Johns Family Dentistry

Common Dental Emergencies

Most people know what to do when an emergency arises. However, many patients don’t know what to do when they’re eating their favorite food and a tooth breaks. Most people don’t know how to handle a cracked, fractured, or even knocked-out tooth. For this reason, Johns Family Dentistry wants to help patients stay prepared in case an emergency happens.

Additionally, Dr. Johns will do everything he can to see you the same day, so the first steps should always be to schedule an emergency appointment. Until you arrive, here’s what you should do.


An avulsed tooth is always considered a dental emergency. In order to save the tooth and increase the chance of a successful implantation, it’s essential that you get to the dentist as soon as possible. Until then, take note of the following steps:  First, find the tooth. Once found, only pick it up by the top, known as the crown. Touching the root will reduce the tooth’s ability to be reimplanted.  Then, rinse any dirt or debris off the tooth, making sure to leave any tissue still attached to the root.  Finally, attempt to place the tooth back into the socket the same way it was facing. This will help preserve the tooth until you get to your dentist. If you aren’t comfortable doing this, place the tooth into a container of milk, saline solution, saltwater, or saliva if none of these liquids are available.


If you only chip your tooth cosmetically and there’s no pain, chances are you can wait until Johns Family Dentistry is open during normal business hours. However, a large crack or a crack that extends below the gumline needs to be addressed by a dentist right away. If you have pain, take an over-the-counter painkiller to alleviate it until your dentist visit.  Avoid applying pressure to the affected tooth.


If you wake up to tooth pain with no explanation, it could be a sign of significant tooth decay, an infection or abscess, or damage that resulted from teeth grinding. Besides taking Advil or Motrin, you’ll need to visit your dentist so he can determine the cause.  If the pain is lingering or not consistent, take note of when the pain occurs to help your dentist create a more accurate diagnosis.

Regardless of the emergency you’re experiencing, you don’t have to wait until tomorrow to address it.  Johns Family Dentistry in Puyallup is more than likely able to see you the same day to treat your case.  The sooner you get your case treated, the better your outcome will be.  Schedule an appointment with Dr. Johns today to get treated!

Stress in the Workplace

Everyone who ever held a job has, at some point, felt the pressure of work-related stress. Any job can have stressful elements, even if you love what you do. But when work stress becomes chronic, it can be overwhelming – and harmful both physical and emotional health.

Stress is a common cause of health problems and your oral health is no exception. Stress may contribute to teeth grinding, gum disease, dry mouth and canker sores and may also impact your oral health routine and diet – increasing your risk of tooth decay.

Most of us are not in a situation where we can switch jobs. So here are some things to consider for your stressful position: develop healthy responses, establish boundaries, take time to recharge, learn how to relax, talk to your supervisor, get some support.

For oral health, invest in an occlusal guard. Dr. Johns can have a custom made guard made especially for you to take the load off your teeth and jaw from grinding/bruxism. Avoid stressful habits such as smoking, consuming alcohol and eating high sugar foods.

Best advice? Even in a stressful environment where you are may experience pressure to meet a deadline or to fulfill a challenging obligation, find support. Sometimes we find the best support in our co-workers, those fellow employees that are in the trenches day-to-day with you.

Christmas…a time of giving.

Christmas is one of the happiest holidays. During this season, people often are more generous. Families gather to help neighbors; donations are made to people in need. The practice of giving is not a recent innovation – it began on the first Christmas when Jesus was born. Everyone in the story had something to give.

With an overwhelming response from our patients during our November “Turkey Drive,” Johns Family Dentistry is proudly involved in giving back to our community during this season.

For the month of December, our office adorns beautiful Christmas decor. In our lobby, you can find our Christmas tree, decorated with tree tags that indicate an age and gift suggestion. This year, Johns Family Dentistry is working with the Puyallup School District in providing a Merry Christmas to children in the community whose families are having difficulties making ends meet.  

Feel free to stop in the practice, select a tag and return the unwrapped, new gift by December 11th.

