Further tests uncovered an immunological disorder commonly referred to as “Bubble Boy Syndrome,” which is treatable, but will require a bone marrow transplant to correct.
Dena’s older son proved to be a poor donor match, and neither Dena or her husband matched well either. Fortunately, five matching donors have been identified, but their availability is still unknown.
In the mean time, Dena’s friends and family are doing all they can to raise money to help Dena and her husband , Dennis, through this emotionally trying time. All the while, Dena is staying at the Ronald McDonald House in Seattle, getting to the hospital at about 9:00 a.m. every morning, and returning to her apartment at about 9:00 p.m. Dennis, now back to work, is able to be there three to four days a week, but had to come back to work here in Lewiston.
     After visiting with Dena while I was in Brookings, I couldn’t hardly keep back the tears, knowing in my heart that I would probably never work with her again. Moreover, I let her know I was searching for her replacement, and that we’d figure things out when she was finally able to return home.
     As I hung up the phone, I came to realize that we really do live a “five star” life and that we take a lot for granted. Namely, that our kids are all going to grow up healthy, happy, and will never get sick. I guess our brains just don’t think about the alternative…I know mine doesn’t.
     During that entire week, the Frei family was on my mind more than ever. I also had time to reflect on my life, the lives of my children, and the lives of my friends, and came to appreciate that we all have troubles, but that most of us are terribly blessed with stable jobs, good friends, a generous and caring community, and happy and healthy children, who despite their mouthiness, long hair, and occasional obstinate behavior, make us proud and complete our lives every day.
     Last year I read a book called “Good to Great,” which explored the difference between good companies and great companies. Before jumping into too much detail, though, the author mentioned one defining problem in our society. Specifically, that “good is the enemy of great”…that we are so content with just “good” service, that we don’t expect “great” service, or that we are so content with having a “good” life that we don’t strive for a “great” one.
     I guess what I am trying to say is this: based upon what could potentially happen in my life, I really have been blessed, and I want that good-fortune to continue in a “great” way. It really is a “five star” life we are living, after all, and I for one am going to strive towards its continuation.
We all tend to gravitate toward what we think about…our specifically focused thoughts and desires can and will become a laser beam of direction, and I don’t want to be just “good” anymore. I want the “five star” life, and I want it for you too. Let’s all be “great” together.

I Need a What?

dentist — Fri, 24 Mar 2006 04:42:48 +0000

     “I hate to be the bearer of bad news, but sometimes it’s my job.” Not really what you want to hear from your dentist, but sometimes it is my job, and despite my sincere wishes that everyone could come in with perfect teeth with no need for any treatment, that hasn’t been the reality of my world for 11 years now.
     With this in mind, I can tell you of two of the most frequent situations where a new filling is warranted and recommended:
     First, and most understandable, is the tooth with visible decay, or decay that can be easily diagnosed from an x-ray. This is what most of us grew up with and what most of us understand.
Such decay can take several years to show up on an x-ray, and is the end result of long standing plaque accumulation on a specific part of a tooth (often in between the teeth or somewhere within the deep pits and grooves on top). Paired with the sugars in our diet, the bacteria that live within the plaque excretes an acid (for little kids, we call it poop), which over time, literally eats a hole through the enamel. This hole is termed a “cavity,” and if left untreated, can destroy significant portions of the tooth’s remaining structure.
     The most confusing type of filling is done on a tooth which already has an existing filling…most frequently an old silver amalgam filling.
     Though there are some dentists who would recommend the replacement of every silver filling in your mouth, I am not one of them. Despite this, I do very few amalgam fillings anymore, and am very proud of the all white, bonded, composite fillings we place today.
     Regardless, some silver fillings just wear out in time, and for two good reasons:
     First, every metal in a wet environment will eventually break down, rust, oxidize, or corrode. If you don’t believe me, go look at your garden shovel.
     Second, under temperature extremes, tooth structure and amalgam fillings expand and contract at different rates. This puts excessive stress on the tooth and the acute angles of the silver filling itself.
     When it is time to replace the filling(s), they will typically present in a few ways. Sometimes, black or orange fracture lines (usually vertically oriented) will become visible, necessitating replacement of the filling or placement of a crown/onlay. In other cases, an orange, blue, or black “halo” will begin forming about the edges of the filling, indicating the presence of new decay between the filling and tooth. In other cases, the alloy will look like it is actually beginning to “creep” out of the tooth.
     If you see either of our dental hygienists, they will be able to surf around your mouth with a small movie camera, take photographs, and show you where the problems are. In such cases, a picture really is worth a thousand words, and if you wish, they’ll even make you a copy for your fridge.
     As always, this short report is not designed to answer every question that might come up, but rather to serve as a brief overview of something we see on a daily basis in our office. Please don’t hesitate to ask for clarification if you have any questions.

