Saremi Johnstone Dentistry

Hard Nightguard, Soft Nightguard, or Orthotic? It’s all so confusing….

Hard nightguards, soft nightguards, and orthotics are the three most common types of oral appliances that are regularly used to support and protect the jaw joints, muscles,

The three appliances may appear to be very similar, but the functional difference in the mouth are significant. Different appliances are used for different purposes, and are not interchangeable.

Soft Nightguards

Once the most common style of nightguards, this type of guard is slowly falling out of favor. While a soft nightguard will protect the teeth from being damaged further from grinding, studies are showing that a soft nightguard can actually encourage grinding up to 50%. Professionally made custom soft guards are small and comfortable, but may wear down a bit quicker than hard guards. This is a good cost effective option for someone looking to protect their teeth from grinding damage, but do not have TMJ or headache pain.

Hard Nightguards

The hard nightguard is small and low profile yet very durable. They are generally recommended for moderate to extreme grinders and clenchers and/or for people suffering from TMJ discomfort. Hard nightguards also snap on and stay in place.


An orthotic appliance is the most specialized of the three. Unlike the hard or soft nightguards, an orthotic is designed to align the lower jaw and its supporting muscles into a more comfortable position and bite. Orthotics are used to stabilize the bite and minimize the symptoms of TMJ discomfort. Unlike soft and hard nightguards, an orthotic requires both impressions, AND a relaxed bite registration, which takes much more time and expertise than fabricating just a hard or soft nightguard.

We hope this brief outline of hard nightguards, soft nightguards, and orthotics help you in your decision making process. Remember we are always here for you, and are happy to answer any questions or address any concerns you may have.

We look forward to seeing you soon!

Dental Insurance (Dental Benefit Plans)

There are many different kinds and types of Dental Insurance Plans. More correctly referred to as Dental Benefit Plans, these plans can be confusing, frustrating, and difficult to deal with. There are indemnity, PPO, HMO, and discount dental benefit plans.

Indemnity plans or Traditional Insurance plans reimburses it’s members or dentists at the dentist’s Usual, Customary and Reasonable fee (UCR). These plans allow the subscriber to go to any dental office with out being limited to a panel.

PPO, or Prefrred Provider Organization, is the most common form of benefit plans. PPO’s provide members with a list of participating dentists to choose from. These dentists have agreed to a lower fee schedule, which provides the patient with a greater cost savings. Most PPO’s pay 50% on major treatments, 80% for basic care,  and up to 100% for preventative care. These plans usually have maximums around  the $1000 – $1500 mark. Once the PPO has paid out their $1000 maximum, they will no longer cover treatment for that year.  At this point, the client must cover their own dental expenses.

HMO‘s are capitated or prepaid insurances. HMO’s were designed to provide members with basic care at the lowest rate. Participating HMO providers receive a monthly capitation check for the total number of people assigned to the office. This amount is only a few dollars and is intended to offset the administrative costs. HMO’s generally do not pay for any services rendered. Fees are usually greatly reduced, but it is the client who is solely responsible for paying the doctor. An odd thing about HMO plans is that the doctor earns the most by doing the least amount of treatment.

At Saremi Johnstone Dentistry, we do our best to help you maximize your dental benefits, and to minimize your out of pocket costs. Dental benefit plans can be confusing, but we are here to help.

We look forward to seeing you soon!

What is the difference between Bonding and Veneers?

Dental bonding and dental veneers are two different ways to accomplish the goal of changing the visual appearance of teeth. Bonding is accomplished with the direct placement of a tooth colored composite resin material onto the tooth.  Bonding is great in an emergency situation of a fractured tooth, or for minor corrections of teeth shapes, contour, or spacing. However, bonding usually isn’t used to make over an entire smile. It is intended for minor imperfections and repairs such as chips and small breaks, or uneven spacing between teeth. Unlike veneers, bonding can and will stain over time, and will need to be replaced more often than veneers because they do not hold up as well cosmetically.

Veneers are porcelain facings that are bonded to the front surface of a tooth. They are hand made and designed specifically for you. Color, shape, contour, length can all be controlled to your desires, and can truly transform your smile. It is nearly impossible to tell the difference between well made veneers and natural teeth.  Ideally, 8-10 veneers are done to completely enhance your look.

Veneers are also a much longer lasting, more stable way to beautify a smile as they do not change color and are made from a more robust porcelain.  Bonding, while effective in the short term, tends to not last as long and can stain over time. Often, people may chose bonding over veneers because bonding can be more financially affordable, but due to their need to be more often replaced, this initial price savings may end up costing you more in the long term.

