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Midline Misalignment

November 30th, 2022

By and large, the human body is a marvel of symmetry. But, of course, no one is perfect. You might have noticed one ear is a bit higher than the other. That you wear a shoe a half-size bigger on your left foot. That one shirtsleeve always looks longer.

Or that your smile looks off-center. This dental asymmetry could be caused by a condition known as “midline misalignment,” and, unlike that left foot, you can do something about it!

The dividing line between our center teeth, upper and lower, is called the midline. If we draw an imaginary line down the middle of a face, from the forehead to the nose to the midpoint of the chin, that line should go right between the front teeth. When it doesn’t, because the teeth have shifted past the midpoint, it’s often due to a condition called midline misalignment.

This kind of misalignment, also known as a deviated midline, can have several causes:

  • Baby teeth that are lost too early

Baby teeth do more than promote healthy eating and speech development. They also reserve space for permanent teeth. If a primary tooth is lost too early, permanent teeth might “drift” to fill the empty space, causing the midline to move as well.

  • Thumb sucking that goes on too long

As a child gets older, and certainly when by the time permanent teeth start to arrive, aggressive thumb sucking can lead to numerous orthodontic problems, including a deviated midline, as the teeth shift in response to that continuous pressure.

  • Missing adult teeth

When you lose a tooth through decay or trauma, or when an adult tooth simply never develops, the remaining teeth can shift over to fill the open spot.

  • Spacing issues

Crowded teeth, teeth with significant gaps between them, very large teeth, very small teeth—all of these issues can affect spacing and midline alignment.

  • Crossbite

A crossbite is a kind of malocclusion, or bite problem. When you have a crossbite, the teeth don’t fit together properly, with upper teeth fitting inside lower teeth, instead of aligning on the outside where they belong. A deviated midline can indicate a posterior crossbite, where the top back teeth slant inwards or fit inside the bottom back teeth.

A tiny bit of midline shift one way or the other might be nothing to worry about, but if one front tooth is literally the center of attention, or if your teeth are noticeably out of alignment, it’s a good idea to talk to our New Bedford or Mattapoisett, MA orthodontic team.

Because there are several potential causes for midline misalignment, Dr. Neil Oliveira and Dr. Derek Wolkowicz will carefully analyze your individual situation to determine where the problem lies: with the teeth, the bite, or, rarely, the jaw itself.

Dr. Neil Oliveira and Dr. Derek Wolkowicz will also offer you your best dental treatment options. A shift of a few millimeters might be treated with clear aligners or traditional braces. A crossbite could require braces or aligners coupled with elastics (rubber bands) to bring your bite into alignment. A palatal expander can help correct a serious crossbite.

Why visit Orthodontic Specialists of Southeastern Massachusetts because of a little asymmetry? Because a deviated midline is more than a cosmetic concern. If you have a malocclusion to begin with, or if your misalignment leads to changes in chewing habits, which cause new bite problems, you might be facing jaw pain, chipped and cracked teeth, headaches, and all the other unpleasant consequences of malocclusion.

By and large, perfect symmetry in life is unattainable. But if you want a smile that is well-balanced and healthy, talk to us about all the treatments available to make sure your smile—and not a single tooth—is the center of attention.

Positive Aging with Orthodontics

November 23rd, 2022

Crooked or crowded teeth aren’t always just a cosmetic issue; they also are more difficult to clean, which can lead to tooth decay and gum disease. Likewise, if your teeth don’t align properly when you bite (known as malocclusion), this can cause chewing, swallowing, and speaking problems.

You can put these risks to rest and look amazing, however, with well-thought-out orthodontic treatment from Dr. Neil Oliveira and Dr. Derek Wolkowicz. More and more adults are opting for orthodontic treatment and changing their lives in the process.

Childhood is of course the ideal time to get treatment, since the mouth and jaws are still growing, but many adults still can get beautiful and lasting results which can be achieved discreetly and effectively with modern orthodontic appliances and technologies.

Traditional braces used to be the only thing going, and many adults understandably don’t like the way they look. There are so many other options for braces these days that it’s possible for almost any patient to be treated effectively and efficiently — usually in one to two years.

Here are some of the technologies being implemented in our modern New Bedford or Mattapoisett, MA orthodontic office:

  • Clear aligners: Practically invisible clear plastic aligners are great for less severe cases.
  • Lingual braces: These are placed on the back of your teeth instead of the front, and can handle anything that traditional braces can.
  • Ceramic braces: Translucent ceramic brackets make for effective and more discreet treatment.
  • Self-ligating braces: These require less manipulation by the orthodontist, which means fewer appointments and quicker results.

It should also be noted that the goal of orthodontic treatment (especially in adults) isn’t always limited to straightening teeth and/or correcting a bite. Teeth provide support for the lips and cheeks and help define your face.

The relationship between the jaws, teeth, face, soft tissues, and underlying skeleton of the face are important, and an orthodontist takes this into account when designing a smile.