Alternative Rock – A Lesson in Business

dentist — Sat, 24 Sep 2005 04:41:05 +0000

I was alarmed by the observations of author Harry Beckwith, in his book “Selling the Invisible,” when he noted that despite the fact 80% of all working Americans are employed by a “service” industry, exceptional service is steadily declining. In fact, he notes that “service quality has sunk so low, that if no one complains about your service, you shouldn’t [necessarily] feel good. Most people have [simply] given up on complaining.”
A huge fan of the Dave Matthews Band, my wife had been seeking tickets to a concert for almost five years. Committed to seeing the band when it made its yearly stop at the Columbia Gorge Amphitheater, she tracked down two tickets as soon as they became available.
Just before leaving for the concert, that hot August afternoon, we stopped by one of our local department stores to pick up some new sunglasses for me. It was a Sunday, and after a five minute selection process, I made my way to the checkout line to pay for the $19 glasses. Twenty minutes later, and after switching lines, we made our purchase and left the store. Chalk one up Beckwith.
Later that day, we made it to the amphitheater, and since we had not eaten since breakfast, we found our way to the concession and “souvenir” area. As this proved to be the first concert that my wife had attended in about ten years, and the first I had seen in nearly 20 (…Loverboy, when they still had current hits on the radio), we wanted to mark the occasion with a concert t-shirt for her.
Regretfully, we stood in line for about 20 minutes as we watched one of the college aged women behind the counter construct a wind barrier out of empty cardboard boxes, and the other finish her cigarette break…all the while, watching, as the line grew longer and longer. Thank goodness we were near the front of the line to start with! Beckwith two—Service Zero.
When I was a student at the University of Idaho in the 80’s, I had the privilege of working at a fast food restaurant for three years, which was owned by F & K (Happy Day Corporation today). Love ‘em or hate ‘em, there is a great deal to learn from a well managed and successful restaurant…namely cleanliness and service. Right or wrong, I have done my best to emulate what I viewed as successful, and found many of the notions Harry Beckwith introduced in his book reminiscent of what I learned during my three years in the food service industry. In fact, I have often wondered about my potential for “phenomenal” future success, and if anyone would really want to read a book penned by me entitled, “Everything I Ever Wanted to Know About Business, I Learned From a Roast Beef Sandwich.”
Despite the difficulty we had with service prior to the concert, I must be honest when I say that the Dave Matthews Band, who, by Mr. Beckwith’s definition would qualify as a service provider, delivered in every sense of the word. I guess I was expecting some of the same “hair band” stuff from the 80’s, where lights exploded before your eyes and electric guitars pounded your eardrums until they ached, but I got more…much, much more. Closing out their three day stop at the Gorge, I believe we got their “A-Game,” and that what we received was worth every penny. In other words, Dave Brought It!
DMB and my office have no professional ties, but I can say without reservation that I hope that I “bring it,” to the office every day…just like they did. I will never be a performer, but I too provide a service which I am terribly proud of. I hope that if you ever have the opportunity to experience the Dave Matthews Band in concert, read Harry Beckwith’s book, or even introduce your children to the working world of food service via any of Happy Day Corporation’s restaurants, you will take it. Moreover, I invite anyone, in any service position, to take a proactive step toward improving the quality of their service. I, for one, will be doing just that, and I challenge all of my business friends and associates to do the same.

