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Orthodontists and dentists use advanced procedures to treat and save teeth. But sometimes, a tooth just can’t be saved and needs to be extracted. Sometimes it’s due to extensive decay, or infection, or serious injury. Or sometimes, to create a healthy bite, an extraction is necessary during orthodontic treatment.

When does an orthodontist recommend an extraction? Conditions which call for extraction include:

• Incoming Wisdom Teeth

Not many people have enough space in their mouths for four wisdom teeth! And when there’s no room to erupt properly, wisdom teeth can become decayed or infected, push your other teeth out of place, and damage the roots of nearby molars. Extracting wisdom teeth protects your teeth and your bite alignment.

Usually, orthodontic treatment takes place before the wisdom teeth begin to erupt. But if yours start to make an appearance during treatment, your orthodontist and dentist will work together to schedule extraction without interfering too much with your orthodontic treatment plan.

• Tooth and Jaw Structure

Dr. Neil Oliveira and Dr. Derek Wolkowicz and the team at Orthodontic Specialists of Southeastern Massachusetts carefully plan your treatment based on examinations, X-rays, and/or 3D imaging. The goal is to align your teeth and jaws for an attractive smile and a healthy, functional bite. When overcrowding is severe, or if there is a serious malocclusion (bite problem), or if a particular tooth is unusually large or misshapen, your orthodontist might recommend an extraction.

Sometimes more room can be made for teeth with appliances such as palatal expanders or, in other cases, with the help of oral surgery. Extractions are only recommended when they are absolutely necessary.

• Baby Teeth Which Aren’t Coming Out 

Baby teeth normally fall out in a predictable pattern. Front teeth first, canines and molars last. Baby teeth have small roots, and these roots begin to break down when the adult teeth underneath put pressure on them as they start to erupt. As the root gets smaller and smaller, the baby tooth gets looser and looser—until it falls out. 

Sometimes, though, the roots of primary teeth don’t break down, and the baby teeth stay right where they are. This means that the permanent teeth have to erupt someplace else—usually behind those baby teeth. This creates a double row of teeth, and your permanent teeth can become crooked or overlap as they try to fit in. Extracting stubborn baby teeth allows your adult teeth to come in just where they’re supposed to. Because of their small roots, extracting primary teeth is usually simple and straightforward, and can be done in your dentist’s office. 

• Too Many Teeth

Most of us have 32 adult teeth, including wisdom teeth. It’s rare, but sometimes an extra, or supernumerary, tooth develops. Your jaw is most probably not equipped to accommodate any extras, so, in this case, the extra tooth or teeth are removed to give the rest of the teeth the space they need to avoid overlapping or crowding.

When your orthodontist recommends an extraction, it’s because it’s important for your dental health. Dr. Neil Oliveira and Dr. Derek Wolkowicz will refer you to a dentist or a specialist like a periodontist or oral surgeon, who will: 

• discuss the extraction procedure with you, including sedation options
• numb the area 
• gently loosen and then extract the tooth
• provide options for pain management after the procedure
• give you detailed instructions for aftercare
• work with your orthodontist to keep your treatment on schedule

Extraction is never your first choice, or your orthodontist’s! But when an extraction is necessary for tooth and bite alignment, everyone at Orthodontic Specialists of Southeastern Massachusetts in New Bedford or Mattapoisett, MA will coordinate a treatment plan to create your best—and healthiest—smile.

It’s the littlest month of the year, so what better time to think about the dental health of our littlest family members? February is National Children’s Dental Health Month, and we’re here to suggest some of the best dental habits for healthy childhood smiles.

Babies 

• Even before your baby cuts her first adorable tooth, you can start proactive dental care by gently wiping little gums with a clean, moist gauze pad or soft cloth twice a day. This removes bacteria and food particles and helps prepare your baby for brushing.
• When that first tooth does appear, or by age one if it hasn’t yet erupted, it’s time to schedule a visit to the dentist. At this first visit, your child’s dentist will check jaw and tooth development and can give expert guidance on teething, brushing, how much and which kind of toothpaste to use, and topics like thumb-sucking and pacifier use.
• When baby teeth arrive, use a small soft-bristled toothbrush designed to fit comfortably in tiny mouths.
• Use toothpaste as recommended. Children under the age of three who use paste should use a very small amount, no larger than a grain of rice.
• Prevent “baby bottle tooth decay”—don’t put your baby to bed with a bottle. This allows the sugars in formula or, when your child is 12 months or older, milk, to bathe the teeth throughout the night. And babies and toddlers never need sugary juices or sodas in those bottles!

Toddlers 

• Help your child develop a positive relationship with his dental team. Read books or watch videos to help your child learn what to expect. Practice with him by having him open his mouth while you count his teeth. Plan visits when your child isn’t hungry or tired. Be positive yourself—your child will take his cues from you!
• Schedule regular appointments for exams and cleanings. Your child’s dentist will check tooth and jaw development, look for any signs of decay, and evaluate potential problems such as prolonged thumb sucking or pacifier use. 
• By age three, children have most or all of their baby teeth. Use a soft bristled brush to clean your child’s teeth twice each day. As she grows, demonstrate how to brush properly. Your dentist and hygienist will have some great ideas on technique!
• Daily flossing should begin as soon as your child has two teeth which touch. 
• Around age six, your child may be transitioning to solo brushing and flossing—but your oversight is still needed. Make sure all the surfaces of the teeth, including the tops of new molars, are brushed thoroughly. You might provide a timer or a two-minute song or video to make sure your child spends enough time brushing. Flossing can be tricky for young hands, so you’ll need to help with that task for a few years more.

