What exactly is TMD/TMJ?

In recent years, more and more people are hearing about TMD and TMJ at the dentist’s office. As is the case with many acronyms discussed at large, people might be wondering what exactly TMD and TMJ are, and what is in store for your teeth if you are diagnosed. Today we’ve decided to put the spotlight on this little understood condition to better spread awareness and understanding of this disorder among our patients.

What does it stand for?

TMD stands for temporomandibular disorder(s). TMD is used to refer to any sort of problem with your jaw and the face muscles associated with controlling the jaw. The acronym TMJ actually stands for the temporomandibular joints, which connect your jaw to the temporal bones within the skull. These allow the jaw to function properly when you’re talking or yawning, or chewing food for example. When people refer to TMJ as a condition, they actually mean TMD, but are mistakenly calling it by the name of the joints, which can lead to some confusion.

What is the cause of TMD?

The dental community is not sure of a single direct cause of TMD, but many believe that it all stems from problems patients might experience with their jaw muscles or the joint areas. Those with a history of jaw injury, or who have experienced problems with their joint or head and neck muscles (whiplash for example) might find themselves diagnosed with TMD. Those subject to tooth-grinding might also be at risk. Extraneous movement of the disc between the ball & socket of the TMJ, arthritis, and stress can also act as contributing factors.

Symptoms to Look Out For

Aside from pain and discomfort, those who are concerned about TMD should look out for

  • pain or tenderness in the areas that have been mentioned
  • trouble chewing or biting
  • limited range of motion when you try to open your mouth wide
  • lock-jaw (closed or open)
  • clicking or popping sounds as you use your jaws
  • tiredness or swelling in the facial area

So if you’re worried about any of these symptoms, make sure to talk to us about it at your next appointment! If needed, we can conduct an initial exam of the area and possibly take x-rays to determine what treatment options we can consider. As in most dental scenarios the sooner we can act, the healthier you can be!

All About Sealants

At any dentist’s office, you hear all about a number of different procedures done on teeth. Some of the more common ones include fillings and sealants. You probably first heard the word “sealant” in the dentist’s chair when you were a kid, but probably didn’t fully understand what it meant. Here is a quick review of everything you need to know about them!

Sealants can offer an additional level of protection for your teeth. A great “safety net” for those hard to reach areas when brushing, sealants provide peace of mind for any patient. While there is no suitable alternative to brushing and flossing, sealants are great for anyone who might be inconsistent with their brushing, especially children and teens.

What is a sealant? Think of it as a raincoat for your teeth! It’s a thin, plastic coating placed on the chewing surfaces of teeth—usually molars—to prevent tooth decay. The coating quickly bonds into the depressions and grooves of the tooth, forming a protective shield over the enamel of each tooth. Sealants have been shown to reduce decay by up to 80%! And studies have shown that children without sealants have almost three times more cavities than those with sealants.

Here’s what to expect if you or a family member has an appointment to get a sealant:

  1. The tooth getting the sealant will be cleaned and dried.
  2. An acidic gel is then placed on the tooth to “roughen up” the surface, creating a strong bond between tooth and sealant. After just a few seconds, the gel is rinsed off and the tooth is dried again.
  3. Then, the sealant is applied to the grooves of the tooth.
  4. In the final step, a special curing light is used to harden the sealant.

And that’s it! This can be done on multiple teeth during one appointment and the entire process can take anywhere between 5 to 45 minutes, depending on the number of teeth being sealed. Once teeth are sealed, the sealant can last up to 10 years. They are checked during regular visits and your dentist will let you know if it is time for a reapplication.

Even if cavities are present, sealants can still offer numerous benefits. Most sealants are clear, so if you do get one placed on a tooth with a cavity, your dentist can continue to keep an eye on it to make sure the cavity isn’t getting larger and the sealant is doing its job.

