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You might have been one of the lucky few born with perfectly straight teeth and a healthy bite. You might have spent months in orthodontic treatment as a teenager to achieve perfectly straight teeth and a healthy bite. But now that you’re growing older, you might be unhappily surprised to discover that your smile isn’t aging as gracefully as you are.  What’s changed?

That’s a trick question, because our bodies never stop changing, growing, and adapting. And these constant adjustments include the changes taking place in your teeth and mouth. You might begin to notice subtle differences in your smile when you’re in your thirties or forties. After young adulthood, several factors come into play which can cause shifting teeth and a misaligned bite:

• Teeth naturally shift.

Shifting can be a result of the normal changes time brings. The periodontal ligaments which attach our teeth firmly to the jawbone lose some of their strength; the jawbones which hold our teeth in place lose some of their density and begin to narrow. Our teeth also have a natural tendency to move toward the front of the mouth, a phenomenon called “mesial drift.”

Add all of these elements together, and your once straight teeth start to crowd together and even overlap—especially the front bottom teeth.

• Stressful habits stress your teeth.

If you habitually grind or clench your teeth, you’re putting pressure on them. Just like the gentle pressure of braces and aligners can shift teeth into alignment, the more uncontrolled force of grinding can push teeth out of alignment.  

• Losing a tooth affects surrounding teeth.

Nature abhors a vacuum, and so does your smile. If you lose a tooth, your other teeth will automatically start to drift into the space left open by the missing tooth.

• A neglected retainer is gathering dust in a drawer somewhere.

You might have spent time as a teenager in orthodontic treatment, with a beautiful smile to show for all your hard work. And, back in the day, your orthodontist no doubt let you know that you needed to keep wearing your retainer at night once your treatment was completed.

If that’s one healthy habit you abandoned as you got older, don’t be surprised if your teeth start to migrate back to their old, less-than-perfect positions.

Between normal biological changes and the wear and tear of daily life, you might find one day that your smile isn’t that same beaming smile you’re used to seeing in the mirror. And it’s not just an aesthetic concern.

Crooked teeth are harder to clean, and built-up plaque means more decay and gum disease. Shifting teeth can cause malocclusions, or bite problems, which can bring you jaw pain, headaches, and chipped or cracked teeth.

If your smile has changed over time, it’s time to give Dr. Neil Oliveira and Dr. Derek Wolkowicz a call. There are many discreet options which can return your smile to you, including:

• Clear aligners—comfortable, removable, and often unnoticeable.
• Traditional braces—brackets are smaller than ever, and you can choose ceramic brackets which are color-matched to blend in with your enamel.
• Lingual braces—these braces are attached to the inside of the teeth, for complete invisibility.

And what if you’ve never been as confident in your smile as you wanted to be? There’s good news here as well—it’s never too late to see an orthodontist. Make an appointment at our New Bedford or Mattapoisett, MA office to discover how you can make sure your smile looks just as young as you feel!

An overbite is one of the most common malocclusions. If Dr. Neil Oliveira and Dr. Derek Wolkowicz and our team have diagnosed you with an overbite, you probably have lots of questions. Let’s try to answer some of them!

Just what is an “overbite”?

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 healthy bite, the front top teeth project slightly beyond, and slightly overlap, the bottom teeth. A normal overlap is generally considered one or two millimeters.

An overbite is a Class II malocclusion, and means that the upper front teeth cover more of the lower teeth than they should. But that’s a very general definition, and we will diagnose and treat your own, very specific, bite and teeth alignment.

Because overbites aren’t all alike. They might be barely noticeable. Upper teeth might overlap lowers by an extra millimeter or two. In more severe overbites, the upper teeth might cover the lower teeth completely. The amount of overlap and the cause of the overbite will determine your treatment.

What causes an overbite?

Overbites can be dental, caused by tooth alignment, or skeletal, caused by bone development, or a combination of both. They are usually hereditary, so, most often, an overbite is something you’re born with.

The size and position of your jaws, the shape and position of your teeth, all affect your bite alignment. But early oral habits, such as prolonged and vigorous thumb-sucking or pacifier use can contribute to overbite development. Missing teeth and bruxism, or tooth grinding, can also affect the alignment of your bite.

How do we treat an overbite?