It is always a good idea to discuss the differences between veneers and bonding with your dentist, and together, come up with an ideal treatment plan for you that addresses your goals and concerns. We are always here to help, and are happy to answer any of your questions. We look forward to seeing you soon!

(805) 496-7776

3 Quick Tips to Improve your Dental Routiene

Did you know that your home dental care routine is one of the MOST important factors in your oral health? Here are some quick tips to help you make it more effective.

  1.  Floss BEFORE you brush! Yes. Flossing will get the gunk out from in between your teeth, and the tooth brush will brush it away. Then the flouride in the toothpaste can better penetrate in between the teeth and make the enamel more resistant to decay.
  2. Hold your toothbrush at a 45 degree angle to your gums and brush in small circles. And, don’t forget to brush the chewing surfaces of your teeth too!
  3. Brush your tongue! A lot of debris can accumulate on your tongue, and is most likely to be the cause of bad breath. Brush in a circular motion, brushing as much as you can (without gaging).

Good dental home care does more that keep your teeth and gums happy. New studies are showing that that our teeth and gums are greatly connected to systemic health. Periodontal disease is being linked to increased risks of heart disease, diabetes, and even Alzheimer’s.

As always, be sure to see your dentist and dental hygenist regularly! Those regular cleanings and check-ups are important.

We look forward to seeing you soon!

(805) 496-7776

Mouth Guard Use in Sports

A well fitted mouth guard is an essential piece of sports equipment. When participating in any sports, players are at risk for a variety of dental injuries such as; lip and cheek lacerations, chipped or broken teeth, tooth root damage, broken jaws, fractured restorations, and even concussions. Studies have shown that wearing a sports mouth guard can reduce these injuries by as much as 60 times!

Custom sport mouth guards are made using an exact model of a persons own teeth. They are made out of resilient and tear resistant materials. They are comfortable, easy to clean, fit well, and do NOT restrict breathing. A properly fitted sports mouth guard is tasteless, not bulky, have excellent retention, fit, and sufficient thickness in critical areas. Even the best over the counter product cannot insure quality and effectiveness.

The best mouthguard remains one that is custom designed and made by a dental professional. A dentist can take the specific needs of an individual into account when designing their mouthguard. For your custom made sports mouthguard, contact us today! (805) 496-7776



What is TMJ/TMD?

The term “TMJ” is often used to define some sort of pain in the jaw joint. It is actually short for TemporoMandiblar Joint, which is your jaw joint. The term “TMD” refers to TemporoMandibular Disorder, or the disorders related to the jaw joint that can arise from how your joint functions and rests. These disorders and symptoms are numerous, and don’t affect people equally. One person may be able to better tolerate a larger disorder in their jaw joint or bite, while another may be thrown into a spin of debilitating migraines or facial pain by the slightest imbalance. These inconsistent symptoms can make an accurate diagnosis of the condition very difficult, and is often poorly understood by dentists and medical doctors alike.

Just a few common “TMD” symptoms are:

  • Migraines and tension type Headaches
  • Pain in the Jaw Joint
  • Facial pain
  • Clenching and/or bruxing of the teeth
  • Vertigo
  • Ringing in the ears, ear pain, & ear congestion
  • teeth sensitive to cold
  • the jaw locking open or closed

Some people have suffered with these symptoms for so long, that they have adopted them as being normal aspects of their lives, and don’t know to seek help. They manage them with pain relievers, or other things, and never mention them to their dentist, and worse, their dentist never bothers to ask!

The treatment of jaw joint dysfunctions is multifaceted. There are several components that must be taken into account including how the upper and lower teeth fit together, known as occlusion, how the jaw joint itself is positioned, and where the muscles used to posture not just the jaw, but the head and neck as well are positioned. While the occlusion and jaw joint position seem obvious to treating TMD issues, they can not be addressed in absence of the muscles and soft tissues that complete the system.

It has been recognized that as much as 90% of pain in the body comes from the muscles. Since the muscles in the head and neck are all related to or affected by the occlusion or jaw relationship, it is important to address muscle comfort in the in the treatment of people who suffer with bite issues. Often, this aspect is overlooked.

When addressing the jaw joint system, it is important to address the entire system. This involves the teeth, the jaw joint, and the muscles and various soft tissues. A neuromuscular approach to treating TMD is the most complete perspective as it blends all three of these components. This approach starts with gathering objective data to evaluate the function and comfort of the muscles. This data is an excellent starting point for your journey to a comfortable and functional mouth.

