Our Blog

Poor April. While other months celebrate romance, or giving thanks, or costumes and candy, April has—April Fool’s Day and a tax deadline. We might be forgiven for thinking these two dates seem more like warnings than celebrations.

So here’s a new topic for the April calendar: National Facial Protection Month! Take the opportunity this month to review your safety practices while you’re enjoying your favorite activities.

• Mouthguards

If you have a mouthguard for sports or athletic activities, wear it! In any activity or sport where humans come into contact with solid objects (including other humans) tooth injury is possible. A mouthguard will help protect you from dental injuries caused by falls, physical contact, or other accidents that might happen in your active life. And it’s not just your teeth—mouthguards protect your lips, tongue, and jaw as well.

You can buy mouthguards in stock sizes or shape-to-fit models, or you can have a guard made especially for you at our Hanover, NH office. Custom mouthguards fit perfectly and are designed to make breathing and speaking easy and comfortable. If you wear braces, a custom mouthguard can be designed to protect your smile and your appliance. Just talk to Dr. Donald Neely for suggestions!

After all the time and work you’ve put into your orthodontic care, don’t let a sports injury set you back. What else should you consider for your facial protection?

• Helmets

If there’s a helmet available for your sport, use it! Helmets are especially important for protecting athletes from brain injury and concussion, and they help protect the face and jaw as well.

• Face Guards

If you’ve experienced a puck speeding toward you, or a defensive tackle hurtling your way, or a fast ball coming in at 90 miles an hour, you know the importance of wearing a face guard. These guards can help protect your eyes, face, teeth, and jaws. Many sports now recommend using face guards—it’s worth checking to see if your sport is one of them.

• Eye Protection

And let’s not forget eye protection. Whether it’s safety glasses or a visor, protecting your eyes and the bones around them is extremely important. You can even get sports goggles or protective sports glasses with prescription lenses to keep you safe and seeing clearly.

So here are a few suggestions for your calendar this month:

• If you haven’t gotten a mouthguard yet, now’s the time. Tooth and mouth injuries occur in sports beyond hockey and football. If you play basketball, ski, skateboard, ride a bike—in fact, almost any sport where you can fall or make contact with a person or object—a mouthguard is a must.
• If you need to replace an ill-fitting or damaged helmet and face guard, do it before your next game. And do replace a bike helmet if you’ve been in a crash—most likely it won’t be as protective, even if damage isn’t visible.
• Talk to your eye doctor about protective eyewear if off-the-rack products don’t work for you.
• If you are a parent or caregiver, make sure your child athlete has the proper facial protection—and uses it.
• If you are a coach, make sure your athletes have the right protective gear—and wear it.
• It’s also a great time to commit to using your protective gear every single time you’re active.

But, wait—these reminders are helpful and important, but weren’t we promised something to celebrate this April? Good catch! The great news is, using facial protection for sports and athletic activities gives you rewards you can celebrate all year: fewer injuries, fewer visits to the emergency room, and a beautiful, healthy, intact smile. Suit up!

If your pre-teen or teenager is home for the summer, it’s easy to provide braces-friendly lunch options. The school lunchroom, though, presents another challenge altogether. What menu selections are most compatible with braces? And what can you put in that lunch box or brown bag to provide a tempting, healthy lunch during school hours? Let’s look at some options!

From the Cafeteria

Encourage your student to stick with soft foods that don’t require biting into. Some good choices include:

• Soup, either creamy or with soft vegetables
• Salads without crunchy vegetables or croutons
• Soft, shredded chicken or beef
• Egg or tuna salad
• Tofu
• Pasta
• Meatloaf
• Macaroni and cheese
• Soft casseroles
• Steamed vegetables
• Mashed potatoes
• Soft breads or tortillas

Bringing a Lunch?

There are many great options for packing a lunch bag! Just remember to keep foods at the proper temperature, with insulated containers for hot foods and two cold sources, such as two frozen gel packs, for cold foods.