Who should be getting sealants? They are really for everyone! However, the earlier you get them, the better. It is generally recommended that molars are sealed as soon as they appear to keep them cavity-free. This would mean sealing the first molars around age 6 and the second around age 12. Sealants have been around since the 1960s, but if you didn’t get them as a child, it isn’t too late! There’s still time to protect your teeth. Just talk with Dr. Brunacini or Dr. Karagiorgos about them during your next visit.

Sensitive Teeth? You’re not alone…

Something we hear a lot in our dental office is that a patient’s teeth hurt at certain moments – like when you’re eating a long-awaited ice cream on a summer day or when you’re sipping coffee at an early morning meeting. Noticing these moments is important, but why do those frequent twinges happen? We’d like to help you get to the bottom of this particular dental discomfort by sharing some common causes behind tooth sensitivity as well as some tips on how to reduce sensitivity.

What are some causes of tooth sensitivity?

Put simply, tooth enamel protects the crowns of your teeth and the cementum protects the roots of teeth below the gum line. When either of these barriers are depleted, dentin is exposed. If dentin is exposed, hot, cold, acidic, and/or sticky substances are allowed access to nerves and cells inside the tooth via dentin’s microscopic tubules. Whereas before these nerves and cells were protected by enamel and cementum, the dentin tubules are now exposed and this contact will cause nerves to react to certain substances.

Here is a rundown of some of the most common causes behind tooth sensitivity:

  • Overly aggressive tooth-brushing practices, which may or may not be connected to hard-bristled toothbrush usage
  • Highly acidic food and beverage consumption, which leads to erosion of tooth enamel
  • Tooth decay in the form of broken teeth or cavities, and/or worn fillings that no longer fit properly
  • Tooth-grinding (also known as bruxism)
  • Over-bleaching or overuse of whitening products

How to Reduce Sensitivity

Many of the common causes of tooth sensitivity result in the same thing: wearing down the tooth enamel or gum line.

We’ve compiled some recommendations here on how to combat some of these causes and lessen your chances of encountering tooth sensitivity:

  • Switch from a hard-bristled to a soft-bristled toothbrush, and check with us for a quick refresher to make sure that you’re brushing your teeth with good form.
  • Don’t consume as many acidic foods or beverages. What’s acidic, you ask? High-sugar carbs, soda, sticky candy, and other things. We know it’s hard to stop eating some of these foods, but we suggest you try less acidic alternatives like cheese, fruit, and veggies instead. They’re also healthier for you, which is a bonus!
  • If you have broken teeth, cavities, or fillings, please have us take a look at them so that we can find a way to minimize your dentin exposure.
  • Talk to us (and your MD) about tooth-grinding and how it could be affecting your teeth.
  • Take a break from using whitening or bleaching products.

Another thing to consider is that sensitivity can also be a sign of more serious conditions, like gum disease or gums that shrink as you age, a natural phenomenon. In either of these cases, we encourage you to tell us when you encounter a sensitive tooth, so that we can get you on the path to better dental health.

If you’re worried about tooth sensitivity, make sure to let us know at your next appointment, that way we can make a treatment plan to help you get back on the path of eating ice cream or drinking a cup of morning joe again!

The Dentist’s Tool Box

Dentists and hygienists use many different tools during a typical dental exam. You’ve probably never asked what each tool was for, but we are sure you have wondered! Our tool boxes are full of different tools, each with a specific purpose.We wanted to give you a closer look of what these tools are, so here is a brief overview to improve your understanding of the tools we use most often during exams. Here’s a look at four we use daily!

