By and large, the human body is a marvel of symmetry. But, of course, no one is perfect. You might have noticed one ear is a bit higher than the other. That you wear a shoe a half-size bigger on your left foot. That one shirtsleeve always looks longer.

Or that your smile looks off-center. This dental asymmetry could be caused by a condition known as “midline misalignment,” and, unlike that left foot, you can do something about it!

The dividing line between our center teeth, upper and lower, is called the midline. If we draw an imaginary line down the middle of a face, from the forehead to the nose to the midpoint of the chin, that line should go right between the front teeth. When it doesn’t, because the teeth have shifted past the midpoint, it’s often due to a condition called midline misalignment.

This kind of misalignment, also known as a deviated midline, can have several causes:

• Baby teeth that are lost too early

Baby teeth do more than promote healthy eating and speech development. They also reserve space for permanent teeth. If a primary tooth is lost too early, permanent teeth might “drift” to fill the empty space, causing the midline to move as well.

• Thumb sucking that goes on too long

As a child gets older, and certainly when by the time permanent teeth start to arrive, aggressive thumb sucking can lead to numerous orthodontic problems, including a deviated midline, as the teeth shift in response to that continuous pressure.

• Missing adult teeth

When you lose a tooth through decay or trauma, or when an adult tooth simply never develops, the remaining teeth can shift over to fill the open spot.

• Spacing issues

Crowded teeth, teeth with significant gaps between them, very large teeth, very small teeth—all of these issues can affect spacing and midline alignment.

• Crossbite

A crossbite is a kind of malocclusion, or bite problem. When you have a crossbite, the teeth don’t fit together properly, with upper teeth fitting inside lower teeth, instead of aligning on the outside where they belong. A deviated midline can indicate a posterior crossbite, where the top back teeth slant inwards or fit inside the bottom back teeth.

A tiny bit of midline shift one way or the other might be nothing to worry about, but if one front tooth is literally the center of attention, or if your teeth are noticeably out of alignment, it’s a good idea to talk to our Chestnut Hill, Massachusetts orthodontic team.

Because there are several potential causes for midline misalignment, Drs. Cartsos and Zavras will carefully analyze your individual situation to determine where the problem lies: with the teeth, the bite, or, rarely, the jaw itself.

Drs. Cartsos and Zavras will also offer you your best dental treatment options. A shift of a few millimeters might be treated with clear aligners or traditional braces. A crossbite could require braces or aligners coupled with elastics (rubber bands) to bring your bite into alignment. A palatal expander can help correct a serious crossbite.

Why visit Convivial Dental because of a little asymmetry? Because a deviated midline is more than a cosmetic concern. If you have a malocclusion to begin with, or if your misalignment leads to changes in chewing habits, which cause new bite problems, you might be facing jaw pain, chipped and cracked teeth, headaches, and all the other unpleasant consequences of malocclusion.

By and large, perfect symmetry in life is unattainable. But if you want a smile that is well-balanced and healthy, talk to us about all the treatments available to make sure your smile—and not a single tooth—is the center of attention.

Now that you’re entering the working world, or heading off to college, or pursuing any of the many adventures awaiting you in adult life, you’re ready to take on more adult responsibilities. And one of those responsibilities is making sure you maintain your dental health.  

Luckily, it’s not that hard! Successful adulting often means simply making small proactive choices which add up to big long-term benefits. So, let’s look at a few of the everyday habits of dentally successful adults.

Choose a Healthy Lifestyle

• Eat well.

Just like the rest of our bodies, our teeth and gums need a healthy diet to thrive. Sugar-fueled study sessions and energy drink-filled work hours should be the rare exception, not the norm. A diet rich in vitamins and minerals keeps gums healthy and enamel strong.

• Don’t use tobacco products. 

Cigarettes, cigars, pipe smoking, chewing tobacco—any form of tobacco products, especially combined with alcohol use, can greatly increase your chances of developing mouth and throat cancers.

• Talk to your doctor about the HPV vaccine.

HPV (human papillomavirus) can also cause mouth and throat cancers. The American Academy of Pediatrics recommends the HPV vaccine for kids ages 9 through 12. If you haven’t been vaccinated yet, talk to Drs. Cartsos and Zavras about the potential benefits of the HPV vaccine. 

Keep Up with Your Orthodontic Care

If you’ve spent several of your teen years in braces or aligners creating a beautiful, healthy smile, you don’t want to see all your hard work go to waste. Retainers are designed to make sure your teeth stay just where they belong for a lifetime. 

When retainers aren’t worn as directed, especially when braces or aligners first come off, the teeth can shift back to their old positions. Sometimes going back to your regular retainer schedule can fix any minor movement, but sometimes patients need to go back for repeat orthodontic treatment.

How to avoid orthodontic do-overs?

• If you have a retainer, wear it as scheduled to maintain your alignment and healthy bite. 
• Put your retainer in a case when you’re not wearing it. A bent or broken retainer won’t keep your teeth aligned properly and can damage delicate oral tissues!
• If your retainer is damaged, see the dental team at Convivial Dental in Chestnut Hill, Massachusetts ASAP for repair or replacement.

 Practice Good Oral Hygiene

• Brush at least twice a day, for two minutes each time. 