“Then the Grinch thought of something he hadn’t before! What if Christmas, he thought, doesn’t come from a store. What if Christmas…perhaps…means a little bit more!”
― Dr. Seuss, How the Grinch Stole Christmas!

Merry Christmas to all!

Annual Turkey Donation Drive

The meaning of the word Puyallup, is generous people. We are lucky to practice dentistry and live in a community of such generous people, as the people of Puyallup.

This year we celebrate our 10th annual “Turkey Drop!” For a decade, the amazing patients of Johns Family Dentistry have graciously donated turkeys to help families in need.

This year, we ask that you drop off donated turkeys to our office on Monday, November 19-Tuesday, November 20, 2018 through 12:00 pm noon. Our staff will excitedly deliver the turkeys to the local food bank on the afternoon of the 20th, just in time for Thanksgiving.

Thank you for always making this such a successful event!

October is National Dental Hygiene Month

October is National Dental Hygiene Month, an effort to celebrate the work dental hygienists do and to help raise awareness on the importance of good oral health. Easily, we all know that our hygiene team hear at he practice – Nicole, Megan, Heidi and Jillian are four of the best around!

This year, the awareness is focusing on four routines that can help people maintain healthy smiles: brush, floss, rinse and chew. According to, the ADA’s consumer website, the ADA recommends brushing your teeth twice a day, for two minutes, with a soft-bristled brush. The size and shape of the brush should fit the mouth allowing you to reach all areas easily.

The proper brushing technique is to:

  • Place your toothbrush at a 45-degree angle to the gums.
  • Gently move the brush back and forth in short (tooth-wide) strokes.
  • Brush the outer surfaces, the inner surfaces and the chewing surfaces of the teeth.
  • To clean the inside surfaces of the front teeth, tilt the brush vertically and make several up and down strokes.
  • Brush your tongue to remove bacteria and keep your breath fresh.

Although recent news reports have questioned its benefits of cleaning between your teeth, it is still an essential part of taking care of your teeth and gums, according to The ADA recommends cleaning between your teeth once a day to remove plaque that is not removed by brushing. Plaque can eventually harden into calculus or tartar.

Because teeth alone account for less than half of the mouth, rinsing can help eliminate biofilm and bacteria that brushing and flossing cannot. Rinsing often, along with brushing and flossing, may help reduce the chance of dental decay and infection. However, avoid rinses that have alcohol in them, according to

Lastly, clinical studies have shown that chewing sugarless gum for 20 minutes following meals can help prevent tooth decay. The chewing of sugarless gum increases the flow of saliva, which washes away food and other debris, neutralizes acids produced by bacteria in the mouth and provides disease-fighting substances throughout the mouth, according to

As always, feel free to ask any of the Johns Family Dentistry hygiene team for tips!

Fall into a Routine

September is here and with the arrival of the cooler crisp air and changing colors we are adjusting to getting back into the comfort of familiar routines. Bedtimes, back to school schedules, sports, all make our personal time minimal. When will you get a chance to go to the fair? It is important to take the time to stop and breathe, slow your mind down and ask yourself, “What is important now?” By doing this you will be able to establish your priorities and in return you will dine it easier to organize your responsibilities. If you take time to set yourself up for success, everything else tends to fall right into place.

Take Five              

Perform the following each morning upon rising and again in the evening before you lay your head down:

  • Take two minutes to reflect and set your priorities and goals for the day.
  • Take two minutes to schedule it – in you outlook, planner, or whatever you used to track your daily appointments. The most important step is writing it down and scheduling.
  • Take one minute to affirm it by stating your priorities and goals out loud.

Fall is a perfect time to start your healthy routine. Exercising, flossing, simply making the time for your health.

Success comes down to working towards your own best. You must remember your definition of success is up to you.

Fill the Canoe School Supply Drive 2018

For the past 6 years, Johns Family Dentistry have proudly partnered with Red Canoe Credit Union and Puyallup – Communities In Schools, to collect school supplies for all 32 schools in the Puyallup School District.  For every pound that is donated, Red Canoe Credit Union will match on the dollar!  

