We have launched our new website. We are excited how it turned out and want to share some of the new features.

• You can see can request appointment dates/times and we'll get back to you as soon as we return to the office. 
• New patients can access new patient forms to expedite the new patient appointment
• Patient testimonials are easier than ever to see.
• Our patients can leave their own kind words about our office
• New patients can take a virtual tour through our office complete with pictures and biographies

• We have consolidated our blog with our new website. We hope you will jump over to RoswellGAFamilyDentist.com/blog to continue reading our important dental health tips. 

Why Should You Keep Your Dental Appointment

You get the email reminder. Your finger hovers over the reschedule request button. You just don't have time to go get your teeth cleaned. Does this sound like you? I cannot tell you how many times we hear this scenario in our office. Thankfully for them, our patients generally click confirm appointment and take care of their dental health. We hope this is because we have promised to partner with them to take care of their smile.
Countless dental research has proven that regular visits to your dental care provider helps to maintain dental health. Regular dental cleanings by a professional helps to remove calculus that cannot be removed by home care alone. Additionally, decay is always easier and less costly to treat when diagnosed and treated early.
We look forward to each appointment and enjoy sharing our knowledge with our patients. We care about your oral health!
So, the next time you get that email or text reminder, just go ahead and reply confirm. We promise to greet you with a smile and you get to leave with a healthy and clean smile!

The Smile Team at Dr Brian Johnson's dental office

Part Six "The Link Between Oral Health and Over-all Health"

 
This is part 6 of a fantastic series of articles explaining  the link between oral health and overall health. The article was written for dental professionals but really is great. So, please read through and remember to ask our team for any explanations that you may need.
Dr Brian Johnson

 It Is All Related

Why don’t we just get up on our soapboxes and scream at the top of our lungs, “It is all related!” For years, as a profession we have dabbled in the concept of the oral systemic relationships between the oral inflammatory processes that we have all worked with for decades and the systemic inflammatory processes. It is an exciting time in the field of dentistry right now. We are motivated about the future of dentistry and dental hygiene, and we have the ability to really make a mark in the history books! However, if we continue to allow others to educate patients about the oral systemic links, and we take a step back, we’re going to get left behind. There are professions now making the connections faster and with more excitement than we have been. Recently I had the opportunity to have a detailed conversation with an RN who was working with students, as well as within an ICU unit. She indicated she had been working with a group of CNNs, LPNs and PAs who were attempting to get more information about how to be preventive in regard to the respiratory illness that seem to be paramount with patients with NG tubes or intubated patients. If there is a tube down someone’s throat for any period of time, the likelihood that it will immediately begin to form a biofilm is high. This biofilm, which is not regularly removed, is then aspirated down into the lungs of the patient, who can then develop a respiratory illness on top of the original situation that hospitalized he or she in the first place. These professionals were discussing the options to reduce this occurrence – including products containing xylitol, controlling bacterial loads within the patient’s oral cavity and repopulating good bacteria. The RN was appalled by what she found when she researched all of this information. Neither her dentist nor her hygienist had ever mentioned all of the links before. Learning that these preventive measures had been around for years, she asked me what the dental profession is now doing with the information. There is quite a bit of information about the oral-systemic connection present in everyday media. However, much of the information is not from dentists or hygienists. What is this saying about our profession and the stand that we are taking about educating the public about this important topic? At the joint ADA/AMA conference in February 2006, it was stated that “oral health conditions and other health conditions are more closely related than many may once have thought, and viewing them as separate matters no longer makes sense.” At this point as a profession, we needed to band together and take collective action. But still professionals are not becoming educated on the link between the mouth and body. If it’s just a matter of not knowing where to look, check out some of the articles cited in the sidebar. How many times have you had an appointment with a patient and asked if he or she has had any changes in medical history? Most the time you get the answer that it’s the same. And sometimes you find out later that the patient has recently had stents placed, a joint replacement or even a mild heart attack. Unfortunately, most of the time that this happens, it is because we asked the question in an ambiguous way, which leads to ambiguous answers. We have trained the patient to participate in this.

The author is Sarah Cottingham, RDH, BS and the article was published in Dentaltown Magazine in the January issue.

