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Tiny Mouths, Big Concerns

December 30th, 2025

Snoring, Grinding, Speech Challenges, or Thumb Sucking Habits

At Convivial Dental in Chestnut Hill, we care about the tiniest of smiles and the tiniest of muscles, because we know that they can have a big impact on your child’s health and confidence for years to come. We want to make sure that your child starts off on the road to great oral health from an early age. And while cleanings are important, we offer a much more comprehensive approach to growing mouths. One area where we excel is myofunctional therapy. Read on to understand the signs to look for and how our orthodontist, Dr. Vicky Cartsos can help. 

Early signs your child's developing smile may benefit from myofunctional and speech therapy:

  • Mouth breathing, especially at night
  • Snoring or noisy breathing while sleeping
  • Difficulty chewing or swallowing
  • Tongue thrust - it’s what it sounds like: tongue pushing against your child’s front teeth when they are swallowing or speaking
  • Thumb Sucking or prolonged pacifier use
  • Speech delays or unclear verbal communication
  • Teeth Grinding/Bruxism

If any of these sound like you’re kiddo, it’s worth stopping by for an examination. Early detection and treatment can help your child in a myriad of ways, guiding your child’s facial muscles and tongue position to influence jaw growth, tooth alignment, and airway development. 

Myofunctional therapy can include a collaborative effort between an orthodontist, ENT, speech-language pathologist and pediatric dentist for a team based approach. If, upon consultation, it seems like your child could benefit from this type of therapy, Dr. Vicky Cartsos will work on a unique treatment plan for your child. It may include early interceptive orthodontic treatment, muscle and /or tongue exercises, or habit breaking appliances. As with everything at Convivial Dental, the utmost care and highest level of professionalism will be at your child’s fingertips.

Why Convivial Dental? Why Dr. Cartsos? 

Dr. Cartsos is a co-founding member of the Tufts Medical Center Craniofacial-Cleft Lip & Palate Team (Hospital Affiliate). Her passion and mission there has been to contribute her orthodontic expertise to this multidisciplinary team to address complex cases. She often works in conjunction with Pediatric ENT specialists, Plastic Surgeons, Oral Surgeons, Pediatric Dentists, Geneticists, Speech pathologists, Audiologists and Nutrition specialists to provide total rehabilitation of the face, teeth and jaws. While your kiddo likely doesn’t need the full resources of the Tufts team behind them, Dr. Cartsos’ expertise there lends her the ability to help more children smile their healthiest, happiest and brightest. 

If your child is exhibiting any of the above signs, we encourage you to schedule a complimentary consultation with us. We provide the highest level of care and our reviews speak for themselves. Whether you’re looking for extensive care or just curious if this article relates to your child, we’d love to see you! Making smiles makes our day. 

Call us today at 617-735-0800 or click below to schedule a free consultation - we can start virtually or in person - your choice!

Foods that Can Harm Enamel

December 24th, 2025

Many people who are careful about brushing and flossing their teeth wonder how they still end up with cavities or tooth decay. Several factors affect wear and tear on tooth enamel. Diet is a major factor, with certain foods increasing the likelihood that your enamel will become discolored or decayed. Pay close attention to the foods you eat to keep your pearly whites looking healthy and clean.

What causes enamel damage?

Tooth enamel refers to the hard, semi-translucent, whitish part of the tooth that shows above your gums. The enamel is primarily composed of minerals that are strong but susceptible to highly acidic foods. When acid reacts with the minerals in enamel, it results in tooth decay. Strongly pigmented foods can also damage enamel by discoloring the surface of the tooth.

Foods that harm enamel

Acidic foods are the greatest source of enamel damage. To determine whether a food is acidic, look up its pH. Scientists use pH, on a one-to-seven scale, to define the relative acidity or alkalinity of a substance. Foods with low pH levels, between a one and three, are high in acidity and may damage your enamel. Foods with high pH levels, such as a six or seven, are far less likely to cause enamel harm.