There are many types of treatment available. Dr. Neil Oliveira and Dr. Derek Wolkowicz will recommend a treatment plan based on the type and severity of your overbite. Because some treatments are effective while bones are still growing, your age plays a part as well.

• Braces and Aligners

If dental issues are the main reason for your overbite, braces or clear aligners can be very effective. Rubber bands are commonly used to help bring teeth and jaw into alignment.

• Functional Appliances

If the overbite 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 forming.

For young patients, there are several appliances that can help correct an overbite. Some, like the Herbst appliance, work inside the mouth, while others, like headgear, are worn externally. Your orthodontist will recommend the most effective appliance for your needs.

• Surgical treatment

In some cases, where the problem is skeletal rather than dental, surgical treatment might be necessary to reshape the jawbone itself. This is especially true for adults, whose bones have finished forming.

If we recommend surgery, oral and maxillofacial surgeons are experts in surgical procedures designed to create a healthy and symmetrical jaw alignment. Dr. Neil Oliveira and Dr. Derek Wolkowicz will work with your surgeon to design a treatment plan, which will usually include braces or other appliances following surgery.

Why treat your overbite?

Sometimes, a very slight overbite won’t require treatment. A serious, moderate, or even mild overbite, though, can lead to many dental and medical problems, including:

• Crooked, crowded teeth
• Worn teeth and enamel
• Problems speaking or chewing
• Difficulty sleeping
• Headaches, facial, and temporomandibular (jaw) joint pain

When you work with our New Bedford or Mattapoisett, MA team to correct your overbite, you’ll not only prevent these unpleasant consequences, but you’ll achieve major benefits as well—a healthy, comfortable bite, and an attractive, confident smile. If you’d like more than an overbite overview, Dr. Neil Oliveira and Dr. Derek Wolkowicz can provide the specific information and treatment plan you need to make that healthy bite and that confident smile a reality!  

If you play a contact sport, you know about mouthguards. You know about the cushioning protection they provide for your teeth. And not just your teeth—mouthguards also help protect your lips, tongue, and jaw, helping you avoid or minimize many of the injuries caused by collisions.

But you don’t have to be part of the defensive line or face off on center ice to wear a mouthguard. It pays to be proactive with your oral health in any activity where impact is a possibility. Whether you play a team sport, practice gymnastics, ride a bike, ski, skateboard, or participate in other athletic pastimes, there’s almost always the risk of impact—with a ball, with the mat, with the sidewalk, with another person.

So, how do mouthguards protect your teeth and mouth? It’s a combination of materials and design. Mouthguards are made of a strong, cushioning material such as plastic or silicone which helps absorb and distribute the force of impact, usually in the form of a horseshoe-shaped piece which fits over your upper teeth. The specific design can be tailored to the sport or activity you’ll be using it for.

And now that you’re wearing braces? Working toward an attractive, healthy smile doesn’t mean you can’t be active or find a mouthguard which will work for you. In fact, when you wear braces, mouthguards do double duty—they protect your mouth and teeth, and they protect your braces, too!

Even minor impacts can damage wires and brackets, and damaged braces means more time at the orthodontist and lost treatment time. More important, your guard not only helps protect your brackets and wires from impact injury, it protects your delicate mouth tissue from trauma caused by impact with your brackets and wires.

Because you probably have braces on both upper and lower teeth, the usual mouthguard design might not work for you. To make sure you’re completely protected, you may need a guard which covers both upper and lower arches.

There are over-the-counter mouth guards designed for braces, and even for covering both your upper and lower teeth. These might be one-size-fits-all or fit-it-yourself guards, or models which should be used only after a fitting at our New Bedford or Mattapoisett, MA orthodontic office. While some of these guards are better than others, the best option for your teeth—and your braces—might be a custom mouthguard.

What are the benefits of a custom guard for orthodontic patients? They:

• Provide a perfect fit around teeth and braces
• Protect better because they fit better
• Are designed for easy breathing and speaking
• Are less bulky
• Are more durable
• Fit more comfortably
• Can accommodate orthodontic adjustments
• Can be tailored to your specific sport or activity.

Custom mouthguards are more expensive, because they are individually crafted for your teeth and braces, but in terms of effectiveness, they are the best guards out there—because they are individually crafted for your teeth and braces. If cost is an issue, Dr. Neil Oliveira and Dr. Derek Wolkowicz can let you know whether an over-the-counter option might work for you.

