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You’ve made an appointment at our Boston, Massachusetts office to treat your cavity, the decayed area has been removed, and the site has been cleaned and prepared for a filling. Now it’s decision time. What kind of filling should you choose? Well, that depends. There are durability, aesthetic, and price considerations involved in any of your choices, so let’s look at some options before you decide.

Gold

This is a classic choice for a reason. Gold is very durable and can last longer than fillings made from other materials. Because they are crafted from precious metal, gold fillings are more expensive than other alternatives. They are also most often indirect fillings—that is, they are not immediately placed in a tooth, but are formed based on a mold of your tooth taken on your first visit and set in position on a second visit. A gold filling is also noticeable, which can be a matter of concern or a style statement!

Metal Amalgam

An amalgam is a mixture, and an amalgam filling is usually composed of several metallic elements, including silver, tin, copper, and mercury. This filling is also very durable and is one of the most cost-effective choices. Its silver color does not blend into the tooth, so visibility is a factor. Amalgam fillings are considered a safe option, but, if you wonder about potential metal allergies or the amount and kind of mercury involved, we will be happy to discuss your concerns. One possible drawback to amalgam fillings is that sometimes more tooth structure needs to be removed to accommodate them, so this is also a subject we can discuss.

Composite Resins

These fillings are often selected because they are both durable and almost invisible when the color is matched to your tooth. Made of acrylic resin and powdered glass, a composite filling is what is called a “direct filling”—one that can be completed and bonded to the tooth in one visit. These are often more expensive than amalgam fillings, but might be preferable for cosmetic reasons, especially when a front tooth is involved. They also need less tooth structure removed to accommodate them and can be better bonded to small excavations than some other options. They can be prone to staining over time.

Ceramic

Ceramic fillings have the virtue of being virtually undetectable. They can be color-matched to your teeth for a seamless look, and are more stain-resistant than composite fillings. They are also a more expensive option, and, like gold fillings, can involve a two-phase process with a filling molded to fit the excavation site placed in your tooth on a second visit.

John Pappas and our team are happy to discuss all of your options before it is time to treat your cavity, since there are a number of factors which might impact your decision. A molar will require a more durable filling than a front tooth, while being less visible when you smile or speak. Insurance plans might pay for only a portion of a filling’s cost if it is more expensive than an amalgam, or will pay for a composite filling only if it is in a visible location. We can help you decide which filling best fits all your needs, providing you with the healthy and beautiful smile you deserve!

Oral surgery can be intimidating, especially if you show any signs of an infection afterwards. John Pappas and our team want you to be informed about what to watch for after you’ve undergone surgery.

Oral surgery procedures are intended to reduce pain and prevent infection. Sometimes complications occur after your surgery, and if infection ensues, it will require swift medical attention.

People undergo oral surgery for many reasons, such as:

• Impacted or infected teeth
• Tooth loss, jaw problems
• Facial injuries or infections
• Birth defects
• Sleep apnea

Symptoms of Infection

• Pain that won’t go away with medication
• Steadily swelling of gums, jaw, or face
• Redness or oozing of pus from the area
• Fever that doesn't subside
• Difficulty opening the mouth or jaw
• Excessive bleeding for 24 hours
• Difficulty breathing or swallowing (emergency situation)

After the initial surgery, don’t become worried right away if you notice any of these symptoms. It’s normal to show some blood and swelling after surgery, but that should stop fairly soon with the help of gauze and medication.

You will most likely be numb from the procedure and we will advise you to avoid hard foods for the first day. Pain medication will be administered, and you should take it before you begin to notice pain. A cold compress can also help with swelling and initial pain.

You will be advised not to brush your teeth in the region where the surgery occurred. You may use a prescription mouth rinse, or you can gargle with warm salt water to reduce the swelling. If you follow these directions, you can speed the healing process for a quick recovery.

Don’t fret: a post-surgery infection is not a common development. It happens most often to people who have a compromised immune system or diabetes. Let John Pappas know beforehand if you have either of these and we may prescribe an antibiotic to help prevent the spread of infection in the areas of your mouth that get worked on.

If you think you may be experiencing complications after a surgery, please don’t hesitate to reach out to our Boston, Massachusetts office for advice.  

When your wisdom teeth start to emerge it can definitely be painful, but it can be even worse if your wisdom teeth become impacted. Impacted wisdom teeth are trying to erupt but are unable to do so because there is not sufficient room for them to emerge. This usually means that your wisdom teeth are painfully lodged in your jawbone.

While you may not see any real signs of the emerging wisdom teeth when they are impacted, what you can’t see can still definitely hurt you. Some of the indicators of impacted wisdom teeth are listed below.

• Jaw Pain: Pain in the back of your jaw is a common indicator of impacted wisdom teeth. The pain often concentrates in the area around your gums.
• Changes in the Mouth: You may notice some changes in your mouth when you have impacted wisdom teeth. Reddish gums, swelling in the jaw, bleeding gums, and bad breath can all be indicators that you are dealing with impacted wisdom teeth.
• Headaches: If you suddenly start having headaches, especially at the same time as some of the other issues mentioned above, they may indicate impacted wisdom teeth.
• Chewing Issues: Problems with chewing normally can indicate impacted wisdom teeth. If you are having trouble making the chewing motions because your mouth won’t quite open and close as easily as it used to, impacted wisdom teeth may be the culprit.

The Solution

If you are suffering from impacted wisdom teeth, the best solution is usually going to be removal. This is not a problem that will resolve naturally, and in fact, your pain and other symptoms may worsen as your wisdom teeth become increasingly impacted. At Masterpiece Dentistry at Copley, John Pappas can review the details of wisdom teeth removal surgery with you and help you determine if this is the best solution for your situation.

Dental sealants are an excellent way to protect children’s teeth from tooth decay by coating them with a thin plastic material. Their teeth look and feel like normal, but they are protected from plaque build-up and decay early on. John Pappas and our staff recommend sealants as a preventive measure for children before any decay appears on their teeth.

Who should get dental sealants?

Dental sealants are intended for young children as soon as their first teeth come in. Decay is most common in the molars, so taking your child to Masterpiece Dentistry at Copley for sealants right when you see the molars grow in gives your child the best chance to fight tooth decay.

A child’s first set of permanent molars grow in between ages five and seven, while the second permanent molars come in between 11 and 14 years of age. Some teens and adults who don’t have tooth decay may get sealants as well, but it is less common.

How long do dental sealants last?

Once the sealant has been placed on the teeth, it lasts up to ten years. Expect to have John Pappas check the sealant at every visit to our Boston, Massachusetts office, which should be twice a year. We will look at the sealant and determine if it needs to be replaced.

What is the process of getting sealants?

Applying sealants is a simple, pain-free procedure that is done quickly at Masterpiece Dentistry at Copley. There is absolutely no effect on the tooth structure from sealants.

For starters, the teeth are cleaned carefully, then dried with an absorbent material. A mild acid solution is applied to them to roughen them slightly. This is done so the sealant can bond properly to the teeth. Then the teeth are rinsed and dried, and the sealant material is painted on and dried with a special light.

Molars are susceptible to decay early on, which is why sealants are an important treatment to get for your children’s first set of teeth.