John W. Harden, Jr., DMD

Dentist - Atlanta

Emory University Hospital Midtown

550 Peachtree Street NE, Suite 1410, Atlanta, GA 30308

(404) 523-6236
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By John W. Harden, Jr., DMD
June 24, 2017
Category: Oral Health
Tags: nutrition   sugar  
ForYourTeethsSakeExerciseCautionConsumingEnergyorSportsDrinks

Energy drink makers would have you believe their products are a healthy rehydration choice for athletes while also giving them keener focus and renewed vitality. But before adding them to your sports regimen, you should also consider what effect these beverages could have on your teeth.

Energy drinks are similar in ingredients to sports drinks like Gatorade® and PowerAde®, which mostly consist of water, salts, vitamins, sugars and acids. In addition, energy drinks like Red Bull® and Monster Energy® add caffeine to boost energy.

Besides their sugar content, the main threat from a dental health perspective for both of these drinks is their acidity, which can severely erode tooth enamel. The irreplaceable loss of enamel significantly increases your risk of tooth decay and eventually tooth loss.

The threat of enamel erosion is especially pronounced whenever the mouth’s pH level falls below 5.5. The acidity of both sports and energy drinks falls well below this mark. In one experimental study samples of enamel exposed to a number of sports drinks lost an average of 1.5% of mineral content over five days; energy drinks more than doubled that loss at 3.1%.

Given the potential harm these beverages, especially energy drinks, can cause your teeth, you should exercise caution when consuming them. In fact, our best advice is for you to avoid energy drinks altogether, for your overall health as well as your teeth’s sake.

Unless you’re participating in a physically intense sport, water is your best source for hydration after exertion.  If you do drink sports beverages, try to limit them to meal times when your saliva is most active to neutralize mouth acid. You can also rinse out your mouth with water after drinking to help further reduce mouth acidity.

As an athlete, you’ve trained your body to be at its optimum physical peak. Don’t let energy or sports drinks take the edge off your health, especially your teeth.

If you would like more information on the effects of sports or energy drinks on dental health, 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 “Sports and Energy Beverages Bathe Teeth in Erosive Acids.”

By John W. Harden, Jr., DMD
June 09, 2017
Category: Oral Health
JamieFoxxChipsaTooth-ThisTimebyAccident

Some people are lucky — they never seem to have a mishap, dental or otherwise. But for the rest of us, accidents just happen sometimes. Take actor Jamie Foxx, for example. A few years ago, he actually had a dentist intentionally chip one of his teeth so he could portray a homeless man more realistically. But recently, he got a chipped tooth in the more conventional way… well, conventional in Hollywood, anyway. It happened while he was shooting the movie Sleepless with co-star Michelle Monaghan.

“Yeah, we were doing a scene and somehow the action cue got thrown off or I wasn't looking,” he told an interviewer. “But boom! She comes down the pike. And I could tell because all this right here [my teeth] are fake. So as soon as that hit, I could taste the little chalkiness, but we kept rolling.” Ouch! So what's the best way to repair a chipped tooth? The answer it: it all depends…

For natural teeth that have only a small chip or minor crack, cosmetic bonding is a quick and relatively easy solution. In this procedure, a tooth-colored composite resin, made of a plastic matrix with inorganic glass fillers, is applied directly to the tooth's surface and then hardened or “cured” by a special light. Bonding offers a good color match, but isn't recommended if a large portion of the tooth structure is missing. It's also less permanent than other types of restoration, but may last up to 10 years.

When more of the tooth is missing, a crown or dental veneer may be a better answer. Veneers are super strong, wafer-thin coverings that are placed over the entire front surface of the tooth. They are made in a lab from a model of your teeth, and applied in a separate procedure that may involve removal of some natural tooth material. They can cover moderate chips or cracks, and even correct problems with tooth color or spacing.

