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Orthodontists do everything they can to save teeth, but sometimes, a tooth is so damaged by accident, injury, infection, or decay that extraction is the only option. Or perhaps your child’s wisdom teeth are starting to come in—and starting to cause problems. Or, when this is the healthiest alternative, an extraction might be necessary for orthodontic reasons.

While there are several possible reasons an extraction might be necessary, one thing is true for any extraction: you want to make sure that your child is as comfortable as possible and heals as quickly as possible after the procedure.

Aftercare and recovery time isn’t exactly the same for every extraction. Whether your child’s tooth is a baby tooth or a permanent one, whether it’s a single tooth or several, whether it’s erupted or impacted, whether a local anesthetic or sedation is recommended—these factors and more can make a difference in recovery time.

Dr. Neil Oliveira and Dr. Derek Wolkowicz will provide you with clear, specific instructions for helping your child to a speedy recovery after an extraction. We’d also like to offer you some general aftercare ideas to make sure your child is as comfortable as possible while recovering.

• Bleeding

Some bleeding is normal after an extraction. Follow your dentist or oral surgeon’s instructions carefully to minimize bleeding at the extraction site. Your child will probably need to keep a gauze pack in place for as long as directed to reduce bleeding and to help a clot form. If bleeding is heavier than expected or goes on longer than expected, call our New Bedford or Mattapoisett, MA office.

• Swelling

Swelling is a normal response to extractions. Your dentist might suggest cold compresses to help reduce swelling immediately after the extraction. If you don’t have an ice pack, ask whether a bag of frozen peas or corn can substitute.

With any cold compress, it’s important to protect your child’s skin from injury. Follow your dentist’s suggestions for application and be sure not to exceed the time limits recommended. And don’t apply a compress directly to your child’s face—wrap a towel or cloth around the bag or pack to protect the skin.

• Careful Cleaning

The area around the extraction shouldn’t be disturbed or touched. The blood clot that forms after an extraction protects the area from irritation and infection caused by food particles and bacteria. If a clot is dislodged accidentally, it can lead to a condition called dry socket, which can be very painful.

This means no brushing near the extraction site, and no heavy rinsing or spitting for as long as directed. If your child is younger, you might need to help with brushing over the days following to make sure those sturdy bristles don’t get close to the extraction site before it’s healed.

• Soothing Foods

Have a supply of your child’s favorite comfort foods handy while healing, such as cream soups, mashed potatoes, scrambled eggs, gelatin, yogurt, and smoothies. Hot and cold foods can be irritating, so stick to cool or lukewarm foods for the first few days. Encourage your child to drink lots of liquids, but nothing carbonated. And do wait until any numbness wears off before giving your child chewable foods to avoid biting tongue or cheeks.

Remove spicy favorites from the menu, which can be irritating, as well as chewy, crunchy, or jagged foods like crackers, since tiny, sharp bits of food can make their way inside the site. Remind your child to chew on the side of the mouth opposite from the extraction site. And, since suction is an all-too-easy way to dislodge the clot over the extraction site, no straws!

• Schedule Recovery Time

Make sure your child rests and takes it easy after the procedure. Exercise, lifting, even bending over can dislodge a protective clot, so re-schedule any physically demanding sports and activities until your child is given the dental all clear.

• Medication

If your child has been given a prescription for pain medication or antibiotics, follow the instructions as directed. Dr. Neil Oliveira and Dr. Derek Wolkowicz might recommend age-appropriate over the counter pain relievers to have on hand. For severe or continuing pain, call your orthodontist or oral surgeon right away.

• Coordinate Dental Schedules

Orthodontic extractions, if needed, will be scheduled into your child’s orthodontic treatment plan. Treatment can begin or resume when the extraction site has healed.

If an emergency extraction is necessary, call our New Bedford or Mattapoisett, MA office so we can be aware of the situation and can coordinate with your child’s dentist or oral surgeon to keep treatment on track as much as possible.

An extraction can be worrying for both patient and parent, so talk to your orthodontist for the best ways to make this experience a positive one for your child before, during, and after treatment.

Water picks, sometimes called “oral irrigators,” make an excellent addition to your regular home care regimen of brushing and flossing. Especially helpful to those who suffer from periodontal disease and those patients of ours undergoing orthodontic treatment with full-bracketed braces, water picks use powerful tiny bursts of water to dislodge food scraps, bacteria, and other debris nestled in the crevices of your mouth. Children undergoing orthodontic treatment may find using a water pick is beneficial if their toothbrush bristles tend to get caught on their wires or brackets.

When you use a water pick, you’re not only dislodging any particles or debris and bacteria you might have missed when brushing, you are also gently massaging the gums, which helps promote blood flow in the gums and keeps them healthy. While water picks are an excellent addition to your daily fight against gingivitis and other periodontal diseases, they are incapable of fully removing plaque, which is why Dr. Neil Oliveira and Dr. Derek Wolkowicz and our team at Orthodontic Specialists of Southeastern Massachusetts want to remind you to keep brushing and flossing every day.

