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If this is your first winter with braces, you might be wondering how to make the best of the holiday season. Dr. Neil Oliveira and Dr. Derek Wolkowicz and our team have some suggestions for happy and healthy holiday smiles.

Treat Yourself

Winter means tasty holiday treats, and just because you wear braces doesn’t mean you need to step away from the holiday table! You can enjoy your favorites if you remember to check your list for the usual problem foods. Hard, crunchy, chewy, and sticky items? Naughty list.

• Crunchy vegetables on the appetizer plate
• Nuts
• Hard rolls
• Candy canes and other hard sugar treats
• Caramels, Toffee and other sticky candies
• Pecan pie
• Fruit cake

Luckily, there are plenty of nice alternatives.

• Turkey and ham—remember, small pieces are best
• Dressing and stuffing
• Mashed potatoes
• Soft breads and rolls
• Pumpkin pie—but skip a tough crust!
• Cheesecake
• Soft cookies and cakes
• Soft chocolates

We’re happy to provide recommendations for braces-friendly holiday foods. And we don’t expect you to turn down every sweet treat this season.  Just be sure that if you enjoy something sugary, brush carefully after indulging.

Express Yourself

While you’re decking the halls, or pinning up the New Year’s balloons and streamers, or even choosing a great holiday outfit, don't forget that your ligatures can be decorative as well as functional.

• Celebrating Christmas? Red and green bands around your brackets are jolly and traditional.
• How about Hanukkah? Try blue and white!
• Love the season? Icy silvers and pale blues are a frosty statement—and can have the benefit of making your teeth look whiter, as well. Snowy white? The arctic idea is great, but white bands can sometimes make teeth look more yellow, or become stained themselves.
• Glam New Year? Gold adds sparkle to your smile, but can bring out any yellow tones in your teeth. Silver might be the perfect choice, because it is generally neutral with enamel shades.

Check out our ligature colors for the best possible choices for your teeth and coloring. Take advantage of these options to create a fresh, confident look for the season. Give others the gift of your smile!

Look After Yourself

Winter comes with some special reminders about your dental health.

• Winter sports are a great way to celebrate the snow and ice, but be sure to protect your teeth and braces. If you enjoy skiing, snowboarding, ice skating, hockey, or any other winter activities, talk to us about why a mouth guard is so important.
• While you enjoy your winter break, don’t forget to keep up with your dental routine. And because ‘tis the season for holiday treats, be especially careful to clean your teeth and braces after sweet desserts and snacks. Don’t forget to floss!
• What do cold breezes and hot chocolate have in common? They can both trigger tooth sensitivity! While some sensitivity is normal after an adjustment, if you find you are experiencing tooth sensitivity more often or more strongly than you usually do, give us a call. It might be something as simple as brushing habits, or you might need to see your dentist.

If you have any questions about your braces, in this season or any other, just ask when you visit our New Bedford or Mattapoisett, MA office. Your beautiful, healthy, and confident smile can make this the most wonderful time of the year!

When does an underbite need surgery? The short answer is: when Dr. Neil Oliveira and Dr. Derek Wolkowicz and our team recommend surgery as the best way to give you a healthy, functional bite. But let’s take a longer look, and see just why your doctors might come to that conclusion.

• First, what exactly is an underbite?

In a perfect bite, the upper and lower jaws align, well, perfectly. Upper teeth overlap lower teeth very slightly, upper and lower teeth meet comfortably, and jawbones and joints function smoothly. When the alignment is off, it causes a malocclusion, or “bad bite.”

When we talk about an underbite, or Class 3 malocclusion, it means that the lower jaw protrudes further than the upper jaw. This protrusion causes the bottom teeth and jaw to overlap the upper teeth and jaw.

• What causes an underbite?

Sometimes an underbite is caused by childhood behaviors while the teeth and jaw are developing, including tongue thrusting or prolonged thumb-sucking and pacifier use. (Working to stop these behaviors before they affect tooth and jaw formation is one of the many good reasons children should have regular visits with their dentists and pediatricians.)

Most underbites are genetic, however, and tend to run in families. It’s estimated that from five to ten percent of the population has some form of underbite. The lower jawbone (mandible) might be overdeveloped, the upper jawbone (maxilla) might be underdeveloped, both bones could be affected, or, sometimes, tooth size and placement might cause an underbite. These irregularities in jaw shape and size and/or tooth crowding are not something that can be prevented, and require professional treatment.

• Why? What’s the problem with an underbite?

Even a minor underbite can cause difficulties with biting and chewing. A more severe underbite can lead to speech problems, decay and loss of enamel where the teeth overlap, mouth breathing and sleep apnea, persistent jaw and temporomandibular joint pain, and self-confidence issues.

• Can’t my dentist treat my underbite?