• Sandwiches with soft filling (no chunky peanut butter!) on soft bread. Thinly sliced, easy to chew cold cuts will work, but cold cuts like salami are too chewy. Cut the crusts off if necessary. Cutting sandwich wedges into smaller portions will also make them easier to eat.
• Hard boiled eggs
• Hummus and soft pita wedges
• String cheese and soft crackers
• Applesauce
• Yogurt
• Soft fruits such as berries or bananas
• Jell-O or other gelatin dessert cups
• Pudding cups

When to Say “No, Thank You”

If you have to bite into it, if it’s chewy, or if it’s crunchy, it’s best to choose something else! Here are some common culprits when it comes to broken brackets and wires:

• Caramel
• Hard candy
• Popcorn
• Whole carrots
• Whole apples
• Hard rolls
• Pizza
• Corn on the cob

And remember to send your child to school with a brush and floss to clean teeth and braces after lunch. Dental hygiene is very important now, because brackets and wires can both trap food particles and make brushing them away more difficult. This can lead to increased plaque, cavities, and staining around the area of the braces. If it’s impossible to brush, be sure to remind your student to rinse thoroughly with water after eating.

Lunch hour should be a time to relax, get together with friends, and recharge for the rest of the school day. Talk to us about the most (and least) braces-friendly foods and recipes. By learning what foods to avoid and adjusting some old favorites, your school-age child can continue to enjoy healthy, tasty lunches. Most important, visiting Dr. Donald Neely at our Hanover, NH office for an emergency repair will not be on anyone’s list of afterschool activities!

The topic is tubes. No, we’re not talking about TV shows, or sports socks, or British subway systems. We’re talking toothpaste! With so many options out there, which toothpaste should you be looking for to keep your teeth their cleanest and healthiest during orthodontic treatment?

• Fantastic Fluoride

The last thing you want while you’re wearing braces is a cavity. Cavities develop when plaque sticks to a tooth. The oral bacteria found in plaque produce acids that weaken your enamel. Over time, these acid attacks lead to the breakdown of the enamel and a cavity forms. But you have a way to stop this process. Fluoride provides protection against cavities. Fluoride toothpastes contain minerals that actually strengthen your enamel, and can even repair early damage before a cavity has a chance to form. Whichever toothpaste you choose, fluoride is the most important ingredient.

• Terrific Tartar-Control

What is tartar, anyway? Tartar, or calculus, is hardened plaque. It’s so hard, it can’t be removed by brushing alone—that’s why your dental hygienist uses special tools to remove it when you have a cleaning. Tartar buildup can lead to receding gums and gum disease, so prevent this buildup before it starts by using a toothpaste especially formulated to remove plaque.

• Desensitizing Decisions

There are many causes for tooth sensitivity. If painful sensitivity is caused by hot or cold drinks, it could mean a dental issue such as decay or a damaged tooth, and your dentist can help diagnose and treat the problem. Sensitivity be a sign that you’re not cleaning around your braces well enough, leading to sore and inflamed gums. Sometimes sensitivity can actually be caused by over-enthusiastic brushing. Remember, massage, don’t scrub! For some extra-sensitive teeth, a desensitizing toothpaste or even a prescription toothpaste can help. If you find that your teeth are more sensitive only after an adjustment, give us a call. This is usually temporary.

• What about Whitening?

Whitening toothpastes do a good job of taking care of some surface stains, so why not use them? Because they take care of some surface stains. When your braces are in place, your brackets cover a small portion of your enamel—a portion that won’t be whitened as you brush. Generally, because whitening toothpastes don’t make a huge difference in tooth color, this might not be a problem. Talk to Dr. Donald Neely before you decide to whiten, and we’ll have suggestions just for you.

In fact, if you have any questions about the best toothpastes for orthodontic patients, contact our Hanover, NH office! Getting your braces is a great step forward on your way to a beautiful smile. Let us help you choose the right toothpaste to make sure that beautiful smile is a healthy and lasting one.

When does an underbite need surgery? The short answer is: when Dr. Donald Neely and our team recommend surgery as the best way to give you a healthy, functional bite. But let’s take a longer look, and see just why your doctors might come to that conclusion.