We believe that every child deserves the chance to start the school year with the right tools to succeed.   With the generous donations provided by our patients, together we can make this philanthropic event successful.

Please drop off your new school supplies to our office now until Thursday, August 23.  As an added bonus you will be entered into a drawing for a chance to win tickets (2) to see Toby Keith at the Washington State Fair on September 15, 2018.

The supplies that are considered high needs are the following:

  • 2-3 inch binders
  • Dividers
  • Highlighters
  • Sharpies
  • 3 Ring Pencil Pouches
  • Colored Pencils

All of us here at JFD appreciate your giving hearts and support.  Thank you!

Great Dental Ideas for a Happy 4th of July


Holidays are often the stressful times for our health and especially our teeth. We tend to feel free to temporarily forget the careful health guidelines and routines we’ve set up for our families. And why not? It’s OK to relax and take a break once in a while, especially on holidays like July 4th when we are already celebrating our freedom!

But you don’t have to totally abandon care for your teeth in order to have a good time. Here are three great ideas to keep you smiling this July 4th weekend.

Eat this not that.

While it can be tempting to go for chips or candy to snack on, try choosing options that are both fun and healthy. The patriotic parfait pictured is made with plain Greek yogurt which is a dental super food. And the berries provide just the right amount of sweetness to tame the celebration sweet tooth. Getting kids involved in making these treats is a sure-fire way to get them excited about eating healthy and can be a great activity to keep little hands busy.

Don’t forget the water (for more reasons than you think).

July 4th often means plenty of time spent outside, whether that’s watching fireworks or enjoying a family kickball game. Choose water as your number one cooler choice. It’s better for teeth than sodas and sports drinks and it helps keep you hydrated. Even more, when you’re out on a picnic and a toothbrush isn’t available, a quick rinse with water after meals can be the next best thing. Water helps rinse away food particles trapped in teeth and limits the growth of bacteria.

Travelling? Give everyone their own “tooth-care bag”.

Just because you’re away from home doesn’t mean that you have to neglect your family’s brushing routine. Be sure to pack everyone’s toothbrush, toothpaste and floss. A great way to get small kids excited about brushing while on vacation is to create their very own “tooth-care bag”. Purchase a fun new toothbrush along with travel-sized toothpaste and floss and use a zippered pencil pouch for each child. Children also enjoy using craft supplies to decorate their own tooth kit. You may be surprised when you find them excited and looking forward to brushing time.

7 Things Your Tongue Says About You….

Who knew that saying “Ahhh” could be so educational? You might think that a symptom on your tongue—such as an unusual color or texture—is no big deal, but what happens in your mouth can often be a helpful glimpse into your overall health. Sometimes symptoms that show up on your tongue can signal other health conditions, such as diabetes, vitamin deficiencies, and even scarlet fever.

White Patches
If you notice this discoloration, “first try brushing your tongue each morning and evening for a week or two to make sure it’s not an oral hygiene issue,” says Dr. Johns. If it lingers, it might be an overgrowth of candida (a.k.a. yeast or thrush). You’re at a higher risk of developing this condition if you’re on antibiotics, have diabetes, are on chemotherapy, inhale steroids to treat asthma or COPD, or have a compromised immune system. Candida is usually very treatable with an anti-fungal swish-and-spit liquid or pill. White patches could also be a sign of leukoplakia, which is often caused by tobacco or chronic alcohol use. Oral cancer can sometimes develop on or near these patches; if your doctor is concerned he’ll perform a biopsy.

A Webbed or Striped Look
An appearance like this could signal a chronic condition called oral lichen planus, which occurs when the immune system attacks cells in the mouth. Middle-aged women are most commonly affected. If you’re not experiencing pain, a doctor probably won’t treat it, but he will likely monitor your symptoms, because you might be at higher risk of developing oral cancer in those areas. If you’re experiencing pain, you might be given a drug, such as a corticosteroid, a retinoid, or an immunosuppressant.