Most probably not. A very mild underbite can be camouflaged cosmetically with veneers, but this does not address the cause of the underbite, and will not work for moderate or severe underbites.

• Can my orthodontist treat my underbite?

Dr. Neil Oliveira and Dr. Derek Wolkowicz will create an underbite treatment plan after a detailed study of each patient’s individual dental and skeletal structure. Treatment options will vary depending on the cause of the underbite, its severity, and even the patient’s age.

Early intervention is especially important for children who show signs of an underbite. That’s why we recommend that children visit our New Bedford or Mattapoisett, MA office by the age of seven.

If an underbite is caused by tooth misalignment or crowding, braces can reposition the lower teeth. Sometimes extractions are necessary to make room for proper alignment.

If the cause is due to jaw structure, children’s bones are still forming, so treatment can actually help correct bone development. Palatal expanders, headgear, and other appliances are various methods of encouraging and guiding bone development.

But braces and appliances aren’t effective for every patient with an underbite, and especially in patients (usually those in their late teens and older) when the jawbones are already fully formed. In this case, we might suggest coordinating treatment with an oral and maxillofacial surgeon.

• What does an oral and maxillofacial surgeon do?

An oral surgeon has the training, experience, and skill to help correct an underbite by surgically reshaping and repositioning the jawbone. This corrective jaw surgery is called orthognathic surgery.

• What will happen during orthognathic surgery?

Your treatment will be tailored to your specific needs. Two of the common surgical procedures for treating an underbite involve repositioning the upper jaw to lengthen it and/or reshaping the lower jaw to shorten it.

Bone is sometimes removed or added, small bone plates or screws are sometimes used to stabilize the bone after surgery—your surgeon will let you know exactly which procedures will give you a healthy, functional bite. The surgery itself is most often performed under general anesthesia and requires a brief stay in the hospital.

• How will my orthodontist and oral surgeon coordinate my treatment?

Correcting a Class 3 malocclusion can take time. Your oral surgeon will work together with Dr. Neil Oliveira and Dr. Derek Wolkowicz to analyze the interrelationship of teeth, bones, and joints to determine dental and skeletal problems, and will develop the best treatment plan possible to create a healthy alignment.

• So, when does an underbite need surgery?

Sometimes, a minor underbite can be corrected with braces and appliances alone. A serious underbite, however, will often require the specialized skills of both Dr. Neil Oliveira and Dr. Derek Wolkowicz and an oral surgeon.

And, while it’s not the primary purpose of surgery, corrective jaw surgery and orthodontics can also make you happier with your appearance and boost your self-confidence. Achieving a lifetime of beautiful, comfortable, and healthy smiles—that’s the answer to your question.

Your dashboard lights up when your car needs an oil change. Your family smoke detector beeps when you need to switch out the batteries. But when it’s time to replace your toothbrush, you’re on your own. Luckily, there are several not-too-subtle clues that you should be shopping for a new model.

• Fraying

Is your toothbrush looking a bit scruffy? Do those once orderly bristles look like they have the toothbrush equivalent of bed head? Have some bristles vanished altogether? Time to retire that toothbrush. Once the bristles are frayed, you just can’t reach plaque as effectively, especially where it likes to hide between the teeth.

Are you prematurely fraying? You could be brushing too hard. Overbrushing can injure delicate gum tissue, cause wear and tear to tooth enamel, and even damage your braces. If you find your brush fraying after only a few weeks of use, you might be using too much force. Remember, plaque is a sticky film, but it’s a soft sticky film. Ask us for advice on just how hard you need—or don’t need—to brush.

• Odor

This one really goes without saying—no one wants an aromatic toothbrush! How to make sure your toothbrush is fresh and clean?

Always rinse carefully after you brush. This will get rid of any toothpaste, bits of food, or other particles left on your brush.

Let your toothbrush air dry. It might seem more hygienic to keep your brush covered in a bathroom setting, but a closed, moist container is a perfect breeding ground for germs. Don’t let them make a home in your bristles!

• Illness

A cold or a bacterial infection (like strep throat) is no fun. But now that you’re feeling better, it might be time to throw out your toothbrush. The chances of re-infection are very low, unless your immune system is compromised, but this is a perfect opportunity to replace your brush with a fresh, germ-free model.

And if you share your toothbrush, or if you store it right next to a family member’s (which you really shouldn’t do, for this very reason), germs get shared, too. Quarantine your brush while you’re ill, and replace it once you’re out and about.

• Discomfort

Bigger isn’t necessarily better. A brush with a head that’s too big won’t allow you to get into those small spaces in your mouth where plaque likes to collect. And when you are trying to clean around brackets and wires, a regular brush might be a problem. Ask Dr. Neil Oliveira and Dr. Derek Wolkowicz for suggestions for the best tools for clean and comfortable brushing.

Also, harder doesn’t mean more effective. A brush with hard bristles can cause damage to your gums and enamel. We almost always recommend soft-bristled brushes for this every reason.