Sensitive Teeth. What to do?

dentist — Sat, 24 Sep 2005 04:30:10 +0000

Sensitive teeth can make your life miserable. Even your favorite foods can be impossible to enjoy, but in most cases, all is not lost. There are several treatments and recommendations which are often successful.
Before jumping into treatment options, it seems reasonable to first discuss what causes sensitive teeth (dentin hypersensitivity) in the first place. Keep in mind that typical tooth sensitivity, of the nature we are discussing in this short essay, can be treated easily and inexpensively. True dentin hypersensitivity is usually of a temporary nature, and will cause discomfort after eating or drinking something cold, or breathing in cold air. If the pain is more intense and prolonged, see your dentist, because the problem may be a symptom of a more advanced condition.
More times than not, the problem begins with recession of the gums. Like a turtle neck sweater, the gums hug the roots of the teeth, ending at the enamel-root surface junction. As gums recede, the root surfaces become exposed.
There are two main reasons gums recede: First, it is not uncommon to see patients who simply brush with too much pressure, or with a brush that is too hard. Over months and years of being too diligent with the brush, the thin and fragile gum tissue will literally shrink away.
The second cause of recession has to do with poor oral hygiene, which can allow plaque and tartar (hardened plaque) to accumulate around the teeth and gums. The bacteria in this plaque and tartar can lead to gingivitis and periodontal disease, both true infections, which can precede recession of the gums.
If you were to look at the surface of a tooth root under a microscope you would see the small pores or tubules which lead directly to the nerve. Since pressure and temperature stimuli can travel down these tubules and trigger pain, it becomes apparent why the gums are so important.
Preventing recession becomes a delicate balance, then, as brushing too hard can be a problem, and not brushing or flossing at all causes another. With this in mind, if you are a rigorous brusher, take it easy…use a Braun or Sonicare mechanical brush to control the amount of pressure you place on your teeth. Doing this for 2 minutes a day, flossing daily, and seeing your dental hygienist twice a year will certainly help. A similar regimen will also prevent the advancement of periodontal disease and gingivitis, but if you already have an underlying gum condition, more advanced care might be needed.
If the horse is already out of the barn and you are experiencing tooth sensitivity on the exposed roots, we usually recommend the use of sensitivity control toothpastes. The most frequently recognized paste of this nature comes from the Sensodyne family, and possesses potassium nitrate which is a great desensitizer. I usually recommend the plain Sensodyne initially, suggesting that my patients avoid any whitening or tartar controlling formulas. Two or three weeks of use will usually alleviate the problem.
Because brushing habits can be so ingrained in us, it is important to brush lightly or use either of the mechanical brushes mentioned before. You don’t want to immediately scrub off any of the “good” that the Sensodyne is doing by being to mechanically aggressive.
Keep in mind that highly acidic foods can work against you during your “recovery.” Citrus drinks, soda pop, and even tea can contribute to continued sensitivity, so keep their consumption to a minimum.
If you cannot obtain a comfortable level of relief, please call us for treatment. Once diagnosed, we typically place a fluoride varnish over the exposed roots and provide a fluoride gel for our patients to use as part of their nighttime hygiene ritual. We have had a great deal of success treating our patients in this manner, but are aware of other methods of treatment which are equally successful. Resin bonding agents or “oxalate” products can be placed or burnished directly on the affected sites.
All in all, exposed roots need not change your life. Safe, predictable, and inexpensive options do exist.