A crown is the next step up: It's a replacement for the entire visible portion of the tooth, and may be needed when there's extensive damage. Like veneers, crowns (or caps) are made from models of your bite, and require more than one office visit to place; sometimes a root canal may also be needed to save the natural tooth. However, crowns are strong, natural looking, and can last many years.

But what about teeth like Jamie's, which have already been restored? That's a little more complicated than repairing a natural tooth. If the chip is small, it may be possible to smooth it off with standard dental tools. Sometimes, bonding material can be applied, but it may not bond as well with a restoration as it will with a natural tooth; plus, the repaired restoration may not last as long as it should. That's why, in many cases, we will advise that the entire restoration be replaced — it's often the most predictable and long-lasting solution.

Oh, and one more piece of advice: Get a custom-made mouthguard — and use it! This relatively inexpensive device, made in our office from a model of your own teeth, can save you from a serious mishap… whether you're doing Hollywood action scenes, playing sports or just riding a bike. It's the best way to protect your smile from whatever's coming at it!

If you have questions about repairing chipped teeth, please contact us or schedule an appointment for a consultation. You can also learn more by reading the Dear Doctor magazine articles “Artistic Repair of Chipped Teeth With Composite Resin” and “Porcelain Veneers.”

By John W. Harden, Jr., DMD
May 25, 2017
Category: Oral Health
Tags: mouth rash  
CertainMouthRashesDontRespondtoTopicalSteroidTreatments

You've been treating a persistent rash around your mouth with medicated ointments, but it's not going away. The problem may be the ointment — it could actually be sustaining the particular rash you have.

Peri-oral dermatitis is a scaly rash with small bumps (some filled with pus) around the mouth, eyes or nose. It's especially common among women ages 20-45, possibly due to hormonal factors or cosmetic use. Other than its unattractiveness you might not otherwise notice it, although it can cause stinging, itching or burning. There are ways to treat it effectively, though not necessarily the way you might think.

Many skin conditions respond well to topical steroids, like ointments or lotions containing hydrocortisone. But prolonged use of a steroid for skin irritations might actually increase risks for peri-oral dermatitis. Applying it to an existing rash may also deceive you — the steroid constricts some of the skin's tinier blood vessels, which will make the rash appear as if it's fading. The effect, though, usually doesn't last more than an hour. If you continue to use the steroid, the rash won't get better.

The key to alleviating peri-oral dermatitis requires treatment from a physician, dermatologist or dentist, who will also be able to accurately diagnose the specific skin condition you have. If it is peri-oral dermatitis, the first step is to stop using any topical steroids and only wash with mild soap or similar substitute. You'll have to be patient because the rash may at first appear to flare up and worsen before getting better.

Instead of steroids, we may prescribe antibiotics to help clear the rash, typically tetracycline. It may take several weeks of use before the rash begins to clear; as it does clear, you would either stop the antibiotic treatment or taper off over a four-to-five week period.

While some cases of peri-oral dermatitis will clear up and remain that way, some people may experience chronic reoccurrences. Even so, by using the same treatment approach we can still effectively manage the condition for the long-term.

If you would like more information on peri-oral dermatitis and similar rashes, please contact us or schedule an appointment for a consultation.

By John W. Harden, Jr., DMD
May 10, 2017
Category: Oral Health
GiancarloStantonGetsMajor-LeagueMouthProtection

For major-league slugger Giancarlo Stanton, 2014 was a record-breaking year. After the baseball season ended, he signed a 13-year, $325 million contract with the Miami Marlins — the biggest deal in sports history. But earlier that same year, Stanton suffered one of the worst accidents in baseball: He was hit in the face by an 88-mph fastball, sustaining multiple fractures, lacerations, and extensive dental damage.

After the accident, Stanton didn’t play for the remainder of the season. But now he’s back in Spring Training… and he’s got a not-so-secret weapon to help protect him against another injury: A custom-made face guard designed to absorb impacts and keep him from suffering further trauma.

