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Temporomandibular dysfunction (TMD) refers to a diverse range of disorders that relate to muscular function in the jaw and face — the temporomandibular joint (TMJ). That could mean difficulty opening your mouth, pain in the jaw or face, or any sort of problem with the jaw joint.

TMD can be difficult to diagnose because of the varied causes. Whatever the case, an accurate diagnosis from John Pappas helps make treatment as successful as possible.

Most often, jaw problems will resolve themselves within several weeks or months. Surgeries like arthrocentesis, arthroscopy, and open-joint surgery should be a last resort. More conservative and reversible treatments should come first and are in fact the most critical step in the treatment of TMD.

Less invasive treatments like acupuncture and splints can be helpful, but that will depend on your particular case. It’s worth your while to speak with John Pappas at our Boston, Massachusetts office to learn about solutions that could work for you.

A combination of treatments will most often produce the greatest relief for TMJ patients. It’s a good idea to avoid activities that overuse the jaws, such as chewing gum or clenching your jaws.

You can be proactive in finding relief for TMD by trying the following remedies at home:

• Eat soft food: When you eat soft and/or blended food, your jaw gets an opportunity to rest. Avoid chewy and crunchy food, and food that requires you to open your mouth wide, like apples or corn on the cob.
• Apply moist heat: A hot water bottle wrapped in a moist towel can help reduce symptoms.
• Apply ice: Applying an ice pack wrapped in a cloth or towel for no longer than 15 minutes may also reduce pain and promote healing.
• Do jaw exercises: A physical therapist can help identify the exercises that will work for you. Jaw exercises have been shown to be an effective treatment method that can be performed at home.
• Relaxation: Actively try to relax the muscles of the face and lips, and let your teeth come apart. Many find meditation, yoga, and slow, deep breathing to be helpful for reducing stress and tension.
• Avoid wide yawns: Keep your fist under your jaw when you feel a yawn coming on, to keep your jaw from opening too widely.

Happy Oral Cancer Awareness Month! We know oral cancer can be kind of a scary topic, but it’s worth using this opportunity to learn about the disease and spread knowledge so everyone becomes more aware. The more we know, the better we can work to prevent it!

Oral cancer is exactly what it sounds like: cancer that occurs anywhere in the mouth. It could occur on the tongue, the lips, the gums, the tongue, inside the cheek, or in the roof or floor of the mouth. Every  year, more than 8,000 people die from oral cancer. It’s a truly deadly disease.

The reason oral cancer scores a higher death rate than other common cancers such as testicular cancer, Hodgkin’s disease, thyroid cancer, cervical cancer, or even skin cancer, is because it often goes undetected until it's become too advanced and has spread to another part of the body.

So what causes this devastating disease? There is no clear answer, but some potential causes have been identified. By being aware of these, we can be alert and promote prevention of this illness:

• Age: Most patients who develop oral cancer are above the age of 40. If you’re over 40, make sure your doctor checks for signs of oral cancer and that you stay on your dental hygiene regimen.
• Tobacco: Excessive tobacco use, whether in the form of cigarette smoking or tobacco chewing, can be a substantial contributor and cause of oral cancer. So that’s another reason, among many, you should avoid tobacco.
• Alcohol: Excessive alcohol consumption can put you at risk because alcohol converts into a chemical called acetaldehyde, which damages the body’s DNA and blocks cells from repairing the damage. When paired with tobacco, the dehydrating effects of alcohol make it even easier for tobacco to infiltrate mouth tissue.
• Sun exposure: Your lips need SPF, too! Repeated sun exposure increases your risk of contracting cancer on your lips, especially the lower lip.
• Diet: Not getting all the nutrients you need, from vegetables and fruits for instance, can weaken your immune system and make you more vulnerable to the disease.

Obviously, many of these causes relate to lifestyle choices, which we have control over. It's all about balance, being aware, and making small tweaks to our habits if we need to.

If you’re concerned that you may be at risk for oral cancer, give us a call to talk about a screening. And if you’ve been putting off a visit to our Boston, Massachusetts office, now is an excellent time to schedule one. Regular visits to the dentist can be the first line of defense against oral cancer!

