Drs. Cartsos and Zavras and our team have the experience and training to evaluate the present state of your teeth and bite, and to design a treatment plan to give you the healthy, attractive smile you picture for your future. And when you choose Invisalign^® for your treatment, you’ll be able to get an advance view of exactly what that future will look like!

How is this possible? Because when you choose Invisalign, you’re getting the benefit of some of the most advanced technology in orthodontics.

The process begins with a computerized scan of your teeth and mouth. Special scanner software creates a 3D image to capture your smile as it is now. But that’s not all. Using our customized treatment plan, Invisalign software can provide not only a model of your smile today, but an evolving model of what your smile can be. Seeing your present smile transform step-by-step into your future smile is a great motivator to follow that treatment plan!

For each step of your treatment, Drs. Cartsos and Zavras will provide a new set of aligners created to move your teeth and bite toward this goal. Why don’t you need a mold made of your teeth every time you get a new aligner? Because, with Invisalign, we design your aligners to fit your future tooth alignment.

Aligners are not fabricated to snugly fit around your teeth as they are, but as they will be after several days of wear. Each set is molded with small improvements to your alignment, and provides gentle, consistent pressure to move your teeth to that next step.

This “future fit” is why you may experience a bit of discomfort with a new set of aligners. Over the days that you wear them, the fit will become more and more comfortable. This won’t be because your aligners have changed. It will happen because your teeth have gradually moved where your aligners direct them.

Once your teeth and bite have reached this new step in your treatment, it will be time for the next set of aligners in the series, and so on. Drs. Cartsos and Zavras will let you know just how long you need to wear each set, and you can even track your progress with every appointment.

So, are we predicting the future? Not really. When you use Invisalign, we are planning and creating your future smile. Drs. Cartsos and Zavras will use the Invisalign system to customize your treatment for your very specific needs, step by step, and aligner by aligner, until you attain the smile you previewed before you even started treatment.

But one thing we can predict: If you follow our recommendations, keep your appointments at our Chestnut Hill, Massachusetts office, and wear your aligners as directed, there’s going to be a beautiful, healthy smile in your future.

Maybe you’ve wanted braces since childhood. Maybe you had them, but your teeth have shifted over time. Maybe you’re tired of living with an uncomfortable bite. Good news! If you’re not happy with your adult smile, that doesn’t mean you’ve missed the opportunity to have the healthy, attractive smile you’ve always dreamed of.

While there are many benefits to having orthodontic work done as a child, there’s a lot to be said for orthodontic treatment as an adult. After all, you know exactly what you want. You’re dedicated to following your treatment plan. You have plenty of discreet orthodontic options available now, from clear aligners to lingual braces, to make your treatment as inconspicuous as possible.

But, on occasion, adult treatment does come with some adult baggage. Worried about your crowns, fillings, or veneers? If these restorations are part of your dental history, we can generally work with them. Dental implants? Those might fall into a slightly different category.

Implants are a great way to restore your smile because they function like your natural teeth. They are designed to look just like natural teeth, and they allow you to speak, chew, and bite with confidence. Implants even stimulate the jawbone when we chew just as natural teeth do, helping to prevent bone loss in the jaw as we age.

But there is one important difference between implants and natural teeth: implants are firmly anchored in the jaw, while your natural teeth can change position.

Why is this a concern? Because tooth movement is one of the basics of orthodontic treatment. Unlike implants, our teeth aren’t firmly anchored in our jaws. They are held in their sockets by a ligament which cushions them and connects the tooth to the bone.

When braces or aligners gently apply consistent pressure to the teeth, the ligaments and eventually the bones holding the teeth reshape themselves in response to this pressure, and then become stable again during the retainer phase of treatment.

Implants, on the other hand, are crowns attached to a metal cylinder or screw that is surgically implanted into the jawbone. After several months, osseointegration takes place—which is a technical way of saying that the metal base fuses with the bone. This means that there won’t be any movement taking place—good when you’re chewing, but not helpful for realignment!

