If you’ve just gotten braces at our Chestnut Hill, Massachusetts office, you’ve probably also learned a whole new vocabulary. Malocclusion, brackets, archwires, ligatures, elastics—you’ve got the definitions down. But now you’re scheduled for an “adjustment.” What exactly does that mean?

Why Do I Need an Adjustment?

After all, you’ve just gotten braces! But the fact is, moving your teeth to their ideal location is a process that involves many steps. The brackets and wires you have today are only a starting point. Wires, and rubber bands if you need them, put gentle pressure on the teeth, gradually moving them into a better position. Every time we see you, we check the progress you’ve made and adjust your braces to move the teeth into even better alignment. It’s a careful process to make sure your teeth and jaws fit together perfectly for straight teeth and a healthy bite.

What Will Happen at an Adjustment?

Because your braces are made specifically for you, there is no one answer for everyone or even every appointment. Usually, your ligatures (the colorful bands around your brackets) will be removed, and often the orthodontic wire that is attached to your brackets will be removed as well. We’ll check to make sure you are brushing and flossing properly around your wires and brackets, and check on the condition of your braces.

Your wire might be adjusted, or bent, or tightened, or replaced all together. In the beginning, the wire will probably be more flexible. Later in your treatment, you might get a thicker, firmer wire to move your teeth more effectively, or we might bend a wire to move specific teeth.

If you need rubber bands to make sure your bite is in alignment, we’ll show you how to attach and take care of those. We’ll also look for other adjustments that might need to be made to your brackets. If you have any concerns about brackets, wires, or any other part of your braces, let Drs. Cartsos and Zavras know! And once we’re done adjusting your braces, this is your chance to change the color of your ligatures for a new look.

Will It Hurt?

You might suffer some discomfort in the hours after an adjustment, so treat yourself gently! Stick to soft foods for a few days, and treat yourself to something cold and soothing like ice cream, yogurt, or a smoothie. Brush gently if your teeth are sensitive. Usually, over-the-counter pain relievers will take care of any soreness. You can even take a pain reliever 30 minutes to an hour before the adjustment if you are expecting some discomfort. We have more great ideas on how to reduce any tenderness you might feel—let us know if we can suggest some.

Within a day or two, you should be back to normal. If you ever suffer serious discomfort, or if the soreness lasts more than a few days, give us a call.

Remember, each adjustment brings you closer to your goal—straight teeth and a healthy bite. And that’s the definition of a beautiful smile!

TMJ is the quick way of referring to your Temporomandibular Joint. Pardon the pun, but that’s quite a mouthful! What is this joint, what does it do, and, if your Drs. Cartsos and Zavras and our team have told you that you have a TMJ disorder, what can we do to help?

The Temporomandibular Joint

Your two temporomandibular joints are amazing works of anatomical design. These are the joints where the temporal bone in the skull meets the mandible bone of the jaw, and allow our mouths to open and close, move back and forth, and slide from side to side. Muscle, bone, and cartilage work together to provide easy movement and to cushion the joint. But sometimes, the joint doesn’t work as smoothly as it should, and this can lead to Temporomandibular Joint Disorder, or TMD.

When Should You Suspect You Have TMD?

You might have TMD if you experience any of these symptoms:

• Painful chewing
• Pain around your TMJ, or in your face or neck
• Earaches
• Changes in your bite
• Jaws that are limited in movement or lock open or shut
• Clicking, popping or grating noises when you open and shut your jaw

There are many conditions linked to TMD. If you grind your teeth at night, have arthritis in the jaw, have suffered an injury or infection in the area, or have problems with your bite, for example, you might be more likely to have TMJ problems. If you suspect you have TMD, or suffer from any of the symptoms listed above for an extended period, give us a call.

Treating TMD

During your visit to our Chestnut Hill, Massachusetts office, we will check your medical history, and examine your head and neck. We can take an X-ray or scan if needed for further examination of the joint. Because there is no real scientific agreement yet about the best way to treat TMJ disorders, a conservative treatment plan is often best. If you do show signs of TMD, we might first suggest relaxation techniques, over-the-counter pain relievers, or the use of ice packs or moist heat compresses. A change to a softer diet can help, and you should stop chewing gum and making any exaggerated jaw movements.

If these self-care practices aren’t effective, we might suggest a nightguard. This appliance is a comfortable and flexible mouthguard custom fitted for you, and will bring relief from teeth grinding when worn at night. If this treatment is not effective, talk to us about other options.

Luckily, most cases of TMD are temporary and don’t become worse over time. But any persistent discomfort is a good reason to visit us. Whether you have TMD, or any other problem causing you pain in the head or jaw, we want to help.

If you’ve been following your dentist’s advice, you know that you should be devoting two minutes twice a day to gentle, thorough brushing, and floss carefully at least once a day. It’s automatic. It’s habit. You’re in the zone. Now that you have braces or aligners, though, it’s time to step up your game!

Removing Food Particles

No one wants to worry about food particles stuck in braces right after lunch—or, worse, noticed hours after lunch! Because food tends to stick around brackets and wires, Drs. Cartsos and Zavras and our Chestnut Hill, Massachusetts team recommend brushing after a meal. Not only will you be confident in your smile, you’ll be improving your dental health.

But why?

Better Plaque Removal

Plaque is a sticky film containing acid-producing bacteria. These acids lead to weakened enamel and, eventually, cavities. Careful brushing with a fluoride toothpaste helps eliminate plaque. But as you may have discovered, it can be more difficult to clean around brackets and wires. Brushing after eating will help keep plaque from forming on your enamel, and using the right tools (floss made for braces and interproximal brushes) will help clean plaque more effectively.

