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When you have a tooth extracted, your body immediately sets to work to help protect the affected area. The blood that collects at the site of the extraction clots to cover and protect the wound. This is a normal response, and protects the nerves and bone that have been exposed with the removal of your tooth. Normally, the gum tissue will close over the area within a few weeks.

But sometimes the clot becomes dislodged or moved before you have a chance to heal. The result is that the nerves and bone in the extraction site are exposed to air and outside substances. Bacteria can contaminate the wound and lead to pain, infection, and further damage. This condition is known as dry socket.

There are certain activities that should definitely be avoided so you are not at risk for dry socket.

• Straws and suction: The action of using a straw causes suction that can dislodge the clot. You can still enjoy the soothing coolness of a milkshake, but use a spoon.
• Spitting: You might be tempted to rinse and spit immediately to clean your mouth, but spitting can also dislodge the clot. We will let you know how to clean your mouth and teeth for the next few days.
• Smoking: Not only does smoking provide a suction effect that can remove the clot, but smoking and chewing tobacco can slow healing as well.

There are also steps you can take to aid the healing process.

• Caring for your extraction site

John Pappas will give you instructions on caring for your mouth and teeth for the next few days. Gentle care for the extraction site is vital. And treat yourself gently as well. Rest if you need to, and avoid activities that might impact your wound.

• Think about your diet

Stick to soft foods for the first day or so and chew on the side opposite your extraction site. Carbonated and caffeinated beverages should be avoided, as well as food like peanuts or popcorn that lodge in the teeth.

• Watch for symptoms of dry socket

How do you know if you have a dry socket? Monitor your pain and the appearance of the site after the extraction. For the first few days, you might feel some pain in the immediate area. Pain that intensifies after three or four days is usually not a result of the extraction. An unpleasant odor or taste in your mouth could be a sign of dry socket. You might look in the mirror and notice that the clot is no longer there, or appears to have been dislodged. If any of these symptoms occur, call our Boston, Massachusetts office at once. If you are experiencing dry socket, the extraction site needs to be cleaned and protected from further injury, and we can prescribe antibiotics if needed.

Dry socket is a rare occurrence, but if you have any symptoms that concern you, we want to hear about them. We will work with you to make your extraction go as smoothly as possible. Talk to us about your concerns before any procedure, and we will provide detailed information for the healing process. Keep us in the loop as you recuperate, and we will work together to make your recovery a speedy one.

Taking care of your gums is one of the best ways to protect your smile. But sometimes, we treat our gums like an afterthought when it comes to dental care. It might surprise you to learn just how common gum disease is—and how damaging it can be for your oral health.

Surprising Fact #1:

About half of all adults have suffered or are suffering from some form of gum disease. And about half of all children do, too. As we age, the percentages jump—in fact, some studies estimate that eventually 70% of older adults will be affected by gum disease.

Surprising Fact #2:

The major cause of tooth loss in adults isn’t tooth decay or accidents or aging—it’s gum disease.

Surprising Fact #3:

Gum disease is progressive. The gingivitis that begins with a bit of redness or some minor bleeding when you brush might seem like a temporary annoyance. But when ignored, this early form of gum disease can lead to periodontitis, a serious gum condition which causes receding gums, loose teeth, bone and tissue damage, infections, and tooth loss.

Gingivitis

Gum disease begins quietly and invisibly, and it usually starts with plaque. Plaque along the gum line irritates our gum tissue. The body’s immune system responds and triggers inflammation. Gum tissue becomes swollen and red. The gums might feel tender, or bleed easily when you brush or floss.

If you’ve experienced any of these symptoms, it’s time to call our Boston, Massachusetts office. John Pappas might recommend better brushing and flossing habits, a professional cleaning, and/or an anti-plaque treatment. At this stage, with proper care, gingivitis is reversible.

But left untreated, gingivitis can progress over time until it becomes periodontitis. Periodontitis affects not only gum tissue, but the bone and connective tissue which surround our teeth, supporting them and holding them firmly in place.

Mild Periodontitis

As plaque and tartar continue to irritate gum tissue above and below the gum line, inflammation increases, and the gums begin to pull away from the teeth. This is a problem, because the gums normally surround the tooth roots snugly, protecting them from plaque, bacteria, and other toxins.

When gum tissue pulls away, pockets are created between gums and teeth. These pockets become home to more bacteria, causing more irritation, inflammation, and infection. During this phase, the connective and bone tissue around the tooth’s roots might start to break down.

Moderate Periodontitis

As the disease progresses, pockets become deeper. The structures that hold the teeth in place continue to break down, and the teeth start to loosen. As the gums recede, tooth roots become more vulnerable to decay.

Advanced Periodontitis

When periodontitis has reached the advanced stage, there is significant loss of tissue and bone around the teeth. Teeth become looser and foul breath, pus, and pain when biting or chewing are common. Without prompt treatment, there’s a high risk of tooth loss.

