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Retaining That New Smile

August 24th, 2023

For months and months, you’ve been dedicated to following your orthodontic treatment plan. Wearing your bands or putting in the hours with your aligners. Eating orthodontic-friendly foods. Seeing your orthodontist on a regular basis.

But that’s all in the past. Today, your braces are coming off! You’ve finished with your last set of clear aligners! Now it’s time to enjoy your accomplishment and celebrate this moment.

And after you’ve celebrated the moment, what’s next? Why, it’s time to look to the future! Because one thing we can predict for the years ahead is that you’ll want to keep your smile looking as wonderful as it does today. Let’s look at some of the simple steps you can take to retain that new smile.

Keep Up With Your Brushing and Flossing

Wearing braces or aligners meant learning a whole new way to take care of your teeth and gums. You used special tools to clean around your brackets and wires. You learned how to keep your aligners clean and stain-free. You brushed and flossed after every meal and snack break.

So returning to regular hygiene habits should be a cinch—two minutes of thorough brushing at least twice a day, with careful flossing at least once each day. And you’ll probably notice something else which makes your life easier—properly aligned teeth are easier to brush and floss effectively.

But just because it’s easier, doesn’t mean it’s not as important. Keeping your teeth clean and cavity-free and your gums healthy will keep your smile looking its best, so be sure to brush and floss just as consistently as you did when you were in treatment.

See Your Dentist Regularly

Even though you won’t be making regular visits to our New Bedford or Mattapoisett, MA office anymore, that doesn’t mean your dental calendar is clear! Cavities aren’t a good look for your new smile. Neither are tartar stains or red and swollen gums.

Checkups once or twice a year mean that you have a healthy smile as well as a beautifully aligned one. And a professional cleaning from your dentist’s office will make sure it’s a gum-healthy, bright, and stain-free smile as well.

Wear Your Retainer

Your teeth may have moved to their perfect positions, but they haven’t moved there permanently yet.

During orthodontic treatment, gentle pressure from your appliance causes steady, careful tooth movement. As teeth move in the jaw, old bone cells around the roots break down where they’re no longer needed, and new bone cells build up around the roots in their new position. It’s a gradual process which makes sure your teeth are held firmly in the jawbone.

Bu this isn’t the end of the process. When you stop wearing braces or aligners, teeth and ligaments may begin shifting back to their original location. The new bone tissue that holds your teeth in their ideal spots isn’t strong enough yet to stop this shifting, especially with the normal forces of biting, chewing, clenching, and all the other activities that put pressure on teeth.

Your retainer holds your teeth in just the right position while jawbone tissue has time to reshape, rebuild, and stabilize. This can take months or more to accomplish, especially when you’ve had a more serious misalignment or bite correction.

Which also means . . .

Wear Your Retainer as Long as Necessary

Dr. Neil Oliveira and Dr. Derek Wolkowicz will recommend the best retainer for you. Three popular options include:

  • Hawley Retainers—the traditional removable retainer. This appliance uses wires embedded in a molded acrylic plate to keep your teeth properly aligned and to hold your retainer in place.
  • Clear Plastic Retainers—a removable custom retainer made of vacuum-formed plastic. This piece looks and fits over the teeth like a clear aligner.
  • Fixed Retainers—a small single wire bonded to the back of specific teeth to hold them in place and prevent any movement.

For the first few months, you might need to wear your removeable retainer both night and day, and then switch to nighttime wear. Dr. Neil Oliveira and Dr. Derek Wolkowicz might recommend long-term nightly retainer use, or perhaps taper to a few nights a week. A fixed retainer can last for many years. We can’t tell you how long you’ll need to wear your retainer because that answer depends on your specific orthodontic needs.

If you do stop wearing your retainer and find that your teeth are shifting, see Dr. Neil Oliveira and Dr. Derek Wolkowicz as soon as possible. Fixing a slight shift can be fairly uncomplicated, but waiting until your teeth and bite are more seriously out of alignment could require another session in braces or aligners.

The hard work you’ve put in to create your smile is past, and today you’re enjoying all the benefits of aligned teeth and a comfortable bite. Taking simple steps to maintain these benefits will help guarantee a future filled with healthy, confident smiles.

Shark Teeth

August 16th, 2023

It seems like sharks are everywhere these days—on land, sea, and air(waves). A halftime show meme gone viral. A week of summer TV devoted to our favorite apex predators. And who doesn’t have “Baby Shark” playing in their heads all day once they’ve heard it? But are we jumping the shark to discuss this topic in an orthodontic blog?

Not at all! Because today, we’re going to talk about shark teeth—just not the ones you might be expecting.