Plaque begins to build up within hours after your last brushing. Removing plaque morning and evening also removes the cavity-causing bacteria which live in plaque. These bacteria erode enamel and lead to cavities.

• Floss at least once a day. 

Flossing helps remove plaque from your gumline. When plaque accumulates over time, it becomes tartar, a substance so hard that you’ll need a dental professional to remove it. The bacteria in plaque and tartar irritate your gums, and this irritation is the beginning of gum disease. Early stage gum disease (gingivitis) can often be reversed with better brushing and flossing habits—but, even better, help stop gum disease before it starts with daily flossing.

• See your dentist regularly. 

If you’ve been seeing your pediatric dentist since early childhood, you’ve probably developed a great partnership. You know that a visit twice each year, or as recommended, for an exam and a professional cleaning will make sure your smile stays its healthy, sparkling best. 

And now that you’re entering adulthood, it might be time to make a transition to your adult dental team. Some pediatric dentists suggest that patients transition to a new dentist around the age of 18, while others treat young patients through early adulthood. Talk to your dentist about how to graduate most easily and comfortably to a new dental team for your adult years—and then make regular checkups and cleanings with your new dentist a priority.

Not so difficult, right? In fact, you’ve probably adopted most of these healthy habits already. Take charge of your dental health now, make good habits a part of your daily routine, and you’ll be prepared to enjoy a lifetime of healthy, attractive, adult smiles!

 

This may come as a surprise, but brushing your teeth right after a meal can be one of the worst things you can do for your healthy teeth. A toothbrush can be considered an assault weapon against your smile if used immediately after eating certain foods.

Enamel is like the tooth’s shield. It is a hard mineral exterior on each of your teeth. In reality, enamel is the hardest part of the human body—even stronger than bone! I like to regard it as a “super-structure.” But every superhero has a weakness, and enamel’s kryptonite is acid.

A healthy tooth lives in a mouth that has a proper pH balance. When that balance tips from alkaline to acidic, a harmful process called demineralization begins. Demineralization occurs when acids attack and soften the tooth surface. Pores and fissures form and harmful bacteria move in.

With each bite of food or drink, our mouth pH fluctuates. Highly acidic foods tip the balance of your mouth from a healthy alkaline to a dangerous acid. Here are some examples of those sources of acid: citrus fruits, soda, and sugary foods. There are certainly many others, but these are the most common.

So how does brushing your teeth immediately after a meal make this process even worse?

After eating highly acidic foods, your teeth are susceptible to damage. When you brush your teeth in this weakened state you are actually damaging your enamel. The abrasive bristles of the brush wear away the protective surface of the teeth. You should avoid brushing for at least an hour, or take other, simple preventive measures immediately following a meal.

First, rinse with or drink clear water. Then chew some sugarless gum. Both of these practices will produce saliva, restore a healthy pH level in your mouth, and coat your teeth with nourishing minerals. Out of all the sugarless gums available, the best of the best are those that list xylitol as the first ingredient. Another option is to consume cheese, milk, or another non-acidic food or drink to conclude your meal.

After you have given your mouth time to return to a healthy pH, feel free to brush your teeth. Just keep in mind that any time you eat acidic foods, you weaken your teeth. Make sure not to worsen the problem by brushing immediately after dining and damaging your teeth even more. Questions? Call us at Convivial Dental.

At Convivial Dental, we understand that when your child has a dental emergency, it can feel

overwhelming. The good news is—you’re not alone. Knowing what to do in the moment can

help you stay calm, keep your child comfortable, and get the right care when needed.

The following recommendations are based on guidance from the American Academy of

Pediatric Dentistry (AAPD).

Cracked, Chipped, or Injured Tooth

Falls, sports injuries, and playground accidents are common causes of dental

injuries—especially in the front teeth.

What to do:

 - Gently rinse your child’s mouth with water

 - Apply a cold compress to reduce swelling

 - Give an age-appropriate pain reliever if needed

 - Offer soft foods and avoid chewing on the affected side

Even if the tooth looks normal, a dental evaluation is recommended.

Cut or Bitten Tongue, Lip, or Cheek

Apply firm pressure with gauze and use a cold compress.

Seek care if bleeding continues after 10–15 minutes or if the cut is deep.

Knocked-Out Tooth

Baby Teeth: Do not reinsert. Bring the tooth to your dentist.

Permanent Teeth: Hold by the crown, rinse gently, reinsert if possible or store in

milk/saliva.

Seek care immediately (ideally within 30–60 minutes).

Toothache

Rinse, brush, and floss. If pain persists, schedule a dental visit.

Abscess (Dental Infection)

Call your dentist promptly. Swelling or fever requires urgent care.

Broken or Fractured Jaw

Keep your child still, apply a cold compress, avoid food/drink, and seek emergency care

immediately.

Preventing Dental Injuries: Mouth Guards

Mouth guards help prevent dental injuries during sports.

Custom guards provide the best protection.

When in Doubt, Call

Convivial Dental: (617) 735-0800

A Final Note

With preparation and the right information, you can respond calmly and confidently to

dental emergencies.

Gentle Care When You Need It Most

At Convivial Dental, we’re proud to be a trusted dental home for families in Chestnut Hill

and beyond.