Unlike gingivitis, periodontitis isn’t reversible, and requires professional care. Advanced treatments can do a lot to restore gum health:

• Topical, time-release, or oral medications treat infection.
• Scaling and root planing, which are non-surgical deep cleaning procedures, remove plaque and tartar above and below the gum line, and smooth tooth roots to remove bacteria and help the gum tissue reattach to the teeth.
• Flap surgery treats more advanced gum infection, reducing pocket depth and re-securing the gums snugly around the teeth.
• Bone grafts, gum grafts, and other regenerative procedures are available that help restore and repair tissue damaged by gum disease.

That’s good news, and there’s even better news: Because gum disease is typically triggered by plaque, it’s very preventable.

• Brush carefully at least twice each day for at least two minutes. Don’t forget to brush along the gum line!
• Use floss at least once each day or as directed by John Pappas. If you have trouble flossing, ask us for the flossing tools and techniques that will work best for you.
• See your dentist regularly to catch and treat early gum disease while it is still reversible.

While gum health is essential for dental health, healthy gums might mean more than just healthy teeth. Scientists are studying the potential links between gum disease and its effects on conditions such as heart disease, diabetes, and arthritis. Gum health should never be an afterthought. Taking care of your gums is one of the best things you can do to ensure a lifetime of healthy smiles.

When most people think of complications of diabetes, they think of an increased risk of blindness, limb amputation, heart disease, and neuropathy. However, John Pappas and our team want you to know that emerging research is revealing a possible connection between uncontrolled diabetes and dental problems. Whether you have type 2 diabetes or type 1, uncontrolled high blood glucose level increases the risk of certain oral health conditions, including:

• Cavities
• Tooth decay
• Gingivitis (early gum disease)
• Periodontal disease (advanced gum disease)

Diabetes and proper dental care

If you have diabetes, it is more important than ever to take your dental care seriously and practice excellent oral hygiene. These recommendations will help:

1. Manage your diabetes. First and foremost, it is vital to control your high blood sugar in accordance with your physician’s instructions — not only for the sake of your oral health, but your overall health. With properly controlled blood sugar, you reduce your risk of developing gingivitis and other oral health issues.
2. Practice good at-home oral hygiene. This means brushing at least twice a day AND flossing. At a minimum, brush your teeth in the morning and at night, but after meals and snacks if you can. Use a soft toothbrush to avoid injuring your gums. Don’t neglect flossing, because it helps to remove plaque below the gumline and between teeth.
3. Visit the dentist regularly. While it is important to see the dentist every six months even if you don’t have diabetes, it is even more crucial to have a professional teeth cleaning and dental exam if you have the disease. As dental professionals, our team at Masterpiece Dentistry at Copley is able to detect early dental conditions before they develop into something more serious and costly.
4. Tell your dentist that you have diabetes. If you were recently diagnosed with diabetes, be sure to let us know as soon as possible, and remind us at every appointment.
5. Be conscientious about examining your own gums and teeth. By looking for early signs of gum disease, which can include bleeding gums, irritated gums, gums that are red (versus a healthy pink), or swelling, we can get started on treatment right away.

Managing diabetes takes effort, not only in watching your diet, exercising, monitoring your blood sugar levels, and taking your medication, but obtaining proper dental care.

To learn more about the link between diabetes and oral health, or to schedule an appointment with John Pappas, please give us a call at our convenient Boston, Massachusetts office!

If you have been bringing your baby in for regular checkups since that first tooth arrived, you might expect that he or she is already familiar with John Pappas and our staff. Often, though, months pass between visits, which is a very long time for a child. How can you make your preschooler’s return visit a happy one? We have some suggestions!

Before Your Visit

• Prepare your child for her visit. Simple explanations are best for a young child. You might tell your daughter that a dentist is a doctor who helps keep her teeth strong and healthy. Let her know a bit about what will happen. Being told, “You will sit in a special chair,” or, “Can you open wide so we can count your teeth?” will give her some idea of what it’s like to visit our office.
• There are many entertaining books for young children about visiting the dentist. Reading some of these to her for a few days before the appointment will let her know what to expect.
• Use playtime to prepare. You might count your daughter’s teeth or let her “play dentist” and brush the teeth of her favorite doll or stuffed animal.

When You Arrive

• Your attitude can be contagious! If you treat a visit to the dentist like any other outing, chances are your child will too. Your calm presence is exactly what your child needs.
• You might want to come a bit early to let your son explore the office. Bring a favorite toy or book to keep him entertained if you need to. A favorite stuffed toy can be a comfort in an unfamiliar place.
• If you are with your child during his checkup, follow our lead. Don’t be concerned if your child seems uncooperative at first or even throws a tantrum—we are used to working with children, and have techniques to make his experience as relaxed and as positive as we possibly can.

We Are Here to Help

We are your partners in your child’s dental care. Call our Boston, Massachusetts office anytime for suggestions about making your child’s visit a comfortable, comforting experience. Our goal is to start your child confidently on the road to a lifetime of empowering dental visits and lasting dental health.