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Most people think braces are all about their teeth. While it is true orthodontics is meant to move your teeth into proper position, there's more to it than that. To safely move your teeth with braces, you're going to need healthy and stable gums (or periodontium—the tissues that support your teeth).

For this reason it's critical to have your periodontal health evaluated prior to getting braces. This applies particularly to adults, since a 2013 study by the Center For Disease Control found that an estimated 47.2% of adults 30 years of age and older had periodontitis (gum disease). If you do have periodontitis, moving your teeth with braces will only make things worse.

Conversely, there is also risk for periodontal disease if you don't get orthodontic treatment. Malocclusion, as well as crooked and spaced teeth, can all contribute to periodontal disease. In these situations your teeth and gums are more difficult to clean and become breeding grounds for disease causing bacteria. Bad oral hygiene combined with these traits can greatly contribute to the development of periodontitis.

So, periodontics and braces have a tricky relationship. On one hand, you shouldn't get braces if you show signs of developing or have periodontitis, while on the other hand, braces can help prevent the possibility of developing periodontitis by correcting the bite and straightening the teeth.

If you are 30 years of age or older and are considering getting braces, it would be wise to first:

• Let John Pappas know about your desire to get braces
• Get an exam to make sure you're in good periodontal health and a good candidate for braces
• If you are a good candidate, keep an eye on your teeth and gums and get regular dental checkups throughout your entire course of treatment.

If you are in any doubt about the status of your teeth and gums, it's always best to get them checked before embarking with braces treatment. For more information or to have your periodontal health assessed for braces treatment, please contact our Boston, Massachusetts office.

Toothaches in children can be tricky ordeals that cause distress for both the child and the parent. You may feel helpless and frustrated because you cannot pinpoint the location of the pain. It is so hard to see your little one experience discomfort and feel like there is nothing you can do about it. But there are ways you can help. Try these tips the next time your child has a toothache.

Zero in on the Painful Area

The first thing you need to do is find out where the pain is coming from. If your child is old enough, ask him or her to point to the painful area. In younger children, look for swelling and redness on the gums and cheek, dental caries (discolorations on the tooth), or broken teeth. Try to get as close to the location of the pain as possible so you can determine an effective course of action to relieve it.

Try to Find the Cause

Not all toothaches are actually toothaches. A child can bite his or her tongue or cheek, have sore gums, or develop ulcers in the mouth. Teeth that are coming in can also be quite painful. If a tooth is discolored, broken, loose, or has spots that are either darker or lighter than the rest of the tooth, those could be causes of pain.

Five-Step Approach to Dental Pain Relief

1. Floss. Help your child floss to remove any food particles that may be wedged between the teeth and could be causing pain.
2. Rinse with warm salt water. Use a warm salt-water solution and have your child rinse well by swishing or holding the salt water over the painful area.
3. Use a cold compress. This can relieve pain and swelling. If there is no swelling, you can try it anyway to subdue the pain. Try it on for about 15 minutes, then off for 20.
4. Give the child ibuprofen or acetaminophen. Use the appropriate dosage for your child’s age and administer it regularly as directed.
5. See John Pappas. If you determine that the tooth or gum is damaged, or if the pain simply cannot be relieved, call our Boston, Massachusetts office.

If your child is experiencing throbbing pain, fatigue, or fever, you should call your pediatrician as soon as possible. If your child is experiencing mouth pain accompanied by trouble breathing or swallowing, it can indicate a more serious situation and you should take your son or daughter to the emergency room.

Most mouth pain in children can be remedied with the simple steps here. The important thing is that you remain calm, no matter what. You child is taking cues from you and if you panic, he or she will panic.

John Pappas and our team recommend that you brush your teeth two to three times a day, for at least two minutes each time. But have you ever wondered what’s in toothpaste and how it actually works? The mouth is home to more than 500 types of microorganisms that feed on leftover food that gets stuck on and around your teeth. Toothpaste is the best line of defense against all those pesky microorganisms (especially when you brush two to three times a day). Here’s how it works.

Abrasives

Toothpaste contains mild abrasive additives that combat microorganisms and fight plaque. When you brush, the abrasives in toothpaste dislodge food particles and microorganisms more effectively than if you simply brush your teeth with water. The abrasives also work to remove food stains and polish the surface of the tooth. Some toothpastes include ingredients like triclosan and Xylitol. These chemicals prevent the growth of bacteria that produce plaque. Plaque not only causes cavities, but it can also lead to more dangerous issues like periodontal disease.

Fluoride

Fluoride is key ingredient in toothpaste. As the microorganisms in your mouth feed off the leftover food particles, they leave behind acid and sulfur byproducts that wear away the enamel of the teeth. This is the fancy, technical way of saying that the acid on your teeth causes cavities. As for the sulfur byproduct –well, that’s just a fancy, scientific name for bad breath. Fluoride works to fight the acid and help protect the teeth. By brushing, the fluoride is incorporated into the tooth enamel, which in turn makes the tooth more resistant to acid and plaque.

Flavoring and Sweetening Agents

Not all toothpaste tastes the same, right? The type of flavoring or sweetening agents added to the toothpaste doesn't have anything to do with fighting microorganisms and plaque, but taste is one of the most important selling points in finding a toothpaste brand you like. Flavoring agents mask the taste of some of the other ingredients in toothpaste, and without those agents chances are nobody would be brushing their teeth two to three time a day.

Most people hear the word root canal and panic. With today’s state of the art equipment and improved local anesthetic devices, and some knowledge, a root canal does not have to cause panic. Root canals are a common dental procedure, done quite often at our Boston, Massachusetts office.

Why do I need a root canal?

There are several reasons why John Pappas may suggest a root canal including:

• An infection in your tooth that has reached the nerves
• A deep cavity that cannot be filled because the pulp and nerves are also effected
• Injury to the tooth
• A deep cracked tooth
• Broken tooth
• Repeated fillings of the effective tooth

What is a root canal?

A root canal is a dental procedure that is used to prevent the loss of a tooth and relieve pain. Inside your teeth is pulp which consists of soft tissue blood, connective tissue, blood vessels, and nerves. When the pulp becomes infected, swollen or diseased a root canal is necessary to save your tooth. During a root canal, John Pappas will remove the infected pulp. The tooth’s root canals and pulp chamber of your tooth will be cleaned, so all the diseased pulp is removed and then your tooth will be sealed.

What to Expect During a Root Canal

Your root canal will start out just like any other dental procedure. We will go over any questions you may have, and then numb the area surrounding the tooth. After the area is numb the root canal will begin.

The amount of time it takes to do your root canal varies depending on number of roots that need to be cleaned. Most teeth have one root canal, while others have between two and four. For a single canal, the procedure usually lasts less than an hour. The more canals your tooth has the longer amount of time it will take and in some cases, you will require more than one visit.

How much pain will I have after a root canal?

Once the local anesthesia wears off, your pain can be controlled by over the counter pain medications such as Ibuprofen, Naproxen, or Acetaminophen. In some cases, John Pappas may prescribe a prescription dose of pain medication. Within two days you should be feeling much better and able to return to your regular lifestyle.