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Time flies when we are not at the dentist! Before you know it, years may have gone by. Let’s take a moment to explain what takes place when a patient comes back to receive care after an extended period of time.

After a while, small dental concerns or issues can grow into an unexpected journey of discovery and expense. Anxiety is common and expected. Let’s discover first of all, “What brings you here today?” It is a good place to start and once the initial concerns are addressed, a comprehensive plan to restore optimum dental health can be arranged. During the first appointment John Pappas and our team want you to feel comfortable, and establish a confidence allowing you to be open with any questions.

Your visit will take approximately 90 minutes. First, a complete medical and dental history will be recorded and reviewed in one-on-one interview style. This is the time to voice any concern, anxiety issues, worries, etc. Then, X-rays are taken to provide additional information about what is happening beneath the surface of your teeth and gums. Finally, a series of screenings including those for oral cancer, home care evaluation, and periodontal disease are conducted to complete your oral health evaluation.

The hygienist has a great eye for other conditions such as broken fillings, cracked teeth, active decay, and other dental concerns. Then, John Pappas will come in for a comprehensive exam and list and prioritize your dental needs. Our treatment coordinator will present scheduling options, insurance coverage, and payment plans.

Our team will coach you and help you gain control of your own dental destiny with good home care habits. You will receive a bag with a toothbrush, floss, appropriate toothpaste, and any other specialized tools for your needs. You will know how often you need to return for hygiene visits or other dental appointments.

Our patients at Masterpiece Dentistry at Copley are our most important asset, and we strive to create a comfortable experience, no matter how long it has been since your last visit at our Boston, Massachusetts office. From phone conversations to financial arrangements to clinical treatment, we want you to feel confident that our team will meet your needs.

Your smile is in the spotlight every day, helping you greet the world with confidence! But when you’re self-conscious about discolored spots on your teeth, it’s time to get some professional advice to deal with these troublesome tints.

Discolored patches, both dark and light, can develop for a number of different reasons. Some markings are cosmetic only, and some spots require treatment. Some can be removed with a professional cleaning, and some might require more serious restoration. Let’s have a look at some of the common causes of enamel discoloration.

• Cavities

Decayed enamel can appear as a brown spot on the tooth. A dark edge around a filling might mean decay underneath.

Regular checkups at our Boston, Massachusetts office will help catch small cavities before they become big ones. If you need a filling, the filling color can be matched to your tooth color for an undetectable restoration.

• Demineralization

Bacteria in plaque produce acids, which attack our teeth. These acids erode minerals such as calcium and phosphorus from enamel, leaving a weak spot that is vulnerable to decay. This process is called “demineralization,” and often leaves a whiter spot on a tooth where minerals have leached away. Common reasons for demineralization are neglecting dental hygiene, failure to clean around braces, and a diet filled with sugary and acidic foods.

Fluoride and enamel-strengthening toothpastes, a healthy saliva flow, and a balanced diet help our teeth “remineralize,” bathing teeth in minerals that can help replace those that have been lost. But if you have lingering white spots due to demineralization, John Pappas can provide some options, including whitening, microabrasion, and veneers.

• Fluorosis

Fluorosis is a cosmetic condition caused by exposure to too much fluoride while the permanent teeth are still forming (generally, during the years before a child’s eighth birthday). Small white spots and patches are a common result of mild fluorosis. In more serious cases, teeth can be pitted and stained with brown, gray, or black spots.

Preventing fluorosis begins in early childhood. Talk to John Pappas about fluoride levels in local tap water if you have any concerns. Use only the recommended amount of toothpaste (the size of a grain of rice for children three and under; the size of a pea for children three to six), and show your child how to spit out toothpaste and rinse after brushing. Keep fluoride toothpastes and other fluoride products out of the reach of young children. Don’t give children fluoride supplements or fluoride rinses without discussing it with John Pappas.

If your own teeth have been affected by fluorosis, talk to us. Again, this is a cosmetic condition affecting otherwise healthy teeth. Whitening treatments can be helpful in mild cases, microabrasion has been effective for mild to moderate cases, and, for severe cases, cosmetic restorations such as bonding and veneers are an option.

• Tartar

Are you seeing an accumulation of dark brown spots and stains on your teeth, especially between the teeth and at the gum line? This might mean that you have tartar buildup. When you brush plaque away every day, your enamel stays smooth and clear. But when plaque builds up over time, it hardens and becomes tartar.

How hard is tartar? So hard that it can only be removed with a professional cleaning. Eliminate this source of spots and staining with twice daily brushing and daily flossing, and make sure regular professional cleanings are on your calendar.

• Other Causes

Medications taken while teeth were developing (notably, antibiotics in the tetracycline family) can cause discoloration. Medical conditions such as celiac disease and enamel hypoplasia can affect both tooth color and enamel formation.

Cosmetic treatment and restorations can help with discoloration caused by medications, and restorations such as bonding, veneers, and crowns can restore tooth appearance and function when medical conditions cause imperfections in enamel color and structure.

If you’re unhappy with the overall whiteness of your smile, a professional whitening might be just what you’re looking for. If specific patches, streaks, and spots of a different color are dimming your bright smile, it’s time for an exam. John Pappas will be able to tell you the reason for any discolored enamel as well as present you with all your treatment options. Put the spotlight back where it belongs—on your healthy, confidant smile!

Congratulations! Your pregnancy is a time of joy and excitement—and a time to take special care of yourself. You’ve discovered that pregnancy brings many physical changes, but it may still come as a surprise to learn that pregnancy hormones can affect your oral health as well. What should you look out for?