Partners in Health…For Your Kids

dentist — Fri, 24 Jun 2005 04:44:07 +0000

Joe Steven, a dentist in Wichita, puts out a newsletter every other month. To be honest, he uses the newsletter as a platform for KISCO, his dental product company which focuses on obscure gadgets, medicaments, and patient literature. Despite this, I find Joe’s newsletters very entertaining and insightful. Moreover, I have attended two different seminars that Dr. Steven has presented, and found him to be exceptionally wise in dealing with people. As a bonus, I have found many of his products to be incredibly useful and clever.
In one article, from about three years ago, he went into detail about how he raised his two daughters. One ultimately went on to dental school and the other went to law school, so Joe and his wife obviously raised some pretty bright girls. Joe did feel compelled, though, to bribe his girls at an early age with a $1000 promise.
This promise was actually a verbal contract for payment, in cash, to each daughter for $1000, payable on her 21st birthday. The catch? No alcohol. No tobacco.
Joe had been raised in this fashion, and along with ten other children in his family, was able to pass this tradition on to his daughters. As he puts it, “we have way too many teenagers drinking excessively just to have fun and fit in…many of us have known close friends or loved ones who are no longer with us because of teen drinking. The same holds true for knowing children who did poorly in school or dropped out…and of course, many teen pregnancies take place in conjunction with alcohol.”
As my wife and I work toward fashioning a similar tradition for our 10 and 12 year old sons, Dr. Joe and his wife “enjoy great peace of mind knowing that [their] daughters are not drinking and driving, and also knowing that alcohol won’t play a role when they are out with an overly aggressive date.”
Interestingly enough, with both daughters being sorority girls from KU, the Steven’s have watched in amazement as their daughters “party” with their college friends without the crutch of alcohol or cigarettes. This, despite being surrounded by numerous friends who do drink and smoke.
This superficial account of Dr. Steven’s article doesn’t do the notion justice, but I hope that for the parents and grandparents ,who might be reading this, I’ve got the wheels turning. Let’s face it. No matter how much we protect our children, they will be exposed to drugs, alcohol, and tobacco. Hopefully by helping them put off their decision to consume such products until later in life, they will be able to make more informed decisions which don’t hinge on peer pressure.
For anyone wanting a full copy of Dr. Steven’s article, please don’t hesitate to call for a copy.

Life…Welcome to the Dance

dentist — Fri, 24 Jun 2005 04:43:54 +0000

In late May, I had the privilege of visiting Creighton University, where I graduated from dental school a decade ago. To say that things have changed in Omaha since I left is an understatement. To say that my personal experiences in Nebraska rank in the top ten events of my life, a given.
Like David Letterman’s “Top Ten List,” I too have events that rank way up there. Though everything pales in comparison to marrying my wife five years ago, and being present for the birth of our twins, I must say that this reunion joined the list.
Under the guise of the “Spring Dental Assembly,” we headed out to the Midwest in celebration of the dental school’s “100 Year Anniversary.” Usually an event packed with continuing education courses, I instead took the time to show my wife where I once lived, the odd places I ate, and the massive dental clinic where I learned my craft. The cherry on the top of our trip came at two school sponsored events: the all school banquet, and the “Class of 1995” reunion.
To see the many faces was a thrill, but trading the stories was priceless. Though I can never imagine going through something as academically, mentally and psychologically demanding as dental school again, I can also never imagine what it might have been like without the group of friends I made there.
So, as we sat in the Salt Lake airport, during a six hour return layover, I had a lot of time to reflect. Truth be told, I just could not help but sit in amazement at how blessed I really am. I have a wonderful family (not perfect, but none-the-less a wonderful work in progress), I have a near perfect job with wonderful patients, an amazing place to work with great people to work with, and a beautiful community in which to live and practice.
For those of you who know my life story, you know that things haven’t always been that easy. Despite my successes, I took a tough route in getting to my current station in life. Regardless, I would not change a thing. Stuff happens for a reason, after all, and just like Garth Brooks sang several years back, “…I could have missed the pain…but I’d have had to miss the dance.”
I believe life is a dance. The dance is school. The dance is failed exams. The dance is your family. The dance is poopy diapers at midnight. The dance is all of that, AND MORE! I’ve lived it, complained about it, yet REVELED in it.
I’ll admit that I had classmates (at Creighton and the University of Idaho) who hated every second of school. Similarly, I hear people complain about how miserable they are about their jobs, their spouses, and where they are living. Misery and a present station in life, though, need not be permanent, so I always do my best to lend an ear to those in need, but do my best to not wallow in my own failings.
Ten years ago, I read a life changing book that was written by Anthony Robbins entitled “Notes From a Friend.” In the short book he talks about goal setting as if you could not fail, and how your “life goal list” can steer you in the direction you want it to go. He even describes some special training he received when he fulfilled a life goal of driving a NASCAR style race car.
Apparently, the training he received included what to do in the event of a “100 plus” mile per hour skid. Simply put, he was trained to NOT LOOK AT THE WALL. Instead he was told to look where he wanted to go (NOT THE WALL), and that his innate skills, as a driver and a survivor, would tell him exactly what to do. Sounds simple, huh?
Surprisingly, I find my “goal list” once in awhile, and look at all that I have accomplished on it. It is a mystery how, but perhaps it is reveling in “the dance,” or pointing in the direction I want to go that has helped me to this time in my life. Maybe it is the people I surround myself with, or a combination of everything. Regardless, I am blessed. Moreover, I hope that everyone has time in their lives to reflect and find the blessings in their lives. They are all around us, if only we take the time to look.

