Functional braces are a family of braces that use the power of the chewing and face muscles to guide the teeth into better positions. They are especially useful in growing patients – another reason why it is useful to be seek an initial assessment by Dr. Crotty at a young age. Functional braces can be removable (for example the Activator and the Twin-Block braces) or fixed in the mouth (for example the Herbst ).
A Lower Lingual Arch acts as a space maintainer to keep the molars from drifting forward, and prevent them from blocking the space where permanent teeth will eventually erupt. This appliance is commonly used in cases of premature loss of baby tooth or when the lower teeth of a growing child are slightly crowded and no permanent teeth are extracted to correct the problem.
You should expect soreness the first day or two, and it may hurt to chew. We recommend a soft diet initially. You may take Advil or Tylenol to relieve the pain. Avoid sticky or hard foods, and please monitor how many foods you eat that are high in sugar.
Brushing and flossing daily is very important. Be sure to clean around the bands that are connected to the molars and the wire on the tongue side. This will prevent the formation of cavities or infection of the gums.
The duration of wear varies. We will monitor the eruption of new teeth and make adjustments. Generally, the Lower Lingual Arch is removed following the eruption of all the permanent teeth.
The Twin Block functional appliance is designed to correct jaw positioning, so that the bite is properly aligned. It consists of an upper and lower plate, which work together to pull the lower jaw forward. While this appliance is suitable for patients of all ages, it is generally used during Phase 1 of orthodontic treatment, to treat children who have an underdeveloped jaw. To ensure treatment progresses as planned, the appliance should be worn at all times. It should only be removed for cleaning and during sport activities. Patients may experience temporary discomfort and difficulty speaking the first few days of wear. We will provide specific instructions for activating the screw. Patients should follow instructions carefully to ensure effective results are achieved within the least amount of time.
Attached to the upper molars through bonding or by cemented bands, the Rapid Palatal Expander is an orthodontic device used to create a wider space in the upper jaw. It is typically used when the upper jaw is too narrow for the lower jaw or when the upper teeth are crowded or blocked out of the dental arch.
When patients are still growing, their connective tissue between the left and right halves of their upper jaw is very responsive to expansion. By simply activating the expander through turning a screw in the center, with a special key we provide, gradual outward pressure is placed on the left and right halves of the upper jaw. This pressure causes an increased amount of bone to grow between the right and left halves of the jaw, ultimately resulting in an increased width.
The Palatal Arch Bar is an orthodontic appliance used to maintain the upper jaw’s arch width and move molars into positions that wires alone can’t. The appliance is banded around the first molars on each side of the mouth, and a thin wire spans across the roof of the mouth.
Patients should be sure to brush and their appliance daily. Also, avoid sticky, chewy or hard foods as these can get caught between the appliance and the roof of your mouth. These foods may also break your Palatal Arch Bar.
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One of the most common problems orthodontists treat is the discrepancy that occurs when the upper teeth protrude beyond the lower. Ordinarily, when we see a patient with the upper teeth protruding, we tend to think that the upper jaw and teeth are too far forward; but, more often than not, this condition is due to a small lower jaw that is further back than it should be. With these patients, we would like to encourage the lower jaw to catch up in growth, and braces like the Herbst appliance help this happen.
Even though the Herbst appliance prevents the lower jaw from moving backward, opening and closing movement still occur easily, and patients do not have any problems learning to chew their food with their lower jaw in this new position.
As with all kinds of braces, patients with Herbst appliances need to be careful about what they eat. For instance, cold foods such as ice slushes, Popsicles and ice will freeze the cement and make the brace loosen. Sticky foods such as caramels, bubble gum and candy suckers will pull the brace away from the teeth. Hard foods like crisp vegetables and hard candies will bend and loosen the Herbst appliance, too. So stay away from these foods during your orthodontic treatment.
Your Herbst appliance will be checked and adjusted at your appointments. If, sometimes between appointments, you develop some sore areas on the inside of your cheeks, please do not try to adjust the appliance yourself. Call for an appointment so that the necessary adjustments can be made.
At first, your mouth will feel unusually full and speaking will be awkward. But if you practice reading aloud, your ordinary speech will return quickly. You may also notice more saliva than normal, but this will decrease as you become accustomed to the appliance.
In some cases where an underbite is present, we may recommend using reverse headgear (face mask) as part of the treatment plan. This appliance is designed to fix the discrepancy between your upper and lower jaws by moving the upper jaw forward to correct the malocclusion.
For the results to be successful, patient compliance is of the utmost importance. It may take several days to become accustomed to the appliance. With practice, it will become easier to place and remove the reverse headgear. We will determine the length of time you should wear your headgear, but it is generally 10-14 hours per day, which can include wearing while you sleep. You should not wear your headgear while participating in sporting activities.
Sometimes your chin may get irritated from the headgear. If this happens, you should always keep the area clean and often change the insert in the chin cup. If the skin becomes very dry, the use of moisturizing cream twice a day can be helpful. If your jaw joints are extremely sore or you cannot open and close your mouth without difficulty, stop wearing the appliance and contact us for further instructions as we may need to fit you with a different appliance. Also, if your headgear breaks or is bent, call us so we can fit you in with a repair appointment so your treatment will not be delayed.