One of the expected sights when a shark opens its mouth are those rows and rows of shiny shark teeth. Sharks can grow from two to 15 rows of teeth at any one time (and some sharks have even more). This means sharp new teeth are always ready to replace any shark tooth which is lost, broken, or worn out.

An unexpected sight? When children point to their new adult tooth or teeth coming in—right behind their still-firmly rooted baby teeth! This double set of teeth is called “shark teeth,” and, while it certainly might come as a surprise, it’s not all that uncommon. But why do children develop shark teeth at all?

After all, baby, or primary, teeth have small roots, and are designed to come out easily when the adult teeth start arriving. When a permanent tooth starts to erupt, it pushes against the root of the baby tooth above it. This pressure gradually dissolves the root of the primary tooth, and with nothing to anchor it, it’s now loose, wiggly, and ready to fall out. That’s why baby teeth often look like they have no roots at all when they eventually wiggle free.

Sometimes, though, the roots of a primary tooth don’t break down, which means baby teeth stay right where they are. It also means that the permanent teeth have to erupt somewhere else—usually behind those stubborn little baby teeth.

Shark teeth can first appear around the ages of five to seven when the permanent front teeth start arriving, or several years later, when the adult molars begin to come in. Any extra teeth in one small jaw naturally raise concerns about tooth misalignment, especially when those extra teeth are molars. If double molars are causing crowding, it’s a good time for your child to have an orthodontic examination at our New Bedford or Mattapoisett, MA office to make sure the permanent teeth are properly positioned.

Unlike sharks, we don’t have an endless supply of replacement teeth, so it’s understandable to worry when you see anything unexpected. If you want to know more about shark teeth, or if you have any concerns, don’t hesitate to call Dr. Neil Oliveira and Dr. Derek Wolkowicz for expert advice.

Common Malocclusions

August 9th, 2023

When we think orthodontics, we commonly think teeth. Naturally! Straight teeth and a beaming smile are everyone’s orthodontic goal. But orthodontics is a field which specializes in more than misaligned teeth. While your beautifully aligned teeth are the visible outcome of your orthodontic work, a properly aligned bite is the foundation for your healthy smile.

A malocclusion occurs when the teeth and jaws aren’t properly aligned—they don’t fit together the way they should when the mouth is closed. A malocclusion, or bad bite, affects many people to some degree, but not always in exactly the same way. Some of the different types of malocclusion include:

  • Crossbite

A crossbite occurs when upper teeth fit inside lower teeth. An anterior crossbite refers to the front teeth, with one or more upper front teeth, or incisors, fitting behind lower front teeth. A posterior crossbite affects the back teeth, with upper teeth fitting inside the lower teeth on one or both sides of the jaw.

  • Crowding

When the jaw is small and/or the teeth are large, lack of space can result in crowded, twisted, or crooked teeth.

  • Open bite

An anterior open bite means that the front teeth don’t close when biting down, leaving an open space between the upper and lower teeth. A posterior open bite occurs when the back teeth don’t make contact when the front teeth close.

  • Overbite

Our upper front teeth naturally overlap the lower ones a small bit when the teeth are closed. An overbite occurs when the upper teeth significantly overlap the lower teeth.

  • Overjet

When the upper front teeth protrude too far forward over the bottom teeth, it’s called an overjet, or, sometimes, buck teeth. Where an overbite causes a vertical overlap, an overjet takes into account the horizontal relationship of the teeth.

  • Spacing

A jaw that is large, teeth that are small, missing teeth—these conditions can lead to gaps between the teeth.

  • Underbite

An underbite results when the lower teeth and jaw extend further forward than the upper teeth and jaw, causing the bottom teeth to overlap the top teeth.

If you have a malocclusion, what comes next? This depends.

Some malocclusions are so minor that no treatment is necessary. Some are the result of misaligned teeth. Some occur because the upper and lower jaws are growing at different rates. Some are a combination of teeth and jaw misalignments. Some are caused by genetics, while others are caused by injuries or habits like prolonged thumb sucking or tongue thrusting.

Because malocclusions are so varied, your treatment plan will be designed for your specific needs. Braces, aligners, appliances like the Herbst® appliance or the palatal expander, surgery for severe malocclusions—there is a larger variety of treatment options than ever before to help you achieve a healthy bite.

When teeth and jaws don’t fit together as they should, the consequences can be damaged teeth and enamel, problems with the temporomandibular joint, headaches and facial pain, and difficulty chewing, eating, and speaking.

The good news is that early intervention for children can help correct teeth and jaw problems before they become more serious, leading to easier orthodontic care in the teen years, and helping to avoid the possibility of surgery or extractions. This is why Dr. Neil Oliveira and Dr. Derek Wolkowicz and our team recommend an orthodontic assessment at our New Bedford or Mattapoisett, MA office for children around the age of seven.