At Saremi Johnstone Dentistry, we are able to help evaluate your TMD issues and offer our opinion and solutions to your pain. As always, you should feel free to ask your dentist any questions you have regarding TMJ pain and disorders. Or, we would love to have you visit us too., (805) 496-7776

We look forward to seeing you soon.

Replacing Mercury Amalgam Fillings



Dental amalgam has been a common material used to fill cavities for over 150 years. Approximately 1/2 of an amalgam filling is liquid mercury and the other 1/2 is a powered mixture of silver, tin, and copper. The mercury is used to bind the particles together into a strong and solid filling.

In our practice, we find three of the biggest problems with amalgam fillings are;

  1. Over time, amalgam filings crack teeth. Amalgam filling expand and contract differently than tooth structure, so cracks develop causing the tooth to become sensitive and even break. A cracked tooth can be a tricky thing to fix…
  2. Amalgam fillings leak, and lead to secondary decay. Almost every time that we in our practice remove an amalgam filling, we find recurrent decay under the filling. Amalgam fillings do not bond to tooth structure the way other filling materials can, so leaking and decay can be an issue.
  3. They are ugly. Yes, they are unattractive. We find that the primary reason people want their amalgam fillings removed is for aesthetic reasons. It’s no surprise that people don’t like the way their dark amalgam fillings look, and want them replaced with more aesthetic options.

Photo of Teeth Before Fillings


Photo of Teeth After Fillings

If you feel it is time to have your old worn amalgam fillings replaced with a more beautiful alternative, talk to your dentist, or give us a call! We would love to help. We are here to answer any questions and help you make the right decision for you.,  (805) 496-7776.

We look forward to seeing you soon!!



Four Great Reasons NOT to Miss Your Dental Appointment

We know it’s tough to make it to your dental appointments! You need to schedule a time, rearrange your already busy day to make it there, and no one has “Trip to the Dentist” on their list of top 100 things to do. But, we implore you, please make it to your dental appointment!  Here are four great reasons NOT to miss your scheduled dental appointment.

  1. Prevention – It is said that “an ounce of prevention is worth a pound of cure”, and nothing could be more true in the dental field. Once a dental condition causes you pain, it may have progressed to a point of requiring much more extensive and expensive treatment, if your tooth can be saved at all. But, by having your routine dental exam, professional cleaning, and necessary radiographs (x-rays), you are setting yourself up for the best dental health possible.
  2. Benefits – Missing dental appointments costs you time and money. Most dental benefit companies have a “use it or lose it” policy where if you do not take advantage of your benefits in a timely manner, you will lose them. Most dental benefit plans will cover two preventive appointments, so you should take advantage. It could help prevent any future problems.
  3. Appearance – When you keep your dental appointments, we can help you stay looking your best.  Staying attractive and healthy is important to most people. A regular check up exam with your dentist and a professional cleaning with a qualified hygienist can keep your smile healthy and bright! Proper products and treatments can be recommended to keep your smile in tip top condition!
  4. We Worry About YouWhen you miss your scheduled appointment, we worry about you! We worry that you’ve been in a car accident, that you’re ill, we worry about where you are! We love our patients, and truly care about them as people, not just a set of teeth, so when you go “missing”, it’s our nature to worry. Please don’t miss your appointments, and don’t make us worry! We thank you in advance.

Good oral health is directly related to overall health. When your dentist sees you regularly, we are in better position to catch and fix problems early. For example, catching cavities when they are still fixable, or gum disease while it is still reversible. And we also get a chance to catch up with you and all the exciting events in your life. If you haven’t been in in a while, give us a call! We would love to hear from you.  (805)496-7776

We look forward to seeing you soon!


Why Replace Lost Teeth? – The Cost of Not Replacing a Missing Tooth

It is estimated that around that almost 180 million Americans are missing at least one tooth, and over 40 million Americans don’t have any teeth at all.  The loss of a tooth can occur for a variety of reasons including injury, decay, breakage, cancer, injury, smoking, and gum disease.  Regardless of why a tooth is missing, do you know the cost of not replacing a missing tooth?

One of the risks of not replacing a missing tooth is continued bone loss. This bone loss, also known as bone resorption, occurs after a tooth is missing because the roots of the tooth are no longer in the bone of the jaw, leaving a space, and since there is nothing for the bone to hold onto, the jawbone will begin to deteriorate. This bone loss can also impact the teeth around the space, and even affect your facial appearance.  Without replacing the missing tooth, you may find that your face shape change, and you may find your lips appear sunken and uneven.