Part Five "The Link Between Oral Health and Over-all Health" -Diabetes

This is part 5 of a fantastic series of articles explaining  the link between oral health and overall health. The article was written for dental professionals but really is great. So, please read through and remember to ask our team for any explanations that you may need.
Dr Brian Johnson

 Awareness of Diabetes’ Impact on Other Diseases

The incidence of diabetes is on the rise worldwide. Chronic systemic manifestations of diabetes are primarily seen in the vascular system, with specific issues related to the microvasculature including retinopathy, nephropathy and neuropathy. Oral complications of diabetes include gingivitis, periodontitis, xerostomia and consequently, caries. Diabetes is bi-directional, with uncontrolled diabetes leading to periodontitis and severe periodontitis impacting glycemic control.

A researcher at the University of Sharjah in the United Arab Emirates, used a written questionnaire to evaluate the attitudes and awareness of patients with diabetes. The 200 subjects were seeking care at the largest diabetic clinic in Benghazi, Libya. The questions related to oral health and oral care.

The majority of subjects, 71 percent, had Type 2 diabetes, with 18 percent reporting Type 1 and 11 percent unsure which type they had. Subjects ranged in age from 17 to 78 years and had diabetes from one week to 40 years.

Dry mouth was experienced by 84 percent of the group. Smokers accounted for 42 percent of the group. The majority had teeth, but 31 percent were edentulous with only 44 percent of them wearing full dentures. Only 17 percent brushed twice daily and only 12 percent reported daily flossing. The dentist was the primary source of information about oral complications of diabetes and oral care. Those reporting oral infections also had high glycemic control scores. Less than 50 percent were aware that dental diseases are complications of diabetes.

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Clinical Implications: Education is needed from both dental and medical professionals addressing the oral complications associated with diabetes and the importance of good oral hygiene and regular dental care.

  The author is Trisha O'Hehir, RDH, MS who is the Editorial Director at Hygienetown Magazine

Part Four "The Link Between Oral Health and Over-all Health" -Diabetes

This is part 4 of a fantastic series of articles explaining  the link between oral health and overall health. The article was written for dental professionals but really is great. So, please read through and remember to ask our team for any explanations that you may need.
Dr Brian Johnson

Diabetes Part of Multiple Risk Factor Syndrome

Periodontal disease is the sixth-most-common complication of diabetes. The primary cause of death for those with diabetes is cardiovascular disease with risk being three-times higher in people with Type 2 diabetes mellitus (DM). A recent study showed a one percent increase in hemoglobin A1c (HbA1c) level associated with an 18 percent increased risk of cardiovascular disease.

This case report follows the diagnosis and treatment of a 62-year-old Japanese woman presenting with severe periodontitis and diabetes. She was diagnosed 10 years earlier with DM, was receiving daily insulin injections and had no other complications of diabetes besides periodontitis. She was also a smoker and took oral medications for high blood pressure and high cholesterol.

Clinically, several teeth were missing, anterior teeth were flared and severe bone loss was evident around some teeth with severe mobility. Plaque and calculus levels were high throughout the mouth. Periodontal treatment was provided including surgery and oral hygiene instructions. Following treatment her HbA1c level, cholesterol levels and blood pressure improved. The patient was then followed and remained stable for four years while receiving periodontal maintenance therapy. She then developed myocardial infarction. During this time she showed continuous deterioration of her HbA1c level and also increased periodontitis. Following coronary bypass surgery and re-establishment of periodontal maintenance therapy, systemic markers improved. The long-term clustering of these risk factors is associated with development of heart problems.

  The author is Trisha O'Hehir, RDH, MS who is the Editorial Director at Hygienetown Magazine

Part Two, "The Link Between Oral Health and Over-All Health"-Diabetes

 This is part 2 of a fantastic series of articles explaining  the link between oral health and overall health. The article was written for dental professionals but really is great. So, please read through and remember to ask our team for any explanations that you may need.
Dr Brian Johnson

Diabetes and Dentistry

Diabetes mellitus (DM) is a relatively common metabolic disorder affecting approximately 10 percent, or 20 million Americans, with the incidence increasing. DM is a bi-directional disorder, affecting oral health and oral health affecting DM. Three primary types of DM are Type 1, Type 2 and gestational DM. Type 1 accounts for 10 percent and Type 2, 85-90 percent. Gestational DM occurs during pregnancy and in most cases resolves after childbirth.

