Our Blog

Orthognathic surgery is surgery to correct a wide variety of abnormalities of our patients' jaw and teeth. The surgery is often done in conjunction with orthodontic treatment. While the patient’s appearance may be significantly improved as a result, the primary purpose of the surgery is to correct functional problems including but not limited to:

• Unbalanced facial appearance
• Protruding jaw
• Open bite (upper and lower teeth don’t overlap properly
• Excessive wearing down of the teeth
• Difficulty with chewing or biting
• Chronic mouth breathing
• Sleeping problems such as sleep apnea
• TMJ pain (jaw joint pain)
• Restoring facial injuries

Knowing when to start the orthodontic treatment in preparation for orthognathic surgery can also be tricky if our team at Orthodontic Specialists of Southeastern Massachusetts is treating a teenager. It is important to know when to get started. If orthodontic treatment is initiated too soon and the teenager is still growing, the patient will either need to hold in braces until his or her growth is complete and they are ready for surgery or the braces will have to be removed and then placed again when growth is complete. Neither of these options is attractive since it requires longer time in treatment, which is something all our patients want to avoid. Our team at Orthodontic Specialists of Southeastern Massachusetts strives to get all patients finished with treatment as quickly as possible because it is healthier for the teeth and gums and gives them a beautiful smile to enjoy for a lifetime.

If you are considering orthognathic surgery or you have been told that you need jaw surgery, give us a call to schedule your initial consultation today. Dr. Neil Oliveira and Dr. Derek Wolkowicz and our team at Orthodontic Specialists of Southeastern Massachusetts will explain our treatment plan in a way you will understand and we will keep you informed every step of the way.

A lot of our patients are curious about the difference between an orthodontist and a dentist. In fact, one of the most common questions we hear at Orthodontic Specialists of Southeastern Massachusetts is, “Dentists and orthodontists are all the same, right?”

A general dentist is your primary dental care provider. Dentists diagnose, treat, and manage your overall oral healthcare needs, including gum care, root canals, fillings, crowns, veneers, and bridges.

Orthodontists, such as Dr. Neil Oliveira and Dr. Derek Wolkowicz, are more concerned with diagnosis, prevention, interception, and treatment of malocclusion, or what we call “bad bite,” of the teeth. Orthodontists focus on tooth and jaw alignment and bite problems such as overbites and underbites, and are responsible for straightening teeth via bands, wires, braces, and other fixed or removable corrective treatment options, like braces and clear aligners. Orthodontists treat children as well as adults who wish to improve the function of their bite and appearance of their smile.

Before becoming an orthodontist, doctors such as Dr. Neil Oliveira and Dr. Derek Wolkowicz start out in dental school and earn a dental degree, just like your general dentist. After dental school, those doctors who decide they are interested in the orthodontic field, stay in school for a few more years and become experts in orthodontia, which is one of nine specialties within the dental field.

Isn’t it nice to know we have orthodontic experts here at Orthodontic Specialists of Southeastern Massachusetts to help you through any type of treatment your teeth and jaw might need? To schedule your initial appointment at our New Bedford or Mattapoisett, MA office, please give us a call today!

Sports are great for children for a variety of reasons. Children can develop their motor skills, learn how to solve conflicts and work together, and develop their work ethics. As a parent, you may recognize the benefits of sports, but also naturally worry about your child’s health and safety. Your job goes beyond providing a water bottle and making sure your child follows the rules of the game.

Although you may not think of your child’s teeth first when you think about sports, accidents can happen that affect your children’s teeth. A stray hockey stick, an errant basketball, or a misguided dive after a volleyball are examples of ways a child could lose a tooth. In fact, studies show that young athletes lose more than three million teeth each year.

Becoming a Better Athlete to Protect Teeth

Becoming a better athlete involves refining skills, learning the rules of the game, and being a good sport. These components are not just about winning. They are also about safety. Young athletes who are better ball-handlers and who are careful to avoid fouls and penalties are less likely to have harmful contact with the ball, teammates, or opponents. Children who are better roller-bladers are less likely to take a face plant into the blacktop, and more likely to save their teeth. Being a good sport and avoiding unnecessary contact is one way to protect teeth.

Proper Protective Equipment for Teeth

If your child is in a sport that poses a high threat to teeth, it is essential for your child to wear a mouthguard. Mouthguards fit your child’s mouth and consist of soft plastic. Dr. Neil Oliveira and Dr. Derek Wolkowicz can custom fit a mouthguard if generic ones are uncomfortable. While children may resist wearing a mouthguard initially, your persistence in insisting that they wear it should be enough to convince them. A helmet or face mask provides additional protection.

While prevention is best, rapid treatment can improve the situation if your child does happen to lose a tooth during sports. Rapid implantation can work in about ten percent of cases. To learn about ways to save a lost tooth, contact our New Bedford or Mattapoisett, MA office.

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.