If you haven’t yet replaced a missing tooth with an implant, it’s often best to wait before starting orthodontic work. We can design treatment around a missing tooth, leaving room to accommodate an implant in just the right spot when your orthodontic treatment is finished.

If you have an implant already, the placement of your implant will help determine your treatment:

• If your implant is already perfectly placed for your future alignment, braces or aligners can be designed to work with and around your implant.
• If the placement is almost ideal, you might find a very small degree of misalignment acceptable, and we can plan your treatment around your existing implant.
• If it’s not possible to work with your implant where it’s presently located, it is possible to remove an implant. You would then have the implant procedure redone after your orthodontic work is complete.

Talk to Drs. Cartsos and Zavras about your treatment possibilities. By analyzing your orthodontic goals and working with your dental history, we can let you know exactly what can be done for your teeth and bite—even if you have an implant.

True, there are many benefits to having orthodontic work done in your childhood, but there’s a lot to be said for orthodontic treatment as an adult. And the greatest benefit of all? You’ll finally have the healthy, self-confident smile you’ve always dreamed of. Talk to our Chestnut Hill, Massachusetts team about making that smile a reality.

We’re not talking about tearing up at the end of a sad movie, or that uncomfortable scratchy feeling you get from a coarse wool sweater—no shame in that kind of sensitivity! But it is a shame if you’re feeling unpleasant tooth sensitivity, especially while you’re wearing braces. No fear—we have some helpful ideas to make you more comfortable as you create your healthy, confident smile.

What do we mean by tooth sensitivity? You know it if you’ve felt it. Pain when you have a cold drink. Or a hot one. Or a sweet treat. Wincing when a light breeze hits your smile. Discomfort after an adjustment.

Fortunately, these annoying twinges can be avoided or eased with some proactive practices.

Keep Up with Your Brushing and Flossing

The oral bacteria in plaque break down enamel when they’re left on the teeth for too long. The result is a cavity, which leaves your sensitive dentin, the layer of the tooth between the enamel and the inner pulp chamber, exposed to elements which can trigger pain. These all-too-common elements include heat, cold, air, or sweet foods. If you suspect you have a cavity, a visit to the dentist will make sure your tooth is cleaned and filled to prevent further damage.

Better yet, prevent cavities before they cause tooth sensitivity. It can be harder to keep your teeth their cleanest while you’re in braces, but it’s more important than ever. You don’t want to have brackets and wires removed, even temporarily, to treat a cavity! You can keep decay at bay by:

• Brushing after every meal and snack.
• Flossing whenever necessary, making sure to clean around your brackets and wires.
• Using cleaning tools made for braces for the easiest and most effective dental hygiene.

Avoid Aggressive Brushing

If you’re using anything other than a soft toothbrush, time for a shopping trip! Using a stiff bristled brush is almost always too abrasive for even the strongest enamel. And vigorous brushing is more harmful than helpful. Poor tools and poor technique can wear away enamel, and, when enamel is worn away, the more sensitive dentin is exposed. Your gums can also be injured, exposing the tops of your roots—which are more sensitive than the enameled crowns.

If your teeth are sensitive because of abrasive brushing, talk to Drs. Cartsos and Zavras about possible solutions for keeping your teeth both clean and strong.

• Use a softer-bristled brush.
• Try toothpaste designed for sensitive teeth.
• Practice proper brushing technique. Gently rub, don’t scrub!

Care for Yourself after Adjustments

Your teeth might be sensitive after an adjustment. This discomfort is normal, and should pass in a few days. In the meantime, treat yourself kindly.

• Brush as usual, taking special care to brush gently.
• Fill your menu with soft and soothing foods. Cool treats like classic ice cream and pudding, or healthier choices like frozen yogurt and fruit smoothies. Comfort foods like cream soups and mashed potatoes. Or all-day breakfasts of oatmeal, pillowy pancakes, or scrambled eggs.
• Take over the counter medication as recommended and as necessary.

