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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?

Bottled Water: Friend or Foe?

July 26th, 2023

Some people choose bottled water over tap because they think it’s cleaner. Some do it out of convenience: It’s easy to grab a bottle of water to take with you for the day as you run out the door or hop in your car.

Whatever the reason, bottled water has been coming in ahead of tap water for the last couple of years. What many people may not know is that choosing bottled water over tap can actually be detrimental to your dental health.

Most brands of bottled water fail to include a vital ingredient: fluoride. Fluoride plays an important role in helping maintain good oral health because it helps strengthen our teeth. Stronger teeth mean a lower chance of tooth decay, and who doesn’t want that?

When we choose bottled water over tap water, we deprive our pearly whites of something they might very well need.

The good news is that the American Dental Association has endorsed both community water fluoridation and products that contain fluoride as a safe way to prevent tooth decay. If bottled water happens to be the preference for you or your family, you don’t necessarily have to force everyone to start drinking tap water.

Just check the label and make sure the brand you purchase contains fluoride.

It’s essential to remember that switching up the water you drink isn’t going to put you on the fast track to perfect teeth, though. Flossing and brushing three times a day is vital!

If you have any questions about fluoride or your dental health, don’t hesitate to ask Dr. Neil Oliveira and Dr. Derek Wolkowicz at our New Bedford or Mattapoisett, MA office!

Your Sunny Smile

July 19th, 2023

Your beaming smile makes a sunny day even brighter—and that sunny day can return the favor! How does the sun affect your dental health? Let’s shine some light on the subject.

You may have heard how important calcium is to your body. Over 99% of the calcium in our bodies is used to form teeth and bones, providing strength and structure to the hardest parts of the body. But that’s not the only task on the calcium to-do list. Calcium is also necessary for:

  • muscles to work
  • nerves to carry messages
  • blood to deliver nutrients and oxygen
  • the release of hormones

When we don’t get enough calcium in our diets, our bodies start to draw the calcium they need for these critical functions from our teeth and bones. Over time, a severe calcium deficiency can lead to teeth that are brittle, or more vulnerable to decay, or loose due to weakened bone density in the jaw.

Keeping up with your calcium is especially important when you’re wearing braces or aligners. Calcium helps protect you from tooth decay and gum disease, which could delay your treatment. And you want your jaw bones strong and healthy as the bone tissue reforms and then stabilizes around your teeth as they move to their new, ideal positions.

We can get the calcium we need from a balanced diet. Dairy products are our most common source of calcium, and several servings of milk, cheese, or yogurt each day supply most of our needs. If dairy’s not on your menu, though, you can get calcium from other foods like broccoli, kale, collard greens, canned salmon, or sardines. Because calcium is so essential to our health, many foods are fortified with it, including fortified juices, bread, cereals—even tofu!

But there’s a snag here, and it’s a big one. We can’t really benefit from our careful consumption of calcium without the help of vitamin D. If calcium is the doorway to strong teeth and bones, vitamin D is the key which unlocks all of calcium’s benefits.

Without enough vitamin D, our bodies can’t absorb and make use of calcium. However, getting enough of this essential vitamin can be a problem. While we can get most of the vitamins we need from a balanced diet, there aren’t a lot of foods which are naturally rich in vitamin D.

So, how do we get this vital vitamin? The original option comes from nature.

  • Sunlight

Vitamin D is called “the sunshine vitamin” because of the unique chemical reaction which creates it. When the ultraviolet B rays of the sun reach special cells in our skin, they convert cholesterol in these cells to a basic form of vitamin D. These vitamin molecules travel through the body, picking up hydrogen and oxygen molecules in the liver and kidneys to become active vitamin D.

Since sunlight exposure is easy, available, and free, it seems like a simple solution to getting the vitamin D we need.

But we’ve understandably moved away from the days of basking in the sun for hours at a time. Over-exposure to UV rays damages the skin, causing premature aging and, worse, a much greater risk of skin cancer. If you enjoy time in the sun, talk to your doctor about safe sun exposure, which can depend on the part of the country you live in, the time of year, and your individual skin type.

And, if you need to avoid sun exposure, there are other opportunities for getting the vitamin D you need.

  • Diet

While there aren’t a lot of foods which are naturally rich in vitamin D, there are still a few options on the menu. Oily fish like salmon, tuna, and herring—and old-fashioned cod liver oil—are good sources of the vitamin. But most of us don’t live on a strict fish diet!

Instead, we can get the vitamin D we need from fortified foods. Vitamin D is commonly added to cow’s milk, soy milk, orange juice, and cereals to make sure the calcium in our diet is working effectively to keep our teeth and bones strong. Check out nutritional labels to discover whether your favorite grocery products contain vitamin D. And don’t forget to choose foods that are braces-friendly, as well!

  • Supplements

For hundreds of years, people who lived in climates and cities without a lot of sunshine suffered from the effects of vitamin D deficiency. Diseases like rickets, where the teeth and bones don’t form properly, were common in children. Adults who couldn’t absorb enough calcium suffered from weak teeth and bones.

Today, depending on age, allergies to sun or food products, dietary choices, and health conditions, some people are still at risk for vitamin D deficiency. If you’ve been diagnosed with this deficiency, your doctor might recommend a vitamin D supplement. (It’s important to take any supplement as directed, because taking too much vitamin D can be harmful, too.)

So, which form of vitamin D is best? Fortified foods? Supplements? Or is it that radiant original source—the sun? No need to worry. With any form of vitamin D, you’re getting the key you need to unlock the benefits of the calcium in your diet—for healthy teeth and bones before, during, and after your treatment at our New Bedford or Mattapoisett, MA orthodontic office. Your sunny smile will thank you!