If you have sensitive teeth or gums and find it uncomfortable to floss daily, water picks are a good alternative to reduce discomfort while effectively cleaning between teeth. Diabetics sometimes prefer water picks to flossing because they don't cause bleeding of the gums, which can be a problem with floss. If you have a permanent bridge, crowns, or other dental restoration, you may find that a water pick helps you keep the area around the restorations clean.

So how do you choose the right water pick?

Water picks are available for home or portable use. The home versions tend to be larger and use standard electrical outlets, while portable models use batteries. Aside from the size difference, they work in the same manner, both using pulsating water streams. A more crucial difference between water picks is the ability to adjust the pressure. Most home models will let you choose from several pressure settings, depending on how sensitive your teeth and gums are. Most portable models have only one pressure setting. If you want to use mouthwash or a dental rinse in your water pick, check the label first; some models suggest using water only.

Please give us a call at our New Bedford or Mattapoisett, MA office if you have any questions about water picks, or ask Dr. Neil Oliveira and Dr. Derek Wolkowicz during your next visit!

Two-phase orthodontic treatment involves two separate and distinct periods that your child receives orthodontic treatment. It allows your son or daughter to begin early treatment of bite and jaw problems, in order to reduce the dental issues he or she experiences later on.

Two-phase orthodontic treatment with Dr. Neil Oliveira and Dr. Derek Wolkowicz can improve how well the second phase of the treatment works and helps to make room for permanent teeth. Overall, two-phase treatment helps to position the teeth and the jaw for an attractive profile. Our team at Orthodontic Specialists of Southeastern Massachusetts recommends that you bring your child to our New Bedford or Mattapoisett, MA office at the age of seven or eight, so that Dr. Neil Oliveira and Dr. Derek Wolkowicz can determine if early (Phase-One) treatment is necessary.

Phase-One

Phase-One orthodontic treatment is known as early treatment. It begins shortly after your child’s first orthodontic examination, usually around age eight or nine. The main goal of Phase-One orthodontic treatment is to help make room for permanent teeth, which reduces crooked teeth as a result of overcrowding. It treats the jaw and bite growth, and issues like crossbite or underbite. This can reduce the need for your child to undergo extractions.

Phase-Two

Phase-Two orthodontic treatment is when braces are placed on the upper and/or lower teeth. The purpose is not just to correct spaces or misaligned teeth, but also to correct overbite or underbite concerns. Phase-Two usually begins around age 11 or 12, and the braces are worn for an average of two to three years, depending on your child’s unique needs. Some children have fewer issues and wear braces for little more than a year, while others need them for up to four years.

Signs your child needs two-phase orthodontic treatment

If your child exhibits the following signs, he or she may be a good candidate for two-phase orthodontic treatment:

• Losing baby teeth early, before five years of age
• Problems with biting or chewing
• Sucking the thumb after age five
• Evidence of a crossbite, where the teeth don’t come together when opening or closing of the mouth
• Teeth are crowded at age seven or eight
• Protruding teeth on the top or bottom

Not all children need to have early treatment, but if your child shows any of these signs, you should bring him or her to us for an evaluation at Orthodontic Specialists of Southeastern Massachusetts.

Happy Independence Day from Dr. Neil Oliveira and Dr. Derek Wolkowicz and team! The Fourth of July celebrations in America may have changed a lot over the years, but there is no doubt that we Americans love to celebrate the anniversary of our country's independence! Today we're devoting the Orthodontic Specialists of Southeastern Massachusetts blog to some fun facts about the Fourth!

• My, how we have grown! This year the United States Census Bureau estimates that our country has 313.9 million residents celebrating the Fourth of July this year, but back in 1776 there were just 2.5 million members of the country.
• Our country loves to show how proud that we are of our independence. Did you know that there are 31 United States places with the word “Liberty” in their names? The state of Iowa actually has four towns with the word Liberty in the name: Libertyville, New Liberty, North Liberty, and West Liberty.
• The United States loves Fourth of July food! It is expected that around 150 million hot dogs are eaten on the Fourth each year. One of the Fourth's most popular sides, potato salad, goes just perfectly with the hotdogs and hamburgers that are standard Fourth of July fare. Some people choose potato chips instead, but we wouldn't have such a plethora of potatoes if not for the prodigious production of the states of Idaho and Washington -- they provide about half of all the potatoes in the United States today!
• Americans love celebrating the Fourth outdoors: About 74 million Americans fire up their BBQ grill every Fourth of July.
• The Chinese contribution: Did you know that Americans have spent more than $211 million on fireworks that were imported from China?

No matter how your family chooses to celebrate the Fourth, stay safe, take precautions, and don't forget to brush after your fabulous Fourth feast!