My Blog

By Paul David Epstein, D.M.D. & Associates, P.C.
October 13, 2017
Category: Oral Health
Tags: tmj disorders  
WhytheTreatmentModelforYourJawJointDisorderMatters

Your temporomandibular joints (TMJ), located where your lower jaw meets the skull, play an essential role in nearly every mouth function. It’s nearly impossible to eat or speak without them.

Likewise, jaw joint disorders (temporomandibular joint disorders or TMD) can make your life miserable. Not only can you experience extreme discomfort or pain, your ability to eat certain foods or speak clearly could be impaired.

But don’t assume you have TMD if you have these and other symptoms — there are other conditions with similar symptoms. You’ll need a definitive diagnosis of TMD from a qualified physician or dentist, particularly one who’s completed post-graduate programs in Oral Medicine or Orofacial Pain, before considering treatment.

If you are diagnosed with TMD, you may then face treatment choices that emanate from one of two models: one is an older dental model based on theories that the joint and muscle dysfunction is mainly caused by poor bites or other dental problems. This model encourages treatments like orthodontically moving teeth, crowning problem teeth or adjusting bites by grinding down tooth surfaces.

A newer treatment model, though, has supplanted this older one and is now practiced by the majority of dentists. This is a medical model that views TMJs like any other joint in the body, and thus subject to the same sort of orthopedic problems found elsewhere: sore muscles, inflamed joints, strained tendons and ligaments, and disk problems. Treatments tend to be less invasive or irreversible than those from the dental model.

The newer model encourages treatments like physical therapy, medication, occlusive guards or stress management. The American Association of Dental Research (AADR) in fact recommends that TMD patients begin their treatment from the medical model rather than the dental one, unless there are indications to the contrary. Many studies have concluded that a majority of patients gain significant relief with these types of therapies.

If a physician or dentist recommends more invasive treatment, particularly surgery, consider seeking a second opinion. Unlike the therapies mentioned above, surgical treatments have a spotty record when it comes to effectiveness — some patients even report their conditions worsening afterward. Try the less-invasive approach first — you may find improvement in your symptoms and quality of life.

If you would like more information on treating TMD, please contact us or schedule an appointment for a consultation. You can also learn more about this topic by reading the Dear Doctor magazine article “Seeking Relief from TMD.”

By Paul David Epstein, D.M.D. & Associates, P.C.
October 10, 2017
Category: Dental Procedures
Tags: cosmetic dentistry  

Discover the many ways cosmetic dentistry in Burlington can enhance your appearance.cosmetic dentistry

Whether your wedding is fast approaching or you are just getting back into the world of dating, there are many reasons why you may be interested in boosting your appearance. Cosmetic dentistry is one of the best ways to give your look that little enhancement it needs to really shine. A beautiful smile says a lot about you. Here’s how our Burlington, MA, cosmetic dentist, Dr. Paul Epstein, can help you.

Dental Bonding and Contouring

Not all cosmetic dentistry treatments have to be expensive, nor do they have to require multiple trips to our office. In fact, bonding and contouring are the most inexpensive and non-invasive cosmetic options you can get.

Contouring involves shaving off small bits of enamel to change the size or shape of a tooth, while bonding uses a tooth-colored resin to cover small imperfections like discolorations, chips and cracks. If you only have minor flaws in your smile, these complementary cosmetic treatments may be all you really need.

Teeth Whitening

While whitening toothpastes and at-home whitening kits might work for some people, if you have rather deep-set or severe stains then you may require a stronger whitening approach. This is where professional teeth whitening comes in. Our Burlington dentist has been trained to safely and effectively use this powerful whitening system to deliver brighter results in just one visit. Some people can achieve a smile that’s several shades whiter thanks to in-office whitening.

Dental Veneers

Sometimes there are discolorations that teeth whitening can’t treat and gaps between teeth that can’t be hidden with dental bonding; fortunately, these issues can easily be addressed with porcelain veneers. These very thin shells are custom made to cover your teeth. They are bonded to the front surface of your teeth to hide everything from gaps, minor overlapping and crowding to chips, cracks and misshapen teeth. In as little as two to three visits you could have that Hollywood smile, too.

Paul David Epstein, D.M.D. & Associates in Burlington, MA, is dedicated to giving you a smile you just can’t wait to show off. Isn’t it time you felt confident smiling? We certainly think it’s time. Give us a call today to schedule your cosmetic consultation with us.

By Paul David Epstein, D.M.D. & Associates, P.C.
September 28, 2017
Category: Dental Procedures
CharlizeTheronBackinActionAfterDentalSurgery

When they’re introducing a new movie, actors often take a moment to pay tribute to the people who helped make it happen — like, you know, their dentists. At least that’s what Charlize Theron did at the premiere of her new spy thriller, Atomic Blonde.

"I just want to take a quick moment to thank my dentists," she told a Los Angeles audience as they waited for the film to roll. "I don’t even know if they’re here, but I just want to say thank you."

Why did the starring actress/producer give a shout-out to her dental team? It seems she trained and fought so hard in the action sequences that she actually cracked two teeth!

“I had severe tooth pain, which I never had in my entire life,” Theron told an interviewer from Variety. At first, she thought it was a cavity — but later, she found out it was more serious: One tooth needed a root canal, and the other had to be extracted and replaced with a dental implant — but first, a bone grafting procedure was needed. “I had to put a donor bone in [the jaw] to heal,” she noted, “and then I had another surgery to put a metal screw in there.”