But what about aligners?

If you wear clear aligners, you take them out when you eat. This avoids the problem of food particles trapped in brackets and difficulty brushing around wires. But this doesn’t mean you are home free. Brushing after every meal is also a good idea when you wear aligners.

Our teeth have an organic way to help remove food particles, acids, and bacteria between brushings—saliva! Your aligners, while covering your teeth, decrease their exposure to saliva. It’s really important, then, to make sure you brush after eating. Otherwise, food particles and acids can remain on your teeth after you replace your aligners, increasing the risk of enamel erosion and decay.

Brushing helps keep your aligners clear as well. If you notice aligner discoloration, this could be the result of food residue such as tomato sauce or coffee that remained on the teeth after a meal. Anything that stains your enamel can stain your aligners. And don’t forget about plaque. Plaque can stick not only to your enamel but to your aligners as well. If you notice that your aligners are cloudy, or have an unpleasant odor, talk to us about the best way to keep them their cleanest.

Make a Plan

So, what can you do to make brushing more convenient during a busy day? Be prepared! Keep a small kit with you containing a travel brush, a small tube of toothpaste, floss, and an interproximal brush for quick cleanings when you’re out and about, and you’ll never have to worry about your smile.

Of course, there are occasions when it’s just not possible to brush. At times like this, whether you have traditional braces or aligners, it’s a good idea to rinse well with water after meals or snacks, and brush as soon as you can.

Start your new dental routine now, and soon it will be automatic. An everyday habit. Your new comfort zone. After all, taking a few extra minutes from your day to brush after every meal will be well worth it when you end your orthodontic treatment with a smile that is as healthy as it is beautiful!

What a milestone! The transition from bottle to sippy cup is one of baby’s first steps toward toddler independence. And like all first journeys, some helpful guideposts come in handy. That’s why Drs. Cartsos and Zavras and our team have several recommendations to help you navigate this transition, making sure your baby’s dental health is protected along the way.

Choosing a Sippy Cup

Sippy cups are often a parent’s first choice for this big step in baby’s development. While sippy cups offer a variety of child-safe materials, lively colors, and comfortable handle options, the feature of interest from a dental perspective is lid design.

Sippy cups curb spills because their lids don’t allow liquids to flow out freely, ensuring that drinks make it into baby’s mouth instead of onto furniture or floor. Cup lids might incorporate:

• Built-in straws
• A drinking edge around the rim of the cup which seals when your child isn’t drinking
• Soft spouts
• Hard spouts
• Spouts with valves to prevent liquids from leaking out. (Spouts with valves work like a nipple, which means baby is sucking instead of sipping.)

Which design is best? For short periods, any of these designs can work for you. Over long periods, spouted cups could have the same effects as prolonged thumb-sucking and pacifier use, potentially affecting a child’s tongue positioning, tooth alignment, bite, and speech development. Your dentist will be able to suggest which cups are best for your child’s dental health both short and long term.

What to Put in a Sippy Cup

Once your baby has begun drinking from a cup, it should only hold tooth-friendly drinks.

• Pediatricians generally recommend breast milk and/or formula until your child is 12 months old. You can switch to regular milk (or a healthy milk alternative) once your child is a year old with your doctor’s okay.
• Water can be introduced when your pediatrician thinks your child is ready, usually around the age of six months.
• Because even natural fruit juices have lots of sugar, dentists and pediatricians suggest giving your baby small amounts only—or feed your child fruit instead!
• Skip the sugared drinks, sports drinks, caffeinated drinks, and sodas. They aren’t healthy for little bodies or little teeth.

Help Prevent Tooth Decay

Just like adults, babies can suffer tooth decay, too—and for the same reasons. The bacteria in plaque use the sugars found in our diets to create acids, and acids erode tooth enamel.

When a toddler totes a sippy cup around all day, even filled with healthy drinks, those baby teeth are constantly exposed to the natural sugars found in breast milk, formula, and, for older children, milk. Drinks with more or added sugars, such as juices or sweetened drinks, cause more damage to tooth enamel. Use a sippy cup wisely:

• Offer the cup with meals and snacks, when increased saliva production can help wash away sugars and neutralize the acids which cause cavities.
• Offer water between meals.
• Don’t let your baby take a sippy cup to bed. Some spill-proof cups are designed to be sucked like bottles, and, like bottles, sugary liquids can pool in babies’ mouths as they sleep.
• Get into a tooth-cleaning routine as soon as your child’s teeth start to arrive.

And, while we’re talking about healthy teeth, please don’t let your child toddle around with a sippy cup. A fall while drinking can injure a baby’s mouth and teeth.

Partner with Your Child’s Dentist

The journey from baby to toddler can seem overwhelming sometimes for both you and your child, but you have expert help available! It's a good idea to make a first dental appointment at our Chestnut Hill, Massachusetts office sometime between the appearance of the first baby tooth and your child’s first birthday. This initial visit is an opportunity for Drs. Cartsos and Zavras to:

• Check your child’s overall dental health and development.
• Look for signs of early decay.
• Talk about proactive dental care, including how and when to clean your child’s teeth.
• Answer questions about how you can support your child’s dental health, including the advantages and disadvantages of sippy cups.

Used properly, sippy cups can be a helpful transition on your child’s journey from bottle to cup, and from baby-who-relies-on-you-for-everything to take-charge-toddler. Drs. Cartsos and Zavras and our team are an ideal guide as you and your child chart this path together.