In short, getting orthodontic treatment won’t just give you a good-looking and healthy smile; it can help define and enhance the entire appearance of your face. Knowing just how crucial your teeth are in determining how you look and live will help you age positively and confidently.

Keeping It Clean—Better for Your Retainer, Better for Your Oral Health!

November 16th, 2022

Now that you’ve graduated from your braces or aligners, you might think you’re finished with orthodontic cleaning tips. Not quite yet! Your retainer needs love, too—not just because it can look or smell “less than appealing” without your help, but because it’s good for your dental health.

Removable Retainers

If you have a Hawley retainer or a clear retainer, cleaning it whenever you remove it is a great idea. Unappetizing white patches mean plaque or mineral deposits from your saliva have dried and hardened on your retainer’s surface. And if you notice an unpleasant taste or odor, it probably means that germs and bacteria have made themselves at home and are growing in and on your appliance.

You don’t want old plaque or new bacteria in your mouth! Here are some ways to keep your retainer clean and fresh:

  • After wearing it, you can clean your retainer with a toothbrush, but don’t brush too vigorously. You might scratch it. Use a soft or even extra-soft brush to clean out all the nooks and crannies, and then rinse.
  • Use cleaning products which have been recommended by Dr. Neil Oliveira and Dr. Derek Wolkowicz if your retainer needs a deeper clean. Denture cleaners, retainer cleaners, and even toothpastes can be too abrasive or cause discoloration, so use the products made for your specific retainer.
  • Let your retainer dry before storing it in a dry place after cleaning. Shutting a damp retainer into a closed case provides bacteria with the damp, dark environment they thrive in. (PS—clean your case regularly, too!)
  • One of the benefits of a clear retainer is that it’s almost invisible. And you can help keep it that way by removing it whenever you eat or drink. Your retainer can become stained from colored foods or liquids.

Fixed Retainers

A permanent retainer is a small piece of wire that is custom-fit and bonded to the inside of selected teeth to keep them from shifting. Because food particles and plaque can accumulate around a fixed retainer, brushing after meals and at least twice a day is recommended. Bacteria and plaque cause bad breath, cavities, and tartar buildup, and removing tartar might require removing your retainer.

While a fixed retainer can be tricky to clean, there are techniques and products that make cleaning easier and more effective:

  • An orthodontic toothbrush with a smaller head might reach behind your teeth more comfortably.
  • Don’t forget to floss! Using a floss threader will help you get that wriggly floss behind the retainer and between your teeth.
  • Try a water flosser. These handy devices direct a stream of water right into hard-to-reach places for more thorough cleaning.

If you’re having trouble keeping your retainer clean, our New Bedford or Mattapoisett, MA orthodontic team can teach you all you need to know about tools and techniques to keep your retainer—and your teeth and gums—healthy. An attractive smile is a great thing. A healthy, attractive smile is even better!

Talking Over Your Underbite

November 9th, 2022

You’ve been told that you have a malocclusion called an “underbite.” Let’s look at just what this diagnosis means, and what it means for you.

Just what is an “underbite”?

A malocclusion is another way of saying that you have a problem with your bite, which is the way your jaws and teeth fit together when you bite down. In a typical bite, the front top teeth project slightly beyond, and slightly overlap, the bottom teeth.

An underbite, on the other hand, 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.

What causes an underbite?

Underbites tend to be genetic, and run in families, so, most often, an underbite is something you’re born with. The size of your jaws, the shape of your teeth, or both will affect your bite.

A smaller number of underbites develop because of injuries or early oral habits, such as prolonged and vigorous thumb sucking or tongue thrusting.

How do we treat an underbite?

Your treatment will depend on the type and severity of your underbite, and your age when treatment occurs.

  • Braces and Aligners

If your underbite is a slight one, caused, for example, by crowded or overly large teeth, braces or clear aligners can help move the teeth into proper alignment.

  • Functional Appliances

If the underbite is caused by a problem with upper and lower jaw development, devices called functional appliances can be used to help guide the growth of the jawbones while a child’s bones are still growing and forming.

If you’re a young patient, two appliances commonly used to help correct an underbite are palatal expanders, which gradually widen the upper jaw if it’s too narrow, and reverse pull headgear, which fits both inside the mouth and outside on the face, and provides a steady, gentle pull to encourage the forward growth of the upper jaw.

  • Surgical treatment

In some severe cases, surgical treatment can correct an underbite by reshaping the jawbone itself and positioning it further back to align properly with the upper jaw.

Why treat your underbite?

A serious underbite can cause damaged teeth and enamel, painful problems with the temporomandibular joint, headaches and facial pain, sleep apnea, difficulty chewing, eating, and speaking, and can affect confidence and self-esteem.

By following your treatment plan, you’ll not only prevent these consequences, but you’ll achieve major benefits—a healthy, comfortable bite, and an attractive, confident smile. Want to know more? Talk it over with Dr. Neil Oliveira and Dr. Derek Wolkowicz at our New Bedford or Mattapoisett, MA office for all the information you’ll need!