If you’re an adult with concerns about your teeth or bite, there’s good news for you, too. Dr. Neil Oliveira and Dr. Derek Wolkowicz can devise a treatment plan to improve your bite and your smile no matter what your age.

Of course, despite our title, there’s really no such thing as a “common malocclusion” when we’re talking about your dental health. Each person—and each smile—is unique. Dr. Neil Oliveira and Dr. Derek Wolkowicz will diagnose your malocclusion and create a personalized plan carefully tailored to your exact needs, for an uncommonly attractive, confident, and healthy smile.

Three Reasons We're Fans of Fluoride

August 2nd, 2023

Why all the fuss about fluoride? Your dentist recommends it, your toothpaste is formulated with it, most of our drinking water contains it. Just what is it about this mineral that makes dental professionals sing its praises? Read on for three good reasons why fluoride is a healthy choice for healthier teeth.

  1. Fluoride Works!

Fluoride is an attractive option for protecting your teeth—and we mean that literally. Fluoride protects the surface of your teeth by working on a molecular level to attract minerals which strengthen enamel and help prevent cavities.

Our tooth enamel is mostly made from calcium and phosphate ions. These elements combine to form hydroxyapatite, strong crystals which make up about 95% of our enamel. Hydroxyapatite is so strong, in fact, that tooth enamel is the hardest part of our bodies. What can go wrong?

Acids. Acids created by the bacteria in plaque and the acids in our diet strip away the calcium and phosphate ions in enamel, weakening the surface of the tooth. This process is called demineralization. Over time, weak spots become bigger as acids eat through enamel to the inner tooth, causing decay and cavities.

So, what can fluoride do?

First, fluoride helps remineralize tooth enamel. Fluoride is attracted to the tooth’s surface and bonds with its minerals. It also attracts the calcium and phosphate ions that are found in our saliva to restore any minerals that have been lost. This process helps repair any weak spots that might have begun to form.

But fluoride does more than restore and repair tooth strength—it improves it! Fluoride ions join with calcium and phosphate to form fluorapatite crystals, which are larger and stronger than hydroxyapatite crystals. Even better? These new crystals are more resistant to acids.

  1. Fluoride Is Doubly Effective

Fluoride works both externally and internally. We just looked at how fluoride helps keep teeth strong when applied to the outside of the teeth. This is called a topical application. Systemic benefits come the fluoride we consume in our diets.

Fluoride isn’t found in many foods, but it is found naturally in lakes, rivers, and other water sources. When the local water’s fluoride level is low, many communities add fluoride for its proven ability to prevent cavities. Water fluoridation is safe, has been studied for decades, and has been shown to reduce the risk of cavities by 25% or more for both children and adults.

Systemic fluoride was important when you were younger and still had your baby teeth. This is because fluoride joined with minerals in your adult teeth while they were growing and developing, creating stronger, more cavity-resistant teeth even before they erupted.

And now that your permanent teeth are here, you’re still in luck! When you drink fluoridated water, you’re increasing the amount of fluoride in your saliva. Just like fluoride toothpaste, saliva bathes your teeth with fluoride ions, remineralizing and strengthening the tooth surface and helping repair weak spots in your enamel.

  1. It’s Easy to Get Fluoride Protection

Because so much of our drinking water is fluoridated, most of us really don’t have to think about how to get the recommended amount of fluoride in our diet each day. If your community’s water is low in fluoride, Dr. Neil Oliveira and Dr. Derek Wolkowicz can help you. Prescription fluoride rinses, gels, supplements, and other treatments are available at our New Bedford or Mattapoisett, MA orthodontic office to make sure that your teeth are well-protected, wherever you may live. We will let you know which products are best for you and how often to use them.

Most toothpastes are formulated with fluoride, so you’re getting the enamel-strengthening benefits of this mineral every time you brush. Keeping up with your brushing is especially important while you’re in orthodontic treatment.

Because wearing traditional braces can mean it’s harder to reach all the plaque on your teeth, especially behind wires and around your brackets, that demineralization we talked about earlier is a common problem during treatment. Demineralization often leads to discolored white spots on enamel and, eventually, cavities. If you need more protection than toothpaste alone provides, Dr. Neil Oliveira and Dr. Derek Wolkowicz will suggest fluoride treatments to reduce the risk of demineralization and even reverse some of its effects.

Fluoride isn’t, of course, the only way to look out for your dental health. Proper brushing and flossing are still essential for removing plaque. And sealants for both kids and adults provide long-lasting protection for chewing surfaces. But when it comes to a proven cavity-fighter that’s simple to use, effective, and easily available—is it any wonder we’re big fans of fluoride?