Our Blog

One of the most common reasons for getting braces is because there’s just not enough room for all your teeth to fit next to each other evenly. The result is overlapping and crooked teeth. What’s the first step in creating the space you need? Well, that depends on just how much room you need to align your teeth and bite properly.

When there is going to be a serious need for space, there are orthodontic solutions that can help, including palatal expanders, surgical options, and extractions. But if you only need a tiny bit of room so that regular braces will fit properly, we have a tiny solution—orthodontic spacers!

Why do you need to make space before you get braces? Because Dr. Neil Oliveira and Dr. Derek Wolkowicz might need to make some room around crowded molars so your braces can be installed properly.

For example, you might need orthodontic bands to anchor your braces. An orthodontic band is a slim, custom-fitted ring of metal which fits snugly around a molar. It is durable, provides a place to attach bands and springs to help correct malocclusions (bite problems), and can securely surround a tooth that might be weak because of a large filling. Spacers can separate crowded teeth just enough to allow a band to be fitted around a molar.

Even if you don’t need bands, sometimes separators are necessary to provide enough space between the teeth for your braces to work effectively. The back teeth tend to move even closer together with braces, and, without adequate space, bite problems, risk of decay, and other difficulties can arise.

And while you might think that some serious equipment is in order to make room between those sturdy molars, the typical spacer, or separator, is actually extremely simple--usually a tiny, round elastic band, often made of rubber. Spacers can be placed between tight teeth in a matter of minutes. Each ring is stretched and positioned between your teeth with a special tool. As it returns to its original shape, the spacer’s width provides just enough pressure on the teeth it touches to make a bit of space between them. And a bit of space is usually all you’ll need.

What do spacers feel like? For some people, they can be uncomfortable. You might feel soreness, some pressure, or as though a piece of food is stuck between your teeth. Ask us for suggestions on making you more comfortable, whether it’s dining on ice cream and cold drinks, eating soft foods, or taking over-the-counter pain relief. Separators are only designed to be in place for a very short period (usually under two weeks), but if they are causing you pain, give us a call.

What do you need to do to help the process along? Actually, it’s more what you need not to do. Don’t use dental picks or floss on your separators, avoid chewing gum, and take chewy and sticky foods off the menu. And don’t be tempted to touch or play with your spacers!

Spacers can create space between the teeth so quickly and efficiently that they often fall out on their own after a few days. If your separators fall out, give our New Bedford or Mattapoisett, MA office a call. It could mean that you are ready for your braces, and on the way to a lifetime of healthy, beautiful smiles. And it’s a journey that begins with a tiny, springy step.

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!