An active life should mean proactive dental care. Wearing a mouthguard when you’re wearing braces protects both your body and your orthodontics. Whichever guard option you choose, it’s a good idea to check out the fit with Dr. Neil Oliveira and Dr. Derek Wolkowicz to make sure you’re getting all the protection you need for both when your mouthguard is doing double duty.

It’s a new year, and it couldn’t come fast enough for many of us! Let’s do our part to make this a better year in every way—and you can start by making this the year you quit smoking once and for all.

You know that smoking is very damaging to your body. Smokers are more likely to suffer from lung disease, heart attacks, and strokes. You’re at greater risk for cancer, high blood pressure, blood clots, and blood vessel disorders. With far-reaching consequences like this, it’s no surprise that your oral health suffers when you smoke as well.

How does smoking affect your teeth and mouth?

• Appearance

While this is possibly the least harmful side effect of smoking, it’s a very visible one. Tar and nicotine start staining teeth right away. After months and years of smoking, your teeth can take on an unappealing dark yellow, orange, or brown color. Tobacco staining might require professional whitening treatments because it penetrates the enamel over time.

• Plaque and Tartar

Bacterial plaque and tartar cause cavities and gum disease, and smokers suffer from plaque and tartar buildup more than non-smokers. Tartar, hardened plaque which can only be removed by a dental professional, is especially hard on delicate gum tissue.

• Bad Breath

The chemicals in cigarettes linger on the surfaces of your mouth causing an unpleasant odor, but that’s not the only source of smoker’s breath. Smoking also dries out the mouth, and, without the normal flow of saliva to wash away food particles and bacteria, bad breath results. Another common cause of bad breath? Gum disease—which is also found more frequently among smokers.

• Gum Disease

Smoking has been linked to greater numbers of harmful oral bacteria in the mouth and a greater risk of gingivitis (early gum disease). Periodontitis, or severe gum disease, is much more common among smokers, and can lead to bone and tooth loss. Unsurprisingly, tooth loss is also more common among smokers.  

• Implant Failure

Tooth implants look and function like our original teeth, and are one of the best solutions for tooth loss. While implant failure isn’t common, it does occur significantly more often among smokers. Studies suggest that there are multiple factors at work, which may include a smoker’s bone quality and density, gum tissue affected by constricted blood vessels, and compromised healing.

• Healing Ability

Smoking has been linked to weakened immune systems, so it’s harder to fight off an infection and to heal after injury. Because smoking affects the immune system’s response to inflammation and infection, smokers suffering from gum disease don’t respond as well to treatment. Smokers experience a higher rate of root infections, and smoking also slows the healing process after oral surgeries or trauma.

• Dry Socket

Smoking following a tooth extraction can cause a painful condition called “dry socket.” After extraction, a clot forms to protect the tooth socket. Just as this clot can be dislodged by sucking through a straw or spitting, it can also be dislodged by the force of inhaling and exhaling while smoking.

• Oral Cancer

Research has shown again and again that smoking is the single most serious risk factor for oral cancer. Studies have also shown that you reduce your risk of oral cancer significantly when you quit smoking.

• Consequences for Orthodontic Treatment

Finally, if this is the year that you’re investing the time and effort needed to create an attractive, healthy smile with orthodontic treatment, don’t sabotage yourself by smoking!

Cosmetically, smoking doesn’t just discolor your tooth enamel—tar and nicotine discolor your aligners and braces as well. If one of the reasons you chose clear aligners or ceramic brackets is for their invisible appearance, the last thing you want is yellow aligners and brackets.

More important, smoking, it’s been suggested, can interfere with your orthodontic progress. When blood vessels are constricted, your gums, periodontal ligaments, and bones can’t function at their healthy best, moving your teeth where they need to be steadily and efficiently. This means that your treatment could take longer. And if your smoking has caused gum disease, you might have to put any orthodontic treatment on hold completely until it’s under control.

Quitting smoking is a major accomplishment that will improve your life on every level. It’s always a good idea to talk to Dr. Neil Oliveira and Dr. Derek Wolkowicz for strategies to help you achieve your wellness goals for the new year. Make this the year you stop smoking, and the year your health improves in countless ways because you did.