As sports fans, we’re glad that Stanton was able to overcome his injury and get back in the game. As dentists, we’d like to remind you that you don’t have to be a major-league player to feel the harmful effects of a sports injury — and you don’t have to look far to find a way to protect yourself. In fact, you can get a custom-made mouthguard right here at the dental office.

Mouthguards have a long tradition in sports like football, boxing, and hockey. But did you know that far more Americans are injured every year playing “non-collision” sports like basketball, baseball — and even bicycling? And it doesn’t take a major-league fastball to cause a dental injury: The highest incidence of sports-related dental injuries occurs in 15-to-18-year-old males. In fact, about one-third of all dental injuries among children stem from various types of sports activities. These injuries may result in countless hours being lost from school and work, and cost significant sums for treatment and restoration.

Mouthguards have a proven track record in reducing dental and facial injuries: They are capable of absorbing the energy of a blow to the mouth, and dissipating it in a way that prevents damage to facial structures and teeth. But not all mouthguards are created equal: Custom-fabricated mouthguards, which are produced from an exact model of your mouth made right here in the dental office, offer by far the best protection. They fit better and safeguard the teeth more fully than any off-the-shelf or “boil-and-bite” type can. Plus, they’re more comfortable to wear. And let’s face it: No mouth guard can protect your teeth if you don’t wear it.

What’s more, some recent studies indicate that custom-made mouthguards may offer significant protection against concussion. An increasing awareness of the dangers that concussion may pose to athletes is one more reason why we recommend custom-made mouthguards to active people and their families.

To get his face guard, Giancarlo Stanton reportedly went to a specialist sporting-goods manufacturer in Illinois, and paid around $1,000. But you can get a custom-made mouthguard for yourself or your loved ones right at our office for a fraction of that price. And the peace of mind it can give you is… priceless.

If you have questions about custom-made mouthguards, please contact us or schedule an appointment for a consultation. You can learn more by reading the Dear Doctor magazine articles “An Introduction to Sports Injuries & Dentistry” and “Athletic Mouthguards.”

TechniquesforKeepingImpactedCanineTeethfromSpoilingYourSmile

Although usually an orderly process, some permanent teeth don't come in as they should. In fact, they may not come in at all and remain hidden in the gum — a situation called impaction. This creates multiple problems for function, health and, in the case of front canines, appearance.

Canines are the longer and more pointed teeth on each side of the front-most incisors. They help tear and cut food during chewing, a function impaction eliminates. Besides a higher risk for developing abscesses (isolated areas of infection) and cysts, they can also put pressure on neighboring teeth and damage their roots or cause them to erupt abnormally.

Dentists often remove impacted wisdom and other back teeth to lessen these potential problems. Removing canines, though, has additional considerations: besides compromising ideal chewing function, missing canines often create an unattractive smile.

But before considering removal, there's another technique we might be able to use to save the canines and actually draw them down through the gums to their correct position. It's usually part of an overall orthodontic plan to correct a poor bite (malocclusion).

After pinpointing their exact position with x-rays or CT scanning, a surgeon surgically exposes the impacted canines' crowns through the gums. They then bond small brackets to the crowns and attach a small gold chain to each bracket. They fasten the other end of the chains to orthodontic hardware that exerts downward pressure on the impacted teeth. Over several months this pressure can help move the teeth into their normal positions.

Unfortunately, this technique isn't always advisable: one or more of the impacted teeth may be in a difficult position to attempt it. It's usually best in these situations to remove the teeth, usually sooner rather than later for the sake of neighboring teeth.

Fortunately, with today's advanced restorative techniques, we can eventually replace the canines with dental implants, although that's best undertaken after the patient enters adulthood. In the meantime, we can utilize orthodontic means to preserve the open space and provide a temporary restorative solution.

Whatever route taken, these teeth don't have to become a source of problems, especially for your appearance. Whether through orthodontics or restorative dentistry, impacted canines don't have to ruin your smile.

If you would like more information on various orthodontic procedures, 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 “Exposing Impacted Canines.”





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