  1. Dental Explorer: Described often as a “mini shepherd’s hook,” the dental explorer is a probe that serves numerous purposes. We use this tool by gently touching each of your teeth individually. We are probing for the presence of cavities and testing the hardness of your teeth. It also helps us determine the amount of enamel, plaque, and tartar on each tooth before going through the cleaning process.
  2. Saliva Ejector: In the course of a cleaning, we use a straw-like tool that sounds like a small vacuum. This suction tool is used to remove spit, water, blood, and debris during the cleaning process. It helps keeps the area clean and dry, making the process easier. After each patient, the plastic end of the ejector is disposed of and a new one is added.
  3. Periodontal Probe: Without looking closely, this tool can easily be confused with a dental explorer. They look very similar, however, this probe has a blunt end. The design of the end allows us to measure the space between gum tissue and each tooth, which is important as the space can be an indicator of gum disease.
  4. Scaler: The manual scaler also looks like a dental explorer, but has a sharper pointed end. This tool is used to remove plaque to help keep teeth clean and free of stains. In our office, most hygienists use an ultrasonic scaler to remove plaque. The ultrasonic version has a similar end but, alternatively, vibrates at a rate of 20-45kHz, reducing the time it takes to remove the plaque from each tooth. This ultrasonic tool is accompanied by a jet of cool water for your comfort.

Want to learn more about the dental tools we use? Just ask your hygienist at your next visit! We’d love to show you the differences in person and explain how we use each one!

Introducing Dr. Karagiorgos

This month we would like to take some time to feature the most recent addition to our team here at Falmouth Dental Arts: Dr. Antonios Karagiorgos (pronounced “kara-george-us“) or simply “Dr. K.” Dr. Karagiorgos also goes by Adonis, so please feel free to call him by that name as well. We think he’s a really interesting fellow and we can’t wait for everyone to get to know him as he settles in with us.

  1. Welcome to the Falmouth Dental Arts team. How has it been so far?

It has been a lovely experience; I have really enjoyed meeting the patients and getting to know the staff. Since Glen retired officially, I am now coming in full-time four days a week from Monday to Thursday. I thank both the patients and the staff for making this a smooth transition – it has been a great experience.

  1. How did you decide you wanted to study dentistry?

It’s kind of a long story. I have a cousin from Greece who lived with my family in Massachusetts when I was 18 years old. She was doing an international program to become a pediatric dentist. At one point I remember her telling me: this would be a perfect career for you, since you’re artistic, kind, outgoing, and you love talking to people. At the time I told her that I couldn’t imagine myself working in peoples mouths for a living, so I just dismissed the idea completely.

After graduating with a degree in civil/structural engineering, I worked in the field but I disliked my job. At that point, I was counting the hours to when I would be able to leave work for the day. I was 27 and I knew I didn’t want to do that as a lifelong career. I did many different things; I worked as a project manager for the Olympic games in Athens, Greece, and after that I started the process of joining the Air Force as a pilot but disqualified myself by getting laser eye surgery to correct my vision. Around that time, I went through a health scare that made me decide to pursue a career that would be meaningful and satisfying to me. I thought more about what my cousin had suggested: dentistry. So I went back to school to take all the prerequisites to go to dental school, and meanwhile I worked for the Tufts’ Oral Surgery department as a Dental Assistant, where I assisted in surgical procedures such as extraction, implant placement, and even cosmetic surgery. This experience solidified my desire to pursue dentistry. I really enjoyed the surgical aspect of dentistry and considered specializing but the great thing about general dentistry is that you’re able to do a little bit of everything.

  1. What do you want to bring to Falmouth Dental Arts?

Right now I bring extractions and surgical extractions, but in the future I hope to also bring implant placement and IV sedation to Falmouth Dental Arts.

With my past experience assisting in surgery, I hope to make a bigger contribution to the surgical aspect as far as extractions, and hopefully doing implants in the future. I am trained in intravenous or IV sedation, which is a treatment option that would help patients who are nervous or anxious at dental appointments. Right now we offer oral sedation, where patients take a pill and wait for it to take effect, but hopefully within the next year we can begin to offer IV sedation as an option. IV sedation is more predictable with the added benefit of a faster onset. The goal is to provide moderate conscious sedation, where patients are conscious, still breathing on their own, still able to follow instructions, but relieved of any anxiety to keep patients completely at ease with their dental care.

