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Your Child’s First Visit to the Orthodontist

September 10th, 2025

We often think of braces as a rite of passage for kids in middle and high school. So you might be surprised when your child’s dentist recommends a visit to see Drs. Cartsos and Zavras years earlier than you anticipated. In fact, dentists and orthodontists generally suggest a visit to the orthodontist by age seven at the latest.

Why see an orthodontist so early?

After all, your child is still growing, and many adult teeth haven’t come in at that age. And that’s the whole point.

Around this age, your child will probably have a mix of both baby and adult teeth, so your orthodontist will be able to assess whether there’s enough room for the permanent teeth to erupt without crowding or spacing problems. And malocclusions, or bad bites, caused by problems with jaw size or symmetry can be addressed while young bones are still forming and developing.

If your child has a first appointment coming up on the calendar, here’s a heads up on what often happens during a first visit, and potential problems your orthodontist will be on the lookout for.

What can you expect at a first visit?

The first visit is designed to evaluate how your child’s teeth and jaws work together now, and to look for potential future problems with tooth alignment and jaw structure and development.

First, Drs. Cartsos and Zavras will carefully examine your child’s teeth, jaws, and mouth. Your child will be asked to bite down several times to see how the teeth and jaws fit together, and if there’s any discomfort. Other helpful diagnostic tools could include:

  • Scans or X-rays to evaluate jaw structure and the position of teeth which haven’t erupted yet
  • Photos of your child’s teeth and face
  • An impression of your child’s teeth

If there’s no immediate need for treatment, we might recommend periodic checkups at our Chestnut Hill, Massachusetts orthodontic office to follow the growth and development of your child’s teeth and jaws. If interceptive (early) treatment is your child’s best option for a healthy smile, your orthodontist will explain any immediate orthodontic issues and design a treatment plan tailored to your child’s specific needs.

What are the benefits of early treatment?

Interceptive treatment not only helps correct current orthodontic problems, it can help reduce the need for more complicated treatment in the future, when all of the adult teeth have arrived and bones are fully formed. Among its many benefits, early treatment can:

  • Prevent crowding

If your child has a small upper palate, it can be gently enlarged while the palate is still growing with the help of a palatal expander. This will give the upper teeth the space they need to come in without crowding.

  • Provide space

If primary teeth are lost too early, other teeth can shift out of alignment to fill the empty space. A space maintainer can be custom-made to keep the spot open until the right tooth is ready to erupt. If primary teeth are overstaying their welcome, Drs. Cartsos and Zavras might recommend extraction to allow the adult teeth to erupt in the proper place.

  • Create jaw symmetry

Malocclusions can develop because the upper or lower jaw is too narrow, too far forward, too far back, or the jawbones don’t fit together properly. Drs. Cartsos and Zavras might suggest the use of a functional appliance such as the Herbst® appliance or headgear to help guide symmetrical bone development while your child’s young bones are still growing and forming.

  • Protect teeth

Children with overjets, or protruding upper teeth, are more likely to suffer chips, cracks, and other trauma to those vulnerable front teeth. Functional appliances can help bring the upper and lower jaws into alignment as needed, and braces can move the teeth into alignment.

Every journey to a healthy smile begins with a first visit. And you don’t need to wait until your child is seven. Any time you’re concerned about an orthodontic issue is a good time for a consultation. Talk to Drs. Cartsos and Zavras about what to expect at your first visit to help create a comfortable experience for your child as you begin this journey together.               

To use or not to use mouthwash; that is the question

September 4th, 2025

A famous mouthwash company chose the marketing slogan, “Better than flossing.” As a consumer, would you believe a high-end commercial that essentially tells you to stop flossing? Just use this brand of mouthwash and the risk of gingivitis, cavities, etc., is gone. What a wonderful idea! Now for the reality: This is simply not true.

The company that made these claims received some negative feedback for making this false claim. Does this mean that all mouthwashes are ineffective? Absolutely not. It takes a little bit of research to know which mouthwashes are most effective and best suited for you. Here are some key points to remember when choosing a mouthwash.

First, think about why you want to use a mouthwash. If you are at high risk for cavities, you would benefit from a fluoride mouthwash. Check the labels to see which ones contain fluoride.

If you have active gingivitis, a mouthwash with some antibacterial properties would be preferable. Read the labels carefully. You do not want a mouthwash containing alcohol. If you have active periodontal disease, an antibacterial mouthwash is appropriate, though you may want to discuss which kind would be best for your individual needs.

Prescription mouthwashes are also an option. You should pay close attention to the directions, such as how much and how long to use them. There is one brand in particular whose effectiveness can steadily diminish if you use it continually. There can also be side effects you should discuss with our office and/or your pharmacist.

Some great mouthwashes for kids change the color of plaque on their teeth to help them see how they are doing with their brushing. This is a great learning tool for the child and the parent! Why not pick up a bottle for yourself next time you’re at the store and evaluate your own performance?

Beware of claims that a mouthwash can loosen plaque. This is not accurate. Beware of any mouthwash that has alcohol. This is worth mentioning twice. Take care of your taste buds. If you are using a strong mouthwash, it can reduce your sense of taste.

These tips should help you choose the right mouthwash for your needs. Please contact Drs. Cartsos and Zavras at our Chestnut Hill, Massachusetts office with any specific questions!

Toothbrush Science

August 28th, 2025

Let’s talk science! From the vastness of the cosmos to sub-atomic particles, science helps us understand the world around us and how it works. So, let’s take some familiar scientific fields of study and apply them to your toothbrush.

My toothbrush?

Yes, indeed! When it comes to your oral health, your toothbrush is the first line of defense, so understanding how and why it works so well might help us use this handy tool even more effectively.