There are so many styles of brush out there, you’re bound to find the perfect fit with a little trial and error. Or ask us for suggestions the next time you’re at our New Bedford or Mattapoisett, MA office for an adjustment!

• You’ve Passed the “Best By” Date

Because of its durable construction, your toothbrush can last a long, long time. But no matter how comfortable and effective your toothbrush is right now, it was never meant to go through life with you. Bristles break down over a period of a few months, and just don’t clean as effectively. Your brush should be changed every three months, and this includes changing the head on your electric toothbrush. And because you wear braces, you’re brushing more often, so that three month lifespan might be stretching it.

Unfortunately, you don’t have a flashing light or annoying beep to remind you when it’s time to change brushes, so you’ll have to devise your own reminders. Reminder apps, calendar notes, the first day of a new season—use whatever works best for you. 

Don’t ignore the clues your toothbrush is leaving you. Replacing your brush whenever it’s necessary helps guarantee that the time you spend cleaning your teeth and gums will lead to confident, healthy smiles. Case closed!

Modern orthodontic technology has changed the way you wear braces. Brackets are smaller and come in a variety of shapes and colors. Wires are more efficient. Clear aligners can eliminate the need for brackets and wires altogether. And your high-tech advantages don’t stop there—today’s digital X-rays make creating your treatment plan even more convenient and efficient.

Why Are X-rays Necessary?

Beautifully aligned teeth and a healthy bite are the visible result of your orthodontic work, but there’s a lot going on above and below the surface that needs to be discovered and taken into account before your treatment even begins. X-rays help Dr. Neil Oliveira and Dr. Derek Wolkowicz evaluate:

• The size, shape, and position of your teeth, including impacted teeth and wisdom teeth
• The size, position, and health of your roots throughout treatment
• The size and shape of your jaw bones, and how they affect your teeth alignment and bite
• Your progress during different phases of treatment
• The most effective type of retainer for protecting your beautiful smile after treatment.

How Do X-rays Work?

Traditional X-rays, or radiographs, make use of film just like traditional cameras. When you have an intraoral X-ray, for example, the film is sealed in a moisture- and light-proof packet, and placed inside the mouth to capture images of specific teeth and the bone around them.

The X-ray machine is aligned precisely with the film and an exposure is taken. The image at this point is latent, and won’t show on the film, because, just like photo film, traditional radiographs need to be chemically processed before they produce a visible image.

Digital technology, on the other hand, uses an electronic sensor instead of film. For an intraoral digital X-ray, a small sensor is positioned in the mouth just like a film. When the X-ray is taken, a digital image capture device produces an image which is formed by a matrix of pixels instead of a photo-like film exposure. This format allows the image to be sent directly to a computer for immediate display without requiring processing.

Even though these methods seem very similar, digital X-rays offer some significant advantages over traditional films. Let’s look at how they compare, more or less.

• More Diagnostic Advantages

A traditional X-ray is a fixed image. It cannot be modified or enhanced. Here the digital X-ray offers a clear advantage in evaluating your teeth and the bone structure surrounding them.

Just as you can enlarge certain types of images on your computer without blurring or losing detail, a digital X-ray uses computer software to magnify images while keeping their details sharp. They can also be enhanced through brightness and contrast applications to make details stand out even more.

There is even digital subtraction radiography software available that can be used to compare recent images to older ones, removing (“subtracting”) all the similarities in the two images to display only the changes in the two—even small changes—that have taken place over time.

• Less Exposure to Radiation

Modern technology means traditional X-rays expose patients to less radiation than ever before, but digital X-rays have significant advantages here as well. Radiation exposure can be reduced by an additional 10%, 20%, or more with a digital radiograph.

And while all types of dental X-rays expose you to very little radiation, it’s always best to reduce exposure whenever possible.

• More Convenient for Sharing and Transmitting

If you need to share your X-rays with another dentist or physician, digital technology allows you to simply have them e-mailed to another office or multiple offices. You no longer need to worry about preserving physical copies, either.

• Less Waste

Unlike traditional X-rays, digital X-rays don’t need to be processed, so you save time in the office. And while the processing time is not significant (usually several minutes), if you need to repeat some X-rays for a clearer picture, or require different images for several teeth, this time can add up.

Digital X-rays are also more eco-friendly.  The fact that they don’t need to be developed means that the chemicals used to process traditional films are no longer necessary—which also means that there is no need to dispose of chemical waste products afterward.

Our goal is to provide you with the safest, most efficient, and most effective treatment possible. Digital X-rays are an important tool for orthodontists, helping us to provide you with the best treatment plan possible. If you have any questions about digital X-ray technology, contact our New Bedford or Mattapoisett, MA office. We’re happy to explain the science—and the benefits—behind this high-tech diagnostic tool.