What to do to prevent gum disease? If left untreated, gum disease can lead to discomfort, infection, and even tooth loss. Bacteria in our mouths form a film called plaque. Plaque sticks to our teeth and can lead to gum inflammation. This inflammation can cause our gums to pull away from the teeth creating “pockets” which are home to infection and result in tooth and bone loss. Since the early stages of gum disease are often invisible, what is the secret to keeping our gums healthy?

Luckily, there is no secret to it at all! Preventing most gum disease is a simply a matter of following well-known guidelines, at home and in our Boston, Massachusetts office.

 Healthy Habits at Home

• Regular brushing and flossing

At least two minutes of careful brushing twice a day will help reduce bacteria and plaque. Use floss, picks, and other interdental tools to remove plaque from tight areas between the teeth that your brush might miss.

• If you smoke, now is the time to quit!

Smoking weakens your immune system, making it harder to fight infections and to heal. If you need another reason to quit, improving your oral health is a great one. Talk to us about ways to stop.

• Eating well

We all know sugar is no friend to dental health, and encourages bacterial growth. But eating apples, carrots and other crunchy vegetables can help remove food particles and stimulate the production of saliva, which fights bacteria production. Vitamins and minerals help strengthen bones and build healthy gum tissue. And a balanced diet supports not just your oral health, but the health and well-being of your entire body. Ask us for suggestions for a dental-healthy diet.

Regular Checkups and Cleanings

• We recommend a visit to our Boston, Massachusetts office every six months for a checkup. John Pappas can discover and treat gingivitis (early periodontal disease) and recommend a periodontal exam if there are signs of more severe gum disease. There are some individuals who develop gum disease even with great brushing and flossing habits, so it’s important to have a dentist’s evaluation.
• Having your teeth cleaned every six months will remove plaque that brushing alone can’t handle. If there are signs of more serious gum disease, a periodontal cleaning will remove plaque and tartar from both above and below the gumline.

Brushing, flossing, avoiding smoking, eating well, seeing John Pappas regularly—there’s no secret here! Talk to us about what you can do and what we can do to keep your gums healthy for a lifetime of beautiful smiles.

A dental crown is often called a “cap.” A dental crown covers all of the visible parts of the tooth and has many functions and reasons for placement.

There are several different types of crowns available at Masterpiece Dentistry at Copley. They vary in their material, appearance, and functionality. A PFM, or porcelain fused to high-noble metal, is the most common. A full cast, high noble metal crown is a gold crown, and a stainless-steel crown is meant to be temporary. The most natural-looking crown is one that is all porcelain. These are often used for front teeth.

Getting a crown typically requires two appointments. The first is a preparation with impressions, shaping, and placing a temporary. The impressions are either sent to a dental lab, where the process generally takes two weeks, or done in-office with a machine that can make a crown without needing a second appointment. These crowns are made from a high-quality solid block of porcelain. The shape of the tooth is constructed from a digital 3D image of your tooth.

To accurately determine which type of crown is best, you must first know why you need the crown and in what area of your mouth is it needed, which can be answered when you visit us at Masterpiece Dentistry at Copley. For instance, if you have a gold crown on the lower right and need a new crown directly above on the upper right, the best durability and long-lasting relationship is another gold crown.

If you need a crown on a front tooth, a gold crown may not be the best choice. A PFM has strength but is not ideal, as a dark line will appear at the gum line. A full porcelain crown is going to look as close to a natural tooth as possible, but will have less strength than a gold crown.

There are two types of porcelain crowns, depending on how they are made. A dental lab makes a full porcelain crown by baking layer upon layer to make the porcelain look like natural enamel. A full porcelain crown made in-office out of a solid piece of porcelain will have increased strength. However, the natural layered appearance is extremely difficult to achieve.

A crown is placed on a tooth when added strength is needed. Cracks, large broken-down fillings, or previous root canal treatment are all conditions where a crown is the standard care. The type of crown that is most appropriate depends greatly on location.