Doc, Aren’t They Just Baby Teeth?

dentist — Fri, 24 Jun 2005 04:43:40 +0000

WHAT A GREAT QUESTION!!
Yes, they are just baby teeth, but they do serve a purpose, and in most situations, your child will be better served by saving them.
Baby teeth, milk teeth, deciduous teeth, or primary teeth (whichever you prefer), are very important in the development of a child’s future dental health. First and foremost, they help guide the permanent (adult) teeth into position. As I express to parents, they keep spaces open for the permanent teeth until such time as these teeth are ready to come in…they are like God’s very own orthodontic retainer!
In other words, if a baby tooth is lost prematurely, due to trauma or decay, the neighboring teeth can shift and change the spacing in the mouth. This can potentially cause other problems, such as simple crookedness, or overcrowding when the adult teeth get ready to come in. Social and cosmetic problems can also emerge, and in extreme cases, speech can become affected. If left unattended, decayed baby teeth can also cause infection around adult teeth , affecting normal eruption and possible development of the surrounding teeth. Coupled with the systemic (full body) implications of any infection, it becomes apparent that keeping primary teeth healthy is in the best interest of the child. In some individual cases, this could involve keeping the teeth around for 12-14 years.
The first baby tooth should be visible sometime between the 6th and 10th month of life. Though every dentist knows the typical sequence of eruption for baby teeth, the logic for the order makes little sense. With this in mind, don’t expect everything to emerge in any particular order. Just know that by the age of three, you should see 20 milk white teeth.
By the age of six, most children will begin losing their baby teeth. Usually, the first to go will be the lower incisors, to be followed by the upper incisors. Don’t be alarmed at the size of the new teeth coming in…they are often quite large and may appear to be significantly crowded. If this is the case, or if other forms of crowding are apparent (cross bites or irregular jaw development) our office refers the child to one of our local orthodontists for possible early space gaining procedures.
I have never seen one of these young patients return to my office in wires and brackets, so don’t worry yet. Instead, a fixed or removable (like a retainer) appliance is often all that is needed. Caught early enough, extensive space concerns can usually be corrected in a matter of months and with a high degree of success.
Believe me when I tell you that there is a lot to know about childhood dental development and that there are countless books on the subject. Moreover, I don’t know it all, and I never will. In my office, though, I have put together a pretty good protocol for helping children maintain a healthy mouth which remains conducive to healthy adult dental development.
This protocol may or may not require early extraction of teeth, and may or may not involve the assistance of orthodontists or children’s dentists. Regardless, the plan is one I feel comfortable enough with to subject my own children to. By working together, I am confident that we can help maintain a healthy environment for your children’s mouths to develop in a normal and healthy manner.
Finally, I am not so naïve to assume that this very short article will answer every question you have. In this regard, please don’t hesitate to ask any question, no matter how silly you think it is. They are just baby teeth, after all, but they were put there for a reason. Let’s just keep ‘em healthy.