Type 1 DM is generally diagnosed in childhood. Insulin deficiency is caused by autoimmune destruction of pancreatic beta cells. Onset and diagnosis occur rapidly, as symptoms of dehydration from hyperglycemia and ketoacidosis can lead to coma and death. Those with Type 1 DM require daily insulin injections. The body type for Type 1 DM is lean.

Type 2 DM was considered an adult disease, being diagnosed in overweight and obese adults over age 40. These traditional criteria are becoming blurred as more overweight young adults and children are being diagnosed. Insulin resistance precedes diagnosis of Type 2 DM. A confirmed diagnosis includes a defect in both the action and secretion of insulin. Diagnosis might be delayed for many years, until complications of DM are recognized. Type 2 DM is often controlled with diet and in some cases, oral medications.

Gestational DM may be a predictor of DM later in life, as 50 percent of those with gestational DM remain at risk of developing Type 2 DM later in life. Diagnosis of gestational DM provides an opportunity to initiate prevention strategies early.

 Periodontitis is a well-documented complication of diabetes mellitus (DM) and periodontitis might increase the risk of poor metabolic control. The subgingival microflora associated with periodontitis does not differ between those with and without DM, but those with DM have an exaggerated inflammatory response. In 1993, Dr. Löe proposed that periodontitis be considered the sixth complication of DM. The first five are: retinopathy, nephropathy, neuropathy, macrovascular disease and poor wound healing.

Those with DM have excess glucose in the blood due to a deficiency of insulin secretion or an increased cellular resistance to insulin actions. This leads to a variety of abnormalities involving fats, carbohydrates and proteins. One pathologic mechanism associated with excess glucose leads to the formation of advanced glycation end-products (AGEs). AGEs bind to receptor sites (RAGEs) on endothelial cells of the blood vessel walls and monocytes. These mechanisms are linked to the five identified complications of DM. This might also explain the link to periodontitis.

Periodontal inflammation dumps a variety of cytokines into the blood stream from oral tissues that travel to other areas and tissues of the body. These cytokines trigger an overall systemic immune response and antagonize insulin. In some cases, periodontitis is the first sign of DM. Thirty percent of those with Type 2 DM have yet to be diagnosed. Dentists and dental hygienists play an important role in the recognition of the early signs and symptoms of DM, often evident as periodontitis and poor healing following treatment.

 The author is Trisha O'Hehir, RDH, MS who is the Editorial Director at Hygienetown Magazine

Clinical Practice Supported by Research in Oral Health

The following is an article written by Trish O'Hehir, RDH and was posted in Dentaltown Magazine in January of this year.

Why is it Called Oral-Systemic Connection?

It’s hard to avoid this topic today, with a steady stream of articles and opinion pieces focusing on the associations between oral health and systemic health. Despite links between periodontitis, diabetes and cardiovascular diseases, the dental profession has difficulty convincing other health professionals and the public of the importance of these connections.

It is a start to associate the mouth to the rest of the body. A new organization was recently formed called the American Society for Oral Systemic Health. But are we perpetuating the separation of the mouth and the rest of the body by suggesting that oral health and systemic health are still two different things? Oral health is in fact systemic health.

Two professors at the University of Manitoba in Winnipeg, Canada, suggest the terminology should be changed, to ensure that oral health is recognized as part of systemic health and not a separate entity. They suggest using the terms “oral health” and “overall health” or even “oral” and “non-oral” health rather than “oral-systemic,” which unintentionally separates the mouth from the rest of the body. As an example, they suggest a physician wouldn’t discuss diabetes, an endocrine disease of the pancreas, by referring to the patient’s pancreatic and systemic health. Since the mouth is part of the body, oral diseases with an impact on other parts of the body are in fact systemic diseases and not oral conditions with systemic influence.

Stay tuned over the next few weeks for the rest of this fascinating series of dental health articles.
Dr Brian Johnson