  1. Where did you practice before coming to Falmouth Dental Arts?

Well, while I was training for IV sedation, my wife and I lived up in Bar Harbor for ten months, basically on the doorstep of Acadia National Park. During my training, I also worked full-time in public health dentistry in Ellsworth, where we provided clinical access to those who don’t have the financial means to obtain dental care. After completion of my training we moved to Portland, where I continued to work for public health dentistry in Augusta while working part-time at Falmouth Dental Arts. Although I am now full-time at FDA, I continue to work a few days a month working for public health dentistry as a way to give back.

  1. What do you love about working at Falmouth Dental Arts?

It’s the people. The patients and staff here make my job feel like it’s not even work. It’s a great feeling to be a part of a team like this. And we meet patients from all walks of life, so it’s great to talk to everyone and get to know them.

  1. What do you think the future of dentistry looks like?

This is a very interesting time in dentistry because technology is changing at such a rapid pace and the amount of research going on is unprecedented. We’re on the precipice where we can’t even imagine the changes that will be coming to the field. Dentistry is going to be unrecognizable in 20 years. I look forward to a time when we can help the body repair itself, including the dentin beneath the enamel of patients’ teeth. Whereas now, if a tooth is decaying or breaking down, we intervene with a filling to stop the process of decay, so if we can induce the body to heal itself that would be a great advancement in the field. I’m not sure when it will happen, but regenerative dentistry would be a huge leap forward in dentistry.

Is there any particular piece of technology that you’re really interested in?

I am very interested in 3D imaging. This technology gives us an accurate three-dimensional image of the oral and facial structure, which then functions as a guide in simulated surgery and precision implant placement, which makes surgery less invasive. This will lead to shorter surgery time and faster recovery for the patient. 3D imaging can also make taking impressions for dental work a lot easier and less messy for the patients.

  1. What is an interesting dental fact that most people may not know?

Tooth enamel is the hardest substance in the human body– even harder than bone.

  1. When you’re not taking care of patients’ teeth, what do you like to do? What are some of your hobbies?

I definitely love cooking – that’s a hobby of mine. I also like fly-fishing, snowboarding, and biking, and those are some of the great things that brought us to Maine. My wife and I enjoy being near the water to take advantage of water-related activities.

In high school, I started flying small planes as well; someday I hope to pick that back up again.

  1. What is your favorite part of dental practice?

The patients. I have the opportunity to meet all different kinds of people – which I was missing when I was in front of a computer screen all day as an engineer and didn’t get to interact with others. On top of that, each individual presents different challenges that constantly keep me on my toes. Every day is about finding the best dental solution for each individual while keeping each patient’s special circumstances and aesthetic vision in mind, as well as the financial aspects involved to create the best possible treatment plan for every individual.

There’s also an aspect of artistic expression to what we do: it’s making a filling look like a tooth. In a way, dentistry is a very satisfying form of artistic expression on a small scale.

  1. Your biography on the website reads that you’re licensed to practice dentistry in Maine and Alaska. How did that come to be?

The original plan was to move to Alaska with my wife after training in Bar Harbor but family and our love of the area kept us here. I would like to renew my Alaska license – it recently expired – because in the future I would like to do mission trips, either to underserved communities within the United States, South America, or the Philippines, where my wife is from, and donate my services to people in need.

  1. Do you have any pets?

We have our dog, who has been with us seven months now. He is an Aussie doodle, which is an Australian shepherd-poodle mix. His name is Roux. He is a beloved member of our family.

  1. Favorite dental tip?

Floss, floss, floss!!! Flossing can remove plaque and food debris particles in places where toothbrush bristles cannot easily reach, like under the gum line and especially between your teeth. Plaque buildup can lead to tooth decay and gum disease, which daily flossing can help prevent!


For more about Dr. Karagiorgos, make sure to check out his biography and schedule your next appointment with him today!