Another significant risk of not replacing a missing tooth is the reduced ability to eat certain types of foods. Depending on which tooth or teeth are missing, it may become difficult to bite into and properly chew certain foods. In an attempt to avoid biting and chewing near the missing tooth, you’ll likely begin overusing other teeth to compensate for the missing tooth or teeth. This overuse of other teeth can lead to sore and achy teeth and even a sore jaw. In addition, adjacent teeth on either side of the space may begin to move, leaning into the space area, and the opposing tooth that the missing tooth bites against will begin to over erupt into the missing tooth space. This change in biting surfaces can also make chewing more difficult, and can eventually lead to diminished health and poor nutrition. For example, a common side effect of missing teeth can be digestive issues as you begin to eat softer foods or don’t fully chew foods before swallowing.

If certain teeth are missing, such as the ones in the front, it can also impact the way you speak and your ability to clearly pronounce certain words. You may develop a lisp or a change in how you pronounce certain words and sounds. 

Missing a tooth can affect your self esteem. If a space from the missing tooth can be seen when you smile, eat, or speak, you may start to avoid smiling, eating, and speaking to people in public. This can have a significant impact on your social life, your job, and as a result, the amount of money you are able to earn at your job. If gum disease develops due to the missing tooth, you may begin to experience bad breath, as well. Depending on your age, career path, and relationship status, the lifetime costs of a missing tooth can really add up if you’re not confident to smile, eat, or speak in front of other people.

There are several options available to fill the spaces left by missing teeth including removable partial dentures, fixed bridges, and dental implants. Dental implants are sturdy, durable, and compared to the other options, a much longer lasting option. In addition to offering all those benefits, dental implants can also help to preserve your jawbone because the titanium post used for the implant will actually fuse with the jawbone over time. This helps to continue stimulating growth and minimizes the potential for bone loss. Dental implants can also help restore your confidence because once the process is complete they look and feel and function like real teeth.

There is no question that dealing with a missing tooth can be a stressful and concerning situation. However, if you speak with your dentist, you will quickly learn there are many replacement options available to help fit your lifestyle and budget. Getting to know the risks of not replacing a missing tooth can help you see why you shouldn’t wait to decide on a solution. There is no reason to allow your oral health to suffer when you can easily restore your oral health, and your beautiful smile.

As always, you should feel free to ask you dentist any questions about your missing teeth and your options to restore them. We are always here to help you too. Please feel free to contact us with any of your dental issues at, or at (805)496-7776.

We look forward to seeing you soon!

Teeth Whitening – How? Why? And Where?

Teeth whitening, also known as teeth bleaching, is a very sought out procedure. But with so many options, and lots of conflicting information, it can be confusing to know where to start, just what to do, and if you even should bleach at all!

Most teeth bleaching systems contain an active ingredient such as either carbamide peroxide or hydrogen peroxide in strengths of around 10-22%. These ingredients penetrate the enamel of the teeth and the oxygen molecules from the whitening system react with the discolored molecules of the stain, breaking them apart and causing them to reflect light and make the teeth appear whiter. No “stripping” or removal of the enamel is done.

Many types of dental whitening systems are available. Simple, over the counter systems, such as “White Strips” can be a easy, less costly way to bleach teeth.  These systems, when used consistently over a period of time, such as twice a day, daily for two weeks, can give reasonable results. Over the counter systems can run around the $40-$90 mark.

Professional whitening systems sold in dental offices such as custom made trays with a bleach gel that the tray is filled with, can also give great results in less time. Professional trays with bleach, when used correctly, can give improvement in as little as 5 days. These systems are nice because once you have the trays, you’ll only need to purchase more professional strength bleach anytime you want to “punch up” the whiteness of your teeth. These professional take home systems often run around $250-$550, or even more in some areas.

Professional in office systems such as Zoom! can be completed in about an hour of in office chair time. A gel is applied to your teeth, and a heat or light source may be used to to increase the bleaching process. The end result is the same as the two weeks of daily “white strip” use, or of the five days of bleach tray use. These systems use a high-concentration whitening gels that are not available over the counter. These in office systems can run around $600-$950, or even more in some areas.

Teeth whitening can be an ideal and simple way to improve your smile. No matter which system you chose, you may find that the results fade over time. Whitening can last from up to a year to two years, though longer results have been noted. Please ask your dentist if you have any questions regarding your teeth whitening plans. It is always a pleasure to serve you here at Saremi Johnstone Dentistry!