• First, what exactly is an underbite?

In a perfect bite, the upper and lower jaws align, well, perfectly. Upper teeth overlap lower teeth very slightly, upper and lower teeth meet comfortably, and jawbones and joints function smoothly. When the alignment is off, it causes a malocclusion, or “bad bite.”

When we talk about an underbite, or Class 3 malocclusion, it means that the lower jaw protrudes further than the upper jaw. This protrusion causes the bottom teeth and jaw to overlap the upper teeth and jaw.

• What causes an underbite?

Sometimes an underbite is caused by childhood behaviors while the teeth and jaw are developing, including tongue thrusting or prolonged thumb-sucking and pacifier use. (Working to stop these behaviors before they affect tooth and jaw formation is one of the many good reasons children should have regular visits with their dentists and pediatricians.)

Most underbites are genetic, however, and tend to run in families. It’s estimated that from five to ten percent of the population has some form of underbite. The lower jawbone (mandible) might be overdeveloped, the upper jawbone (maxilla) might be underdeveloped, both bones could be affected, or, sometimes, tooth size and placement might cause an underbite. These irregularities in jaw shape and size and/or tooth crowding are not something that can be prevented, and require professional treatment.

• Why? What’s the problem with an underbite?

Even a minor underbite can cause difficulties with biting and chewing. A more severe underbite can lead to speech problems, decay and loss of enamel where the teeth overlap, mouth breathing and sleep apnea, persistent jaw and temporomandibular joint pain, and self-confidence issues.

• Can’t my dentist treat my underbite?

Most probably not. A very mild underbite can be camouflaged cosmetically with veneers, but this does not address the cause of the underbite, and will not work for moderate or severe underbites.

• Can my orthodontist treat my underbite?

Dr. Donald Neely will create an underbite treatment plan after a detailed study of each patient’s individual dental and skeletal structure. Treatment options will vary depending on the cause of the underbite, its severity, and even the patient’s age.

Early intervention is especially important for children who show signs of an underbite. That’s why we recommend that children visit our Hanover, NH office by the age of seven.

If an underbite is caused by tooth misalignment or crowding, braces can reposition the lower teeth. Sometimes extractions are necessary to make room for proper alignment.

If the cause is due to jaw structure, children’s bones are still forming, so treatment can actually help correct bone development. Palatal expanders, headgear, and other appliances are various methods of encouraging and guiding bone development.

But braces and appliances aren’t effective for every patient with an underbite, and especially in patients (usually those in their late teens and older) when the jawbones are already fully formed. In this case, we might suggest coordinating treatment with an oral and maxillofacial surgeon.

• What does an oral and maxillofacial surgeon do?

An oral surgeon has the training, experience, and skill to help correct an underbite by surgically reshaping and repositioning the jawbone. This corrective jaw surgery is called orthognathic surgery.

• What will happen during orthognathic surgery?

Your treatment will be tailored to your specific needs. Two of the common surgical procedures for treating an underbite involve repositioning the upper jaw to lengthen it and/or reshaping the lower jaw to shorten it.

Bone is sometimes removed or added, small bone plates or screws are sometimes used to stabilize the bone after surgery—your surgeon will let you know exactly which procedures will give you a healthy, functional bite. The surgery itself is most often performed under general anesthesia and requires a brief stay in the hospital.

• How will my orthodontist and oral surgeon coordinate my treatment?

Correcting a Class 3 malocclusion can take time. Your oral surgeon will work together with Dr. Donald Neely to analyze the interrelationship of teeth, bones, and joints to determine dental and skeletal problems, and will develop the best treatment plan possible to create a healthy alignment.

• So, when does an underbite need surgery?

Sometimes, a minor underbite can be corrected with braces and appliances alone. A serious underbite, however, will often require the specialized skills of both Dr. Donald Neely and an oral surgeon.

And, while it’s not the primary purpose of surgery, corrective jaw surgery and orthodontics can also make you happier with your appearance and boost your self-confidence. Achieving a lifetime of beautiful, comfortable, and healthy smiles—that’s the answer to your question.