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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 Dr. Todd Hamilton and Dr. Bryan Whitecotton. 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 Denver, NC 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. Dr. Todd Hamilton and Dr. Bryan Whitecotton 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.

Bite problems are so common that most of us know someone who’s worn braces. So perhaps you’re already familiar with the terms “overbite” and “underbite”—but if you’ve been diagnosed with an “overjet,” that just might be an orthodontic diagnosis that is new to you. If so, here are a few questions and answers to help promote overjet understanding.

Just what is an “overjet”?

An overjet is a type of malocclusion, which means that there’s a problem with your bite, the way your jaws and teeth fit together when you bite down. In a healthy bite, the front top teeth project slightly beyond, and slightly overlap, the bottom teeth. The key word here is “slightly.”

An overjet is a Class II malocclusion, which means that the upper front teeth project further beyond the lower teeth than they should. Overjets and overbites are both Class II malocclusions, and the words are often used interchangeably, but there’s a notable difference between the two conditions.

An overbite occurs when the top teeth overlap the bottom teeth too far vertically, and you can’t see as much of the lower teeth as you should when you bite down.

An overjet is considered more horizontal in nature, where the top teeth project at an outward angle toward the lips instead of pointing straight down toward the bottom teeth. This condition is sometimes called protruding or buck teeth.

What causes an overjet?

The reason for your overjet might be dental (caused by tooth alignment), or skeletal (caused by bone development), or a combination of both.

Overjets can run in families. They can also be caused by the size and position of your jaws and the shape and position of your teeth, all of which affect your bite alignment. But early oral habits, such as prolonged and vigorous thumb-sucking or pacifier use, can also contribute to overjet development.

How do we treat an overjet?

There are many types of treatment available. Dr. Todd Hamilton and Dr. Bryan Whitecotton will recommend a treatment plan based on the cause and severity of your overjet. Because some treatments are effective while bones are still growing, age plays a part as well.

• Braces and Aligners

If you have a mild overjet, and minor dental issues are the main cause of the malocclusion, braces or clear aligners can effective.

• Functional Appliances

If the overjet is caused by a problem with upper and lower jaw development, devices called functional appliances can be used to help guide the growth of the jawbones while a child’s bones are still forming.

For young patients, there are several appliances which can help correct an overjet. Some, such as the Twin Block and the Forsus Spring appliances, work inside the mouth, while others, like headgear, are worn externally. Your orthodontist will recommend the most effective appliance for your needs.

• Surgical treatment

In some cases, where the malocclusion is skeletal in nature as well as dental, surgical treatment might be necessary to reshape the jawbone itself.

If we recommend surgery, oral and maxillofacial surgeons are experts in surgical procedures designed to create a healthy and symmetrical jaw alignment. Dr. Todd Hamilton and Dr. Bryan Whitecotton will work with your surgeon to design a treatment plan, which will usually include braces or other appliances following surgery.

Why treat your overjet?

A serious, moderate, or even mild overjet can lead to many dental and medical problems, including:

• Concerns about facial and dental appearance
• Front teeth which are more at risk for injury
• Difficulty closing the lips
• Problems speaking or chewing
• Headaches, facial, and temporomandibular (jaw) joint pain

When you work with our Denver, NC team to correct your overjet, you’re not just correcting a problem. You’re also creating something—a healthy, comfortable bite, and an attractive, confident smile. We can talk about general answers to your overjet questions, but when it comes to understanding your very individual smile, Dr. Todd Hamilton and Dr. Bryan Whitecotton will have all the answers you need to make that healthy bite and that confident smile a reality! 

Some experiences are great, and we look forward to enjoying them again and again. Others have wonderful outcomes, but you feel no need for a sequel. If you’re wondering whether you need to revisit orthodontic treatment, you’re probably in this second group.

After all, you put in your time as a teenager. All those days in bands and braces, all the adjustments, all that cleaning with little tiny tools in little tiny places. That was a lot of work, and you reaped the rewards of your conscientious orthodontic habits with beautifully aligned teeth and a healthy, comfortable bite.

But now you’ve started to notice that your teeth aren’t quite as beautifully aligned, or your bite’s not quite as comfortable. So, what’s happened? Let’s look at some possibilities, and whether a return to the orthodontist’s office is in order.