Ridges or Indentations
Does your tongue have scalloped edges all of a sudden? These ridges may simply be due to the way your teeth press into your tongue, which often happens while you sleep. Those types of ridges are no big deal and will go away on their own, says Dr. Johns. You might also see ridges if you have a fissured tongue. What’s that? It’s a long crack down the middle of the tongue, and it’s just something you’re born with. “You can also have radiating fissures going perpendicular to the long axis,” says Dr. Johns. “It’s normal; the problem is that sometimes food can get stuck in the fissures if they’re deep enough.” So don’t forget to brush your tongue when you brush your teeth and avoid sticky foods when possible.

Seeing red? A rosy tongue can sometimes go hand-in-hand with a sore throat. “You could have scarlet fever, which is a bacterial condition that occurs in some people who have strep throat, and develop a strawberry tongue. This is usually associated with a really high fever and has to be treated with antibiotics,” says Dr. Johns. A red tongue could also be caused by atrophic glossitis (a.k.a. lost taste buds) due to a vitamin deficiency in folic acid, B12 or iron—in this case, the tongue is usually shiny. If your doc determines that’s the problem, taking supplements that contain those particular nutrients may lead to an improvement of the condition. Another possible trigger: “We often see red tongues in people who have very dry mouths,” says Dr. Johns. “The tongue can feel sensitive and tender. For that, I recommend any over-the-counter product for saliva replacement, sipping on water often, and using sugar-free lozenges.”

“Toward the back of your tongue there are taste buds that are bumpier and larger than the ones that hang out in front,” says Dr. Johns, and they’re not usually a cause for concern. “Sometimes taste buds can be temporarily inflamed and get bigger if you eat something hot.” Other common causes of bumps include canker sores and herpes (cold sores), both of which go away on their own but can be treated to speed healing and ease discomfort. For canker sores, you can use an over-the-counter ointment, avoid spicy and acidic foods, and gargle with baking soda and water. For herpes, a prescription anti-viral pill is needed. If you bite your tongue repeatedly, a lump called a fibroma could develop, which needs to be removed by a doctor. Any ulcer that sticks around and is firm could be a cancerous legion and should be biopsied. The good news is that more and more dentists are now monitoring patients’ mouths for potentially cancerous lesions.

Black and Hairy-Looking
Take a deep breath: This alarming-looking condition is actually benign. It’s sometimes associated with antibiotic use, a yeast infection, diabetes, cancer therapies, or poor oral hygiene. It happens when “the cells on your tongue grow faster than your body can shed them,” says Dr. Johns. But rest assured that this condition generally goes away on its own. And don’t worry—you don’t have to shampoo your tongue. “The tongue isn’t actually hairy. It just looks hairy,” says Dr. Johns.

Some people have a geographic tongue, which looks like a mixture of red and white spots (and sometimes like continents on a world map, hence the name). And these people will likely have it for life. “You have areas on your tongue where some taste buds have been worn down,” says Dr. Johns. “The spots might even seem to move, but it’s not anything to get concerned about. There’s no treatment for it, and it’s actually pretty common.” Some medical research has shown an association between geographic tongue and celiac disease, a condition in which the body’s immune system attacks the small intestine when it ingests gluten—a protein found in wheat, rye, and barley.

The Link Between Medications and Cavities

You may wonder why you’re suddenly getting cavities when you haven’t had them in years. As we get older, we enter a second round of cavity prone years. One common cause of cavities in older adults is dry mouth. Dry mouth is not a normal part of aging. However, it is a side-effect in more than 500 medications, including those for allergies or asthma, high blood pressure, high cholesterol, pain, anxiety or depression, Parkinson’s and Alzheimer’s diseases. This is just one reason why it’s so important to tell your dentist about any medications that you’re taking. Dr. Johns and your dental hygiene team can make recommendations to help relieve your dry mouth symptoms and prevent cavities.