School-Aged Children

• Orthodontists and dentists recommend a first visit to the orthodontist by age seven, or earlier if you notice your child has trouble chewing or biting, if the teeth don’t seem to fit together properly, or if you have any concerns about bite and alignment. When potential problems are discovered right away, early intervention can prevent more serious orthodontic issues from developing later. The team at Orthodontic Specialists of Southeastern Massachusetts in New Bedford or Mattapoisett, MA is happy to answer any questions you might have about early interventions!
• If your child is beginning orthodontic treatment, you can help make the journey easier: 
  • Keep up with appointments and adjustments—missed appointments can delay your child’s progress. 
  • Braces can make brushing and flossing more difficult, so try special brushes and floss designed just for braces. 
  • If needed, remind your child to wear bands or aligners for the recommended number of hours each day. 
  • Be encouraging! Remind your child that these months in braces or aligners will lead to years of healthy, attractive smiles.
• Talk to your dentist about sealants. Permanent molars usually erupt between the ages of six and 12. Sealants are thin coatings which protect the chewing surfaces of these molars from food particles and cavity-causing bacteria which would otherwise collect inside grooves in the enamel.
• Children who play sports and engage in activities with a chance of physical contact should have a well-fitted mouthguard to protect their teeth. Be ready to replace it as often as recommended by Dr. Neil Oliveira and Dr. Derek Wolkowicz or if it’s damaged.
• Increases in hormones during puberty can lead to puberty gingivitis, and swollen, red, and bleeding gums can be the result. Proactive dental hygiene will prevent gum disease from developing. Make sure your child brushes two minutes, twice a day, and flosses once per day. If symptoms persist, it’s time to see the dentist.
• A nutritious diet is essential for healthy teeth and gums. Give your child solid nutritional building blocks with a diet rich in proteins, vitamins, and minerals. If your child wears braces, have a variety of appealing, braces-friendly foods on hand. 

Help your child enjoy a future of healthy, confident smiles by working in partnership with your child’s dentist and the orthodontic team at Orthodontic Specialists of Southeastern Massachusetts. They are ready every month of the year with advice and expertise to make that healthy dental future a reality!

Are you an adult who is considering getting braces? Perhaps you’ve had them before, but over the years that dental work has been reversed. Or maybe you’ve never had any orthodontic work done, but are considering braces for the first time. In either case, Orthodontic Specialists of Southeastern Massachusetts can help you enjoy straighter teeth, an improved bite, and a more beautiful smile. If you are considering getting braces, here is what you need to know about adult orthodontic work from Dr. Neil Oliveira and Dr. Derek Wolkowicz.

Can braces work for adults?

Absolutely! Braces work for just about anyone. However, there are several different types of braces, and not all of them may work for you. Different types of orthodontic treatments include:

• Ceramic braces
• Metal braces
• Self-ligating brackets
• Lingual brackets (braces behind the teeth)
• Invisible braces
• Rubber bands for bite correction
• Headgear and other appliances

By scheduling a consultation, we can determine which treatment or combination of treatments would be best for your specific needs.

How do I get started?

Getting braces can be a little bit daunting. At first glance, the process may appear expensive and time-consuming. However, if you take it step by step, getting braces can be a simple and relatively pain-free experience. Here are the first steps you need to take to get on the road to straight teeth:

First, you need information. If you are nervous about getting braces, or are having trouble getting started, learning more about the process can help ease your mind. Here are a few sample questions to ask:

• What kind of braces do you recommend for my teeth?
• How long will the treatment take?
• How often will I need to come in for adjustments?
• What is the total cost of the treatment? Do you accept insurance? Will you require the full amount up front, or do you have payment plans?

Asking these types of questions will help you understand what to expect during the entire process, which can aid your decision on the proper course of action.

The next step is to complete any prerequisite treatment. During your first meeting with Dr. Neil Oliveira and Dr. Derek Wolkowicz, we’ll need to take some X-rays and molds of your teeth, and then help you determine an appropriate treatment plan. Recommendations may include some preliminary dental work before you get your braces, which can be an important step in making sure your orthodontic treatments are effective.

Once you have completed these steps, you are ready to get started! After you’ve chosen a treatment plan and undergone any necessary prerequisite dental work, you’ll be able to get your braces. Just like that, you’re on your way to a better smile! If you’d like to get started right away, call our New Bedford or Mattapoisett, MA location today!

Brace-ism: believe it or not, it’s a concept. The Urban Dictionary defines brace-ism as “acting mean to people who have braces on their teeth.” Phrases like metal mouth, brace face, and train tracks are common jokes uttered by gap-toothed fools who like to make fun of people with braces.

While ignoring these comments and taking the high road is the best thing to do, there’s nothing wrong with having a few clever retorts and quick-witted comebacks up your sleeve.

1. The next time someone calls you train tracks, break into an obnoxious train imitation, with lots of toot-toot and chuga-chuga-chuga. Finish off your crazy locomotive impersonation with some sort of deafening train horn. That’ll keep the bullies at bay.
2. “It’s better to be a brace face than a space case.”
3. Counter with a ridiculously childish joke that makes the schoolyard tormentor feel even smaller than he already is. “Oh. Yeah. Why did the deer need braces? Because he had buck teeth. Hahaha.” Top it off with an exaggerated eye roll.
4. “Yeah, my brother tells that joke. He’s six. You guys should hang out.” That’ll stop the haters dead in their tracks. Or would that be train tracks?
5. Here’s one from the sarcasm grab bag. “Well, I’m just glad there’s a way to fix what’s wrong with my face.”
6. “I can’t wait to discuss this formative moment at our ten-year class reunion, when my teeth are razor-straight and you’re wearing adult braces.”