Gingivitis

Beginning in the second or third month of pregnancy, your gum tissue may show signs of gingivitis. Pregnancy hormones can cause an increase in the blood supply to your gums and affect the way your gums respond to plaque. These changes may lead to gums that are swollen, red and more likely to bleed upon brushing. This early form of gum disease should be treated as quickly as possible to avoid a more serious condition called periodontitis.

Periodontitis

Without treatment, the inflammation caused by gingivitis can increase. Periodontitis can lead to gums pulling away from the teeth, creating “pockets” that can be home to infection. These infections can lead to bone and tooth loss, so professional treatment is a must.

Pregnancy Granulomas

If you find a dark red swelling along the gumline or between two teeth, it might be a pregnancy granuloma. These granulomas are thought to be triggered by pregnancy hormones and may be a reaction to plaque or some other irritant. They often disappear once your baby is born and usually don’t cause any bother, but if you develop discomfort eating or speaking, your dentist might suggest removal.

You are looking for every way possible to provide your baby with the best start in life, so it is important to know that some studies have suggested a link between periodontal disease in pregnancy and complications such as pre-term delivery and low birth weight. Here are some important ways to maintain your oral health during pregnancy:

• Call John Pappas when you find out you are pregnant. We have suggestions for your dental care that you can use immediately.
• Keep to your regular schedule of dental examinations and cleanings at our Boston, Massachusetts office. If you find your gums beginning to show signs of gingivitis, call our office for an appointment. You might need to have your teeth cleaned more often during your pregnancy to avoid plaque buildup.
• Maintain your daily dental hygiene. Be sure to carefully brush along the gumline to discourage plaque formation. If you have not switched to a soft bristle toothbrush, now is the time! Talk to us about possible rinses or other at-home treatments.
• See a periodontist if needed for more serious gum problems.

Your pregnancy is a time to treat yourself and your baby with care. Talk to our office as soon as you find out you are pregnant. Making your dental health a priority can bring rewards both now and in the future, and we welcome the opportunity to suggest the best possible ways to care for yourself and your baby!

What’s life like for the average 60-year-old today? It’s complicated! We travel. Or we work out. Or we relax with friends. We pursue favorite hobbies or we develop new ones. We work, or start businesses, or volunteer for schools, museums, and charities. We practice the art of writing letters or we text our grandchildren. Whatever else we do, we do our best to stay healthy so we can live our lives to the fullest.

Part of living our lives to the fullest means caring for ourselves. And caring for ourselves means learning how to look out for the potential dental problems that might come with age, and how to keep ourselves in the best of dental health.

• Gum Disease

Gum disease, or periodontitis, is not uncommon in older patients. Certain medical conditions, such as diabetes, can leave you more vulnerable to gum disease. Because gum disease is often symptom free, it can remain unnoticed until the disease has progressed. Good oral hygiene and regular visits to the dentist are the best means of prevention—we are trained to discover gum disease in its earliest stages, and can treat it before the disease causes serious damage to gums, teeth and bone. But if you have delayed seeing a dentist, the good news is that there are many methods of treating gum disease available, including antibiotics, professional plaque removal, and periodontal surgery.

• Tooth Decay

As we age, our gums can recede from the teeth. The new root area that is exposed is more vulnerable to decay because it is not shielded by the hard enamel which protects the upper part, or crown, of the tooth. Maintaining your brushing and flossing routine is the best way to keep cavities from developing. If gum recession is severe, there are surgical methods we can discuss to restore gum health.

• Time

Cosmetically, teeth can yellow with age as the dentin beneath the enamel darkens and the enamel covering it thins. Years of coffee, wine, smoking and other stain-makers take their toll. If you are self-conscious about the appearance of your smile, talk to us about suggestions for whitening and brightening.

Medically, over time our teeth are subject to damage. Enamel and tooth surfaces can wear away, leaving our teeth more at risk for breaks or fractures that can lead to infection, which can result in the need for root canal work. Simple chewing puts an amazing amount of pressure on the teeth—and if you grind your teeth, there is even more stress placed on them. See us regularly for ways to maintain strong teeth, to repair damage if necessary, and to keep your gums and bones healthy if you are a denture wearer.

• Dry Mouth

Dry mouth can be a problem for older patients, often caused by medical conditions or medications. When we produce saliva, it helps remove sugar and the acids sugars produce which attack our enamel. Without normal saliva production, we are more vulnerable to cavities. Dry mouth can also lead to mouth ulcers, oral thrush, sores and infections. If you have been suffering from this condition, talk to us. John Pappas and our team have suggestions that will help.

• Oral Cancer

Oral cancer is something we look for during every check-up. And, if you ever notice any change that causes you concern, call us immediately. Early treatment of oral cancer and other oral diseases leads to the best possible outcome.

• Keep Up With Your Dental Care

The best way to keep our teeth and mouths healthy as we age is with prevention. Regular daily brushing and flossing and office visits twice a year for an examination and a professional cleaning are habits that should last a lifetime. Make sure to tell us about any medical conditions you may have and any medications you are taking, to avoid interactions and relieve unpleasant side effects.

What’s life like for the average older person today? There is no average older person! As we age, we are free to explore our interests in any number of creative and individual ways. But there is one goal we have in common: we all want to keep our smiles healthy and attractive. Call our Boston, Massachusetts office for preventative and restorative care. We want to help you work toward an ageless smile!