Be sensitive to your needs while you’re in braces. If you’re feeling any kind of tooth sensitivity, talk to Drs. Cartsos and Zavras at our Chestnut Hill, Massachusetts office. We have solutions which will make sure you’re both comfortable and twinge-free on your journey to a healthy, attractive smile!

Maybe you’ve known people with braces and aligners—maybe you’ve worn them yourself!—so if braces or aligners are in your teen’s future, you have some idea what to expect and when to expect it.

But quite often, orthodontic issues require more treatment than braces alone can provide. When misalignment affects not only the teeth but the jaw as well, treatment can be more effective when it begins earlier and makes use of a different kind of appliance—the “functional appliance.”

During the years your child’s bones are still rapidly growing and forming, around the ages of eight to 14, functional appliances can help guide tooth movement and encourage jaw growth and development. One of the most widely used of these devices is the Herbst® appliance.

What does the Herbst appliance do?

There are several types of malocclusions, or “bad bites” treated by Drs. Cartsos and Zavras. A common condition called a Class II malocclusion occurs when the upper jaw and teeth project too far forward over the lower jaw and teeth. Signs of a Class II malocclusion might include an overjet (protruding upper teeth), and/or a small or recessive lower jaw.

While correcting this malocclusion often enhances facial symmetry, which can be very important for a child’s confidence, correcting a Class II malocclusion also promotes jaw and dental health. Misaligned teeth are more difficult to clean, which can lead to decay and gum disease. Bite problems can cause persistent jaw pain and damage to the teeth. And, with an overjet, a child’s upper teeth are more at risk for injury.

The Herbst appliance was developed to treat this kind of malocclusion. It moves the lower jaw and teeth forward to create a balanced, healthy smile.

How does the Herbst appliance work?

The Herbst appliance is fixed in place with stainless steel bands or crowns that are secured to four teeth in the rear of the mouth, often the first molars on each side of the upper and lower jaws. The band or crown on each lower tooth is equipped with a small bar that extends toward the front of the mouth.

An arm on each side links the bands or crowns on the upper teeth to the front of the bar assemblies on the lower teeth. Each arm consists of a rod that fits smoothly into a tube. The telescoping action of the rod and tube allows the mouth to open and close normally. When the mouth is closed, the arms on both sides telescope shut, forming compact cylinders that hold the jaw forward.

While a child’s bones are still growing, the lower jaw’s new forward position can stimulate further bone growth and remodeling to maintain the jaw in that forward position. The Herbst appliance also has a restraining effect on the forward movement of the upper jaw. The result is a steady, noticeable improvement in the relationship between the upper teeth and jaw and the lower teeth and jaw.

Is the Herbst appliance hard to take care of?

The Herbst appliance is fairly low maintenance, but, like any orthodontic gear, it should be treated with care.

• It’s important to watch your child’s diet, because sticky, crunchy, and chewy foods can damage the appliance. Save the caramels for a post-treatment celebration!
• Carefully cleaning around the appliance is necessary, because a buildup of bacteria and plaque leads to consequences like bad breath, gum disease, and tooth decay. A water flosser can make reaching and cleaning tight spots easier if a brush alone isn’t effective.
• If the Herbst appliance is damaged, some minor fixes might be doable at home with instructions from your treatment team. But if a band or crown comes loose, or if there’s a problem you’re unfamiliar with, call our Chestnut Hill, Massachusetts office right away.
• To help avoid the need for minor (or major) fixes, playing with the appliance with fingers or tongue, nibbling on pens and pencils, chewing on ice, or any other risky habits should be strictly off limits.

When it comes to your child’s health, you always have high expectations. Drs. Cartsos and Zavras and our team have all the answers you’ll need about what to expect from this phase of your child’s orthodontic treatment, and just why the Herbst appliance is the very best option to create a future of attractive, healthy smiles.