May M. Chang, DDS
Creating Beautiful Healthy Smiles

August Update



August 2020 Update:                                                             July 30, 2020

Greetings everyone,

 We hope everyone is healthy and doing well under the circumstances.  We do not have a lot to report except that June and July has gone well with our visits with our patients.  We have had a full schedule and patients have expressed they are very happy with all the steps we have taken to see them.  We thank you for your patience with all our protocols and questionnaires.  We are happy to be adding two Fridays a month with Dr. Mistry and our hygienist, Tiana Romero from 8:30-3:30 pm to help with your dental needs.

Some patients expressed wanting to know what we are doing to help prevent spread among the staff.  We are taking our temperatures, disinfect our hands and answer a questionnaire every morning when we arrive.  We wear a surgical mask the entire time we are in the office.  We change into our surgical scrubs on arrival and wash them at the end of the day.  We have plexiglass barriers between workstations and in all eating areas.  We stagger our lunches, so we do not have everyone taking lunch at the same time.  We have hand sanitizer everywhere and sinks everywhere for good hand hygiene. Clinical staff change their outer gowns with each patient.  We wear a N95 type sealed mask and then a level 1 surgical mask over that which gets changed with each patient.  We also wear a face shield with each patient which gets disinfected with each patient use.  We are disinfecting touch surfaces in our common areas throughout the day.  We fog our operatories between patients to kill any lingering aerosols, in addition to minimizing aerosols with intra oral and extraoral high volume suction and using rubber dams on most all procedures.  We discuss every morning huddle, how we cannot get complacent with what we are doing inside and outside of the office with social distancing, mask wearing, hand hygiene, where, who and how to gather or travel.  Everyone understands the consequences of letting our guard down.  Be assured Dr. Chang is the COVID police around the office and everyone understands what that means!

If you want additional information on what we are doing to help keep you safe, please visit our website at under COVID-19 for more information.

Overall patients we have seen have been taking good care of their mouths during this pandemic.  We are however seeing more broken teeth and more clenching and TMJ issues with increased stress and tension in people.  Remember to keep your teeth apart, tongue up and muscles relaxed.  We have copied some information below for those of you experiencing any symptoms.

Thanks for reading!


May Chang, DDS, Kiran Mistry, DDS, and Staff 



TMJ & Jaw Pain

  1. Apply moist heat or cold to the joint or muscles that are sore.  Heat or ice applications used up to four times per day can reduce pain and relax the muscles.  For heat, microwave a wet towel for about 1 minute or until towel is warm.  Then wrap the warm towel around a hot water bottle or heated gel pack to keep it warm longer.  Apply it to the affected area for 15-20 minutes.  For cold, use ice wrapped in a thin cloth.  At first, you may feel a burning sensation, and this is normal.  Keep ice on the painful area only until you first feel some numbness, but not more than 5 minutes.  Use what feels best but in general, heat is used for more chronic pain conditions and cold for acute conditions. Never use heat on a tooth ache, only on joint pain.
  2. Eat a pain free diet.  Avoid hard foods such as French bread or bagels.  Avoid chewy foods, such as steak or candy.  Cut fruits and steam vegetables into small pieces.  DO NOT chew gum!
  3. Chew food on both sides of your teeth at the same time or alternate sides.  This will reduce strain to the muscles and joints.  If biting into food with your front teeth is painful, then cut up your food with a fork and knife and chew with your back teeth.
  4. Keep your tongue up, teeth apart and jaw muscles relaxed.  Closely monitor your jaw position during waking hours so that you maintain your jaw in a relaxed, comfortable position.  This often involves placing your tongue lightly on the palate behind your upper front teeth (you can find this position by saying “n”).   This allows the teeth to come apart while relaxing the jaw muscles. If it is a nighttime issue, we can make you a night guard to help relieve symptoms.
  5. Avoid caffeine. Caffeine can interfere with sleep and increase muscle tension.  Caffeine or caffeine like drugs are in coffee, tea, soda, power drinks, and chocolate.  Note that some decaffeinated coffee has up to half as much caffeine as regular coffee.
  6. Avoid oral habits and activities that put strain on the jaw muscles and joints.  Oral habits such as teeth clenching, grinding (bruxism), teeth touching or resting together, biting cheeks or lips, tongue pushing against teeth, jaw tensing, biting objects, shoulder shrugging, neck tensing, and other activities such as overextending yawning, prolonged dental treatments, resting your jaw on your hand, over chewing, excessive singing, or use of musical instruments can strain the jaw. Remind yourself to check regularly to see if these activities are present through reminders such as stickers or timers.  If noticed, these habits should be replaced with positive habits such as tongue up and teeth apart.  Use your own good judgment to minimize activities that cause discomfort.
  7. Keep head up, chin in and shoulders down and back.  Closely monitor your head position over your shoulders to maintain a balanced relaxed head, neck, and shoulder muscles with a forward head posture.  This will help in reducing strain to jaw, neck, and shoulder muscles.
  8. Learn and practice relaxation and abdominal breathing.  This will help reduce your reactions to stressful life events and decrease tension in the jaw and neck.
  9. Avoid events that trigger the pain. Use a pain diary to review daily activities that aggravate the pain and modify your behavior accordingly.
  10. Get a good night’s sleep.  Manage your sleep environment.  Reduce light and noise and lie on a comfortable mattress.  Reduce stimulating activities in late evening including computer work and exercising.  Avoid stomach sleeping since this puts adverse forces on the jaw and neck muscles.
  11. Use anti-inflammatory and pain reducing medications.  Short term use of over the counter ibuprofen, naproxen, acetaminophen, or aspirin (without caffeine) can reduce joint and muscle pain.  If compatible with patient conditions and lifestyle, consider use of combination of analgesic and muscle relaxant in the evening.

Self-care is often a first step in the management of TMJ.  Recognize that this is not a life-threatening situation, even though it can be very uncomfortable.  Injury to the TMJ and jaw muscles is extremely common and joint noises (clicks, pops) and locking of the jaw is also not uncommon.  Most often these symptoms are transient or will come and go.  Changing habits, relaxing the area, and avoiding additional strain or injury will better manage your pain.

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