So which foods should you avoid? Many fruits are high in acidity, including lemons, grapefruit, strawberries, grapes, and apples. The high sugar and acid content in soda makes it another huge contributor to enamel decay. Moderately acidic foods include pineapple, oranges, tomatoes, cottage cheese, maple syrup, yogurt, raisins, pickles, and honey. The foods that are least likely to cause enamel damage include milk, most cheeses, eggs, and water.

Beverages such as red wine and coffee also damage the enamel by discoloring it. Although stains do not necessarily undermine the integrity of your teeth, they can be unsightly.

What can I do to prevent enamel damage?

Fortunately, there are several measures you can take to prevent your enamel from discoloring or decaying. The easiest way to avoid decay is to steer clear of high-acidity foods. This may not always be possible, but eliminating sugary fruit juices and soda from your diet is a good start. Brushing your teeth after each meal and flossing frequently also preserves your enamel. Another good idea is to rinse your mouth with water or mouthwash after eating to wash away high-acidity particles.

Although enamel damage is common, it does not have to be an inevitable occurrence. Knowing the foods that harm your teeth gives you the tools to prevent discoloration and decay. With some easy preventive measures, your teeth will stay strong and white for years to come! Give us a call at Convivial Dental to learn more!

Wax Facts

December 17th, 2025

In the long run, wearing braces is so worth it. Whether you’re working toward straight teeth, an improved bite, or both, you’ll end up with a beautiful smile! But sometimes, in the short run, they can be really annoying. Braces can irritate your lips, tongue, and cheeks while you are getting used to them or after an adjustment. Or a problem wire can poke the inside of your mouth and you can’t see us immediately for a repair. At times like these, Drs. Cartsos and Zavras will recommend orthodontic wax to make your life more comfortable.

  • What is Orthodontic Wax?

Orthodontic wax is made from non-toxic products like beeswax, carnauba wax, and paraffin wax. Some products might contain extras like vitamin E, aloe, or flavorings. The soft wax covers the bracket or wire that is bothering you with a smooth surface that won’t irritate sensitive mouth tissue and will give sore areas a chance to heal.

  • What if I Swallow a Piece?

All dental wax is made of non-toxic ingredients. If you accidentally swallow a bit, no need to worry.

  • Is It Hard to Apply?

It’s not hard, but it takes a bit of practice. First, locate the wire or bracket that is causing the problem. You might know where it is right away, or be able to discover it by discovering which sharp bracket or wire is across from the sore spot in your mouth.

Always wash your hands first. Brush and floss, so you will have a clean surface to apply the wax. The drier the surface, the better the wax will stick, so let the area air dry or use something clean such as sterile gauze to dry around the bracket.  

The wax is actually quite easy to work with. Break off a small piece of wax (no bigger than the size of a popcorn kernel or a pea), roll it in your fingers to soften it, and press the wax firmly but carefully over the problem bracket or wire until it sticks. Rub until the wax is smooth. Don’t worry, we will be happy to show you just how it’s done.

  • Can I Eat with Wax in Place?

If you find that you can eat without much irritation, it’s better to eat without wax over your braces. Remove the wax before eating and brush carefully to remove any food particles from your braces before applying new wax. If you do snack while using wax, be sure to change it after you eat. Wax, after all, sticks easily to your braces—and food particles stick to wax! Not a good look, and not good for your teeth.

  • Brushing and Flossing

Take off any wax before you brush and floss. Your toothbrush will thank you!

You probably have lots of other questions. Can you sleep with wax on your braces? Will it help you be more comfortable at trumpet practice? That’s why we’re here! If you have any questions at all about orthodontic wax and how to use it, call our Chestnut Hill, Massachusetts office. We want to make sure that the months you spend wearing braces are as comfortable as possible on your way to a lifetime of beautiful smiles. It’s so worth it!

What’s the Function of Functional Appliances?