Although it might sound like the kind of treatment only an action hero would need, bone grafting is now a routine part of many dental implant procedures. The reason is that without a sufficient volume of good-quality bone, implant placement is difficult or impossible. That’s because the screw-like implant must be firmly joined with the jawbone, so it can support the replacement tooth.

Fortunately, dentists have a way to help your body build new bone: A relatively small amount of bone material can be placed in the missing tooth’s socket in a procedure called bone grafting. This may come from your own body or, more likely, it may be processed bone material from a laboratory. The donor material can be from a human, animal or synthetic source, but because of stringent processing techniques, the material is safe for human use. Once it is put in place your body takes over, using the grafted material as a scaffold on which to build new bone cells. If jawbone volume is insufficient for implants, it can often be restored to a viable point in a few months.

Better yet, when grafting material is placed in the tooth socket immediately after extraction, it can keep most of the bone loss from occurring in the first place, enabling an implant to be placed as soon as possible — even before the end of a movie’s shooting schedule.

Will Atomic Blonde prove to be an action-movie classic? Only time will tell. But one thing’s for sure: When Charlize Theron walks down the red carpet, she won’t have to worry about a gap in her smile.

If you have questions about bone grafting or dental implants, please contact our office or schedule a consultation. You can read more in the Dear Doctor magazine articles “Dental Implant Surgery” and “Immediate Dental Implant.”

By Paul David Epstein, D.M.D. & Associates, P.C.
September 13, 2017
Category: Dental Procedures
Tags: teeth whitening  
BeSuretoHaveaDentalExamBeforeWhiteningYourTeeth

You’ve been embarrassed for a while now by your yellowed, dull teeth. You’re ready for a change.

There’s a simple and cost-effective way to make that change: you can temporarily brighten your smile with teeth whitening, possibly at home. But before you try it, you should first have a dental examination to find out if whitening is the right choice for you.

First off, healthy teeth with outer enamel staining are the best candidates for whitening. Teeth and gums with tooth decay or periodontal (gum) disease should be treated first before undergoing whitening. A dental exam will uncover any health issues you may have with your mouth.

In the same vein, you’ll want to consider whitening carefully if you have dental work like veneers, crowns or implants. Unlike natural teeth, these non-biological materials won’t be affected by the bleaching agent. We can discuss any potential for color mismatch between your whitened natural teeth and your dental work during your examination.

A dental exam can also uncover one other crucial fact — what kind of tooth staining you have. There are two basic types: extrinsic, staining on the outside enamel as we’ve mentioned earlier; and intrinsic, staining that originates from inside a tooth. The whitening kits you purchase from a store and even some of the whitening techniques we use in the office only diminish extrinsic, not intrinsic staining. To address an intrinsically-stained tooth requires a much more involved, invasive clinical technique only performed by dental professionals.

Finally, a dental examination is a good discussion forum for helping you decide between a home kit and a clinical procedure. While DIY kits are effective for the most part, you won’t be able to precisely control the degree of brightness like we can. This could be important if you want a specific shade of whiteness, from a more subtle and natural shade to dazzling “Hollywood” bright. Shade control could also help minimize color mismatch with dental work.

In the end, we want to help you make the best choice for teeth whitening. Even if you decide to pursue whitening at home, we can offer you valuable advice on what to look for when you buy a kit and how to use it. That alone could help ensure you get the new, bright smile you desire!

If you would like more information on teeth whitening, please contact us or schedule an appointment for a consultation. You can also learn more about this topic by reading the Dear Doctor magazine article “Important Teeth Whitening Questions…Answered!

By Paul David Epstein, D.M.D. & Associates, P.C.
August 29, 2017
Category: Oral Health
HowBigBangTheoryActressMayimBialikGetsHerKidstoFloss

How many actresses have portrayed a neuroscientist on a wildly successful TV comedy while actually holding an advanced degree in neuroscience? As far as we know, exactly one: Mayim Bialik, who plays the lovably geeky Amy Farrah Fowler on CBS' The Big Bang Theory… and earned her PhD from UCLA.

Acknowledging her nerdy side, Bialik recently told Dear Doctor magazine, “I'm different, and I can't not be different.” Yet when it comes to her family's oral health, she wants the same things we all want: good checkups and great-looking smiles. “We're big on teeth and oral care,” she said. “Flossing is really a pleasure in our house.”

How does she get her two young sons to do it?

Bialik uses convenient pre-loaded floss holders that come complete with floss and a handle. “I just keep them in a little glass right next to the toothbrushes so they're open, no one has to reach, they're just right there,” she said. “It's really become such a routine, I don't even have to ask them anymore.”

As many parents have discovered, establishing healthy routines is one of the best things you can do to maintain your family's oral health. Here are some other oral hygiene tips you can try at home:

Brush to the music — Plenty of pop songs are about two minutes long… and that's the length of time you should brush your teeth. If brushing in silence gets boring, add a soundtrack. When the music's over — you're done!

Flossing can be fun — If standard dental floss doesn't appeal, there are many different styles of floss holders, from functional ones to cartoon characters… even some with a martial-arts theme! Find the one that your kids like best, and encourage them to use it.

The eyes don't lie — To show your kids how well (or not) they are cleaning their teeth, try using an over-the-counter disclosing solution. This harmless product will temporarily stain any plaque or debris that got left behind after brushing, so they can immediately see where they missed, and how to improve their hygiene technique — which will lead to better health.

Have regular dental exams & cleanings — When kids see you're enthusiastic about going to the dental office, it helps them feel the same way… and afterward, you can point out how great it feels to have a clean, sparkling smile.

For more information about oral hygiene, please contact our office or schedule a consultation. You can read the interview with Mayim Bialik in the latest issue of Dear Doctor magazine.





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