Biology—the study of living organisms

Unfortunately for your toothbrush, the living organisms we’re talking about here are the bacteria which cause tooth decay and those which can lead to illness. How do these problems arise, and how do we prevent them?

Fight Plaque

Plaque is the sticky film that builds up on teeth, and millions of oral bacteria help make up this biofilm. These bacteria convert sugars and other carbohydrates in the foods we eat into acids. And these acids erode our tooth enamel, leading to tooth decay. (More on this when we get to Chemistry.) The best ways to get rid of plaque?

  • Brush often. The recommended minimum is two minutes of brushing twice a day, but when you’re having orthodontic work done, it’s even more important to banish the plaque that can stick to your braces or inside aligners. Ask us what brushing schedule is best for you.
  • Try an electric toothbrush. For some people with braces, cleaning the teeth is easier and more thorough with an electric brush.
  • Replace your brush regularly. Brushes become worn and frayed after three or four months, and you won’t be brushing as effectively.

Stop Germs from Spreading

  • Don’t share. Sharing toothbrushes can lead to an increased risk of colds and infections.
  • Rinse thoroughly after brushing, making sure you remove any toothpaste or debris left after you brush.
  • Store the brush upright and let it air-dry. Covering the brush or keeping it in a closed container can promote the growth of bacteria more easily.
  • Keep different brushes separate when they’re drying to avoid cross-contamination.
  • Replace your brush regularly!

Chemistry—the study of what makes up substances, their properties, and how they interact

When it comes to improving your brushing chemistry, the best thing you can do for your toothbrush is to put a dab of fluoride toothpaste on it! Why fluoride? Let’s look at the chemistry of tooth enamel.

Tooth enamel is the strongest substance in our bodies—even stronger than bone. But it is not indestructible, and acidic substances can dissolve the mineral bonds which give our enamel its strength, whether they come from the bacteria in plaque or are found in our favorite foods and drinks (sodas, coffee, tomatoes, and citrus are among the tasty, but acidic, culprits).

The enamel in our teeth contains calcium and phosphate ions, minerals which help make it the strongest substance in our bodies. But when the level of acidity in our mouths becomes too high, these minerals begin to dissolve. Eventually, teeth become pitted, bacteria can penetrate more deeply, and decay is the result.

So what can we do? While our saliva helps neutralize acidity naturally, and we can cut back on acidic foods in our diets, using fluoride toothpaste actually helps restore the strength of our enamel in a process known as “remineralization.”

Fluoride works on the surface of enamel to both attract and anchor calcium ions, reducing mineral loss and strengthening the weakened enamel. Fluoride also interacts with the calcium and phosphate compound to create a new compound that is even stronger and more acid-resistant.

When you brush with fluoride toothpaste, you help replace and restore the mineral composition of your enamel—and there’s evidence that fluoride might even interfere with oral bacteria’s ability to produce acid. Now that’s good chemistry!

Physics—the study of matter and energy and their interactions

The matter here is your tooth enamel, and the energy is the force you use when brushing. And this is one time the force should not be with you.

  • Over-vigorous brushing can not only damage your brackets, but can also irritate delicate gum tissue and wear down enamel. A “sawing” back-and-forth motion is both hard on your enamel and misses plaque and debris between the teeth. We’ll be happy to show you the safest and most effective way to brush with braces. Just remember, “Massage, don’t scrub.”
  • A soft toothbrush is almost always your best option when you use a manual brush, but if you’re still a heavy-handed brusher, or have sensitive teeth and gums, consider an electric model. An electric toothbrush should provide a continuous brushing motion without needing any heavy pressure from the brusher. Some models will even let you know when you are brushing too hard.

Brushing harder is not brushing better, and your teeth, gums, and braces will be heathier with careful brushing habits. If you need tips on brushing with braces, contact our Chestnut Hill, Massachusetts office and ask!

There’s a lot of science in the simple act of brushing, but we don’t need to spend hours studying to get a passing grade in dental health. The things you do normally—brushing at least two minutes twice a day, using fluoride toothpaste, and applying proper brushing technique—will help create a smile which will earn you top marks from Drs. Cartsos and Zavras for a lifetime!

The Effects of Biting Your Nails

August 21st, 2025

Also known as onchophagia, the habit of nail biting is one of the so-called “nervous habits” that can be triggered by stress, excitement, or boredom. Approximately half of all kids between the ages of ten and 18 have been nail biters at one time or another. Experts say that about 30 percent of children and 15 percent of adults are nail biters, however most people stop chewing their nails by the time they turn 30.

Here are four dental and general reasons to stop biting your nails:

1. It’s unsanitary: Your nails harbor bacteria and germs, and are almost twice as dirty as fingers. What’s more, swallowing dirty nails can lead to stomach problems.

2. It wears down your teeth: Gnawing your nails can put added stress on your pearly whites, which can lead to crooked teeth.

3. It can delay your orthodontic treatment: For those of our patients wearing braces, nail biting puts additional pressure on teeth and weakens roots.

4. It can cost you, literally: It has been estimated that up to $4,000 in extra dental bills can build up over a lifetime.

Drs. Cartsos and Zavras and our team recommend the following to kick your nail biting habit:

  • Keep your nails trimmed short; you’ll have less of a nail to bite.
  • Coat your nails with a bitter-tasting nail polish.
  • Ask us about obtaining a mouthguard, which can help prevent nail biting.
  • Put a rubber band around your wrist and snap it whenever you get the urge to gnaw on your nails.
  • Think about when and why you chew your nails. Whether you are nervous or just bored, understanding the triggers can help you find a solution and stop the habit.
  • If you can’t stop, behavioral therapy may be an effective option to stop nail biting. Ask Drs. Cartsos and Zavras and our team for a recommendation.
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