Orthodontists and dentists use advanced procedures to treat and save teeth. But sometimes, a tooth just can’t be saved and needs to be extracted. Sometimes it’s due to extensive decay, or infection, or serious injury. Or sometimes, to create a healthy bite, an extraction is necessary during orthodontic treatment.

When does an orthodontist recommend an extraction? Conditions which call for extraction include:

• Incoming Wisdom Teeth

Not many people have enough space in their mouths for four wisdom teeth! And when there’s no room to erupt properly, wisdom teeth can become decayed or infected, push your other teeth out of place, and damage the roots of nearby molars. Extracting wisdom teeth protects your teeth and your bite alignment.

Usually, orthodontic treatment takes place before the wisdom teeth begin to erupt. But if yours start to make an appearance during treatment, your orthodontist and dentist will work together to schedule extraction without interfering too much with your orthodontic treatment plan.

• Tooth and Jaw Structure

Drs. Cartsos and Zavras and the team at Convivial Dental carefully plan your treatment based on examinations, X-rays, and/or 3D imaging. The goal is to align your teeth and jaws for an attractive smile and a healthy, functional bite. When overcrowding is severe, or if there is a serious malocclusion (bite problem), or if a particular tooth is unusually large or misshapen, your orthodontist might recommend an extraction.

Sometimes more room can be made for teeth with appliances such as palatal expanders or, in other cases, with the help of oral surgery. Extractions are only recommended when they are absolutely necessary.

• Baby Teeth Which Aren’t Coming Out 

Baby teeth normally fall out in a predictable pattern. Front teeth first, canines and molars last. Baby teeth have small roots, and these roots begin to break down when the adult teeth underneath put pressure on them as they start to erupt. As the root gets smaller and smaller, the baby tooth gets looser and looser—until it falls out. 

Sometimes, though, the roots of primary teeth don’t break down, and the baby teeth stay right where they are. This means that the permanent teeth have to erupt someplace else—usually behind those baby teeth. This creates a double row of teeth, and your permanent teeth can become crooked or overlap as they try to fit in. Extracting stubborn baby teeth allows your adult teeth to come in just where they’re supposed to. Because of their small roots, extracting primary teeth is usually simple and straightforward, and can be done in your dentist’s office. 

• Too Many Teeth

Most of us have 32 adult teeth, including wisdom teeth. It’s rare, but sometimes an extra, or supernumerary, tooth develops. Your jaw is most probably not equipped to accommodate any extras, so, in this case, the extra tooth or teeth are removed to give the rest of the teeth the space they need to avoid overlapping or crowding.

When your orthodontist recommends an extraction, it’s because it’s important for your dental health. Drs. Cartsos and Zavras will refer you to a dentist or a specialist like a periodontist or oral surgeon, who will: 

• discuss the extraction procedure with you, including sedation options
• numb the area 
• gently loosen and then extract the tooth
• provide options for pain management after the procedure
• give you detailed instructions for aftercare
• work with your orthodontist to keep your treatment on schedule

Extraction is never your first choice, or your orthodontist’s! But when an extraction is necessary for tooth and bite alignment, everyone at Convivial Dental in Chestnut Hill, Massachusetts will coordinate a treatment plan to create your best—and healthiest—smile.

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!

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!

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!