December 10th, 2025

Whenever we bite down, we’re applying force with our jaw muscles. Functional appliances direct these forces to create healthier tooth and jaw alignment. They’re used to help correct bite problems and to encourage symmetrical jaw growth.

Functional appliances aren’t always necessary. Because every child’s teeth and bite are different, orthodontic treatment at our Chestnut Hill, Massachusetts office is carefully tailored to your child’s individual needs.

  • For the child with minor tooth misalignment, traditional braces or aligners might be all that’s needed.
  • For the child with a minor malocclusion, or bite problem, an orthodontist might use elastics (rubber bands) to bring teeth into healthy alignment.
  • For the child who has a more serious malocclusion, involving both tooth and jaw alignment, an orthodontist might recommend a functional appliance.

A severe Class II malocclusion can be caused when the upper jaw or teeth are positioned too far forward, and/or the lower jaw is too small or positioned too far back. Common Class II malocclusions include:

  • Open bite—the front teeth don’t touch when the back teeth bite down, or the back teeth don’t touch when the front teeth close.
  • Overbite—some overbite is normal. A deep overbite occurs when the upper teeth significantly overlap the lower teeth.
  • Overjet—the upper front teeth protrude further horizontally than they should.

Today’s functional appliances come in a variety of designs to treat Class II malocclusions. They can be fixed or removable. They can be used with or without braces. Some are designed to expand the upper palate to make sure there’s room for all the permanent teeth. What they all do is advance the position of the lower teeth and jaw to create a healthier, more comfortable bite.

Fixed devices are attached to the teeth and meant to be used full-time. These include the Forsus™ device, the Herbst® appliance, and the MARA appliance.

  • Forsus Device

This appliance works with braces. A spring coil rod is most often attached to bands on the first molars on the upper jaw. It’s then connected to the arch wire on the lower jaw. Just like elastics—but more effective!—these spring coil rods provide gentle forward pressure that encourages the lower jaw and teeth forward.  

  • Herbst Appliance

The Herbst appliance also applies forward pressure to the lower jaw using telescoping rods connecting the upper and lower teeth. The rods expand as the mouth opens, and telescope together as it closes, positioning the lower jaw further forward while the upper jaw is held back. The Herbst can be worn alone or with braces, and can also be used to expand the upper palate.

  • MARA Appliance

The MARA (Mandibular Anterior Repositioning Appliance) uses an adjustable “elbow” piece connecting bands on upper and lower molars to guide the lower jaw and teeth forward when the jaw closes.

Removable appliances such as Bionator and Twin Block appliances can also improve Class II malocclusions. They are meant to be worn for a specific number of hours each day, and can be taken out for sports or other activities as needed. Because it’s essential to get all the necessary hours in, removable appliances require commitment!

  • Bionators

A bionator is made of wire and acrylic, and it looks a lot like a retainer. The wire fits around the upper front teeth. It’s attached to a smooth piece of acrylic that sits behind the upper teeth and is shaped to guide the lower jaw forward when biting down. The bionator can also be adjusted to expand the upper palate.

  • Twin Block Appliance

The twin block appliance uses two separate pieces made of wire and smooth acrylic. Both pieces are modeled to fit precisely over the upper and lower arches. The acrylic “blocks” fit over the biting surfaces of the teeth, working together like a 3D puzzle. When your child bites down, the upper blocks slide into place behind the lower blocks, pushing the lower jaw and teeth forward. The top plate can also be adjusted to expand the upper palate if needed.

Because these appliances are best used while a child’s bones are still growing and developing, dentists and orthodontists recommend an orthodontic evaluation by age seven. Early treatment with a functional appliance can help correct serious bite problems before or together with braces. In some cases, functional appliances may reduce the need for headgear or surgery.

Todays’ orthodontic technology has made functional appliances more comfortable and efficient than ever before. Talk to Drs. Cartsos and Zavras to discover how an individualized treatment plan and a custom appliance can give your child a healthy bite and a lasting smile.

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