Here are some common recommendations:

Use over-the-counter oral moisturizers, such as a spray or mouthwash.
Consult with your physician on whether to change the medication or dosage.
Drink more water. Carry a water bottle with you, and don’t wait until you’re thirsty to drink. Your mouth needs constant lubrication.
Use sugar-free gum or lozenges to stimulate saliva production.
Get a humidifier to help keep moisture in the air.
Avoid foods and beverages that irritate dry mouths, like coffee, alcohol, carbonated soft drinks, and acidic fruit juices.
Dr. Johns may apply a fluoride gel or varnish to protect your teeth from cavities.

Gum Disease

Many older adults have gum, or periodontal disease, caused by the bacteria in plaque, which irritate the gums, making them swollen, red and more likely to bleed. One reason gum disease is so widespread among adults is that it’s often a painless condition until the advanced stage. If left untreated, gums can begin to pull away from the teeth and form deepened spaces called pockets where food particles and more plaque may collect. Advanced gum disease can eventually destroy the gums, bone and ligaments supporting the teeth leading to tooth loss. The good news is that with regular dental visits gum disease can be treated or prevented entirely.

Mouth Cancer

According to the American Cancer Society, there are about 35,000 cases of mouth, throat and tongue cancer diagnosed each year. The average age of most people diagnosed with these cancers is 62. During dental visits, Dr. Johns will check for any signs of oral cancer. Regular dental visits are important because in the early stages oral cancer typically does not cause pain and early detection saves lives. Some symptoms you may see include open sores, white or reddish patches, and changes in the lips, tongue and lining of the mouth that lasts for more than two weeks.

Paying for Dental Care after Retirement

Many retirees don’t realize that Medicare does not cover routine dental care. Begin to plan for your dental expenses in advance of retirement so you don’t have to let your dental health suffer once you’re on a fixed income.  Johns Family Dentistry has recently introduced a voucher system in our practice that allows patients without traditional dental insurance a way to proceed with dental care at a very reasonable cost.

Do I Need to Take an Antibiotic Before a Dental Procedure?

At times physicians and dentists recommend that a patient take antibiotics before certain dental procedures. This is called “antibiotic prophylaxis.” But why do healthcare providers suggest this extra step?

We all have bacteria in our mouths, and a number of dental treatments—and even daily routines like chewing, brushing or flossing—can allow bacteria to enter the bloodstream (bacteremia). For most of us, this isn’t a problem. A healthy immune system prevents these bacteria from causing any harm. There is concern, however, that for some people bacteremia can cause an infection elsewhere in the body.

Antibiotic prophylaxis is recommended for a small number of people who have specific heart conditions. The American Heart Association has guidelines identifying people who should take antibiotics prior to dental care. Learn more about them here.

Antibiotic prophylaxis guidelines have also been revised for people with orthopedic implants such as artificial joints. Learn more about why the ADA and American Association of Orthopedic Surgeons updated the recommendations and no longer recommend antibiotics for everyone with artificial joints.

Talk with Dr. Johns if you have any questions about antibiotic prophylaxis.

Caregiving for a Disabled or Elderly Loved One

You may have a parent, spouse or friend who has difficulty maintaining a healthy mouth on their own. How can you help? Two things are critical:

Help them keep their mouth clean with reminders to brush and floss daily.
Make sure they get to a dentist regularly.
These steps can prevent many problems, but tasks that once seemed so simple can become very challenging. If your loved one is having difficulty with brushing and flossing, talk to a dentist or hygienist who can provide helpful tips or a different approach. There are dentists who specialize in caring for the elderly and disabled. You can locate a specialist through the Special Care Dentistry Association’s referral directory. For those who wear dentures, pay close attention to their eating habits. If they’re having difficulty eating or are not eating as much as usual, denture problems could be the cause.

When you’re caring for someone who is confined to bed, they may have so many health problems that it’s easy to forget about oral health. However, it’s still very important because bacteria from the mouth can be inhaled into the lungs and cause pneumonia.

If you are a representative for a nursing home resident who needs dental care and is enrolled in Medicaid, there is a regulation, called an Incurred Medical Expense, that may help pay for medically necessary care as determined by a dentist. The Medicaid caseworker at the nursing facility and the dentist providing care can work together to apply the Incurred Medical Expense to pay for needed dental benefits.