• You’ve Lost a Tooth

If you’ve lost a tooth because of injury or decay, that gap is an open invitation for surrounding teeth to move in to fill the void. Whenever you lose a tooth, consider an implant. Implants function, look, and maintain healthy spacing just like natural teeth.

One thing implants can’t do? Move like our own teeth will during orthodontic treatment. Your natural teeth can move because they are held in place within the bone by flexible periodontal ligaments. Implants, on the other hand, are anchored directly to the bone for stability.

If you’re considering new or further orthodontic work and want to replace a lost tooth with an implant, it’s a good idea to talk to Dr. Todd Hamilton and Dr. Bryan Whitecotton to discover the best timing and scheduling for your procedures.

• You’ve Gained a Tooth

Problems with your alignment can also arise if you add a tooth or teeth. If you’re in your late teens or early twenties, wisdom teeth could be in your near future. And a new tooth can throw off the spacing and alignment of your existing teeth.

Talk to Dr. Todd Hamilton and Dr. Bryan Whitecotton about your options if your wisdom teeth are about to make an appearance, and if it looks like your tooth and bite alignment might be affected.

• You’re Getting Older

Our teeth naturally tend to shift as we age. Teeth move forward, causing crowded or crooked front teeth—especially on the lower jaw. There’s even a medical term for this phenomenon: mesial drift. While we don’t know exactly why this drifting occurs, we can treat it.

Adults make up a large—and growing—segment of orthodontic patients. If your teeth have lost their ideal alignment over time, a visit to our Denver, NC office is a great way to bring your youthful smile back. And you’ll probably find your treatment much shorter and more comfortable than it was decades earlier!

• You Haven’t Been Wearing Your Retainer

Remember that word “conscientious” in the second paragraph? You need to wear your retainer conscientiously, for as often and for as long as recommended by Dr. Todd Hamilton and Dr. Bryan Whitecotton.

If you’ve been ignoring a damaged retainer, or you keep forgetting to look for your lost retainer, or you have a perfect, undamaged retainer sitting unworn on your dresser, your teeth can start to shift out of their hard-won alignment within a short time.

Does this mean it’s back to months of bands and adjustments and appointments? Maybe not! See us as soon as you notice any changes in your teeth or bite. When caught early, shifting teeth can be treated much more easily.

What can we do to help you regain your best smile? A lot!

• Treatment Planning

When you need to accommodate implants, wisdom teeth, or other dental work which could affect your tooth alignment, Dr. Todd Hamilton and Dr. Bryan Whitecotton can work with your dentist to make sure your alignment isn’t disturbed in the process. They can also map out a treatment schedule which coordinates your other procedures with any orthodontic treatment.

• Retainer Evaluation/Adjustment

Your retainer is probably a passive retainer, meaning it keeps your teeth in place instead of moving them. If you notice your alignment shifting, or if your retainer is uncomfortable when you try to put it on after a lapse in nightly wear, ask us about a replacement.

• Active Retainers

An active retainer helps move teeth into alignment rather than simply keeping them in place. A new active retainer might be just what you need to correct a slight shift.

• Aligners or Braces

If you have some serious shifting going on, we might recommend a second round of treatment with clear aligners or braces. But there’s good news here, as well! Treatment to correct an orthodontic relapse usually takes less time than it did originally, and treatment options are more comfortable and less noticeable than ever before.

Talk to Dr. Todd Hamilton and Dr. Bryan Whitecotton about an orthodontic sequel if you have any concerns about changes in your bite or alignment. You might need only a simple retainer adjustment or a short time in clear aligners or traditional braces to make your smile its best and healthiest once again. And this time, remember to wear your retainer to make sure there’s no need for Orthodontics—Part III!

Now that you’ve graduated from your braces or aligners, you might think you’re finished with orthodontic cleaning tips. Not quite yet! Your retainer needs love, too—not just because it can look or smell “less than appealing” without your help, but because it’s good for your dental health.

Removable Retainers

If you have a Hawley retainer or a clear retainer, cleaning it whenever you remove it is a great idea. Unappetizing white patches mean plaque or mineral deposits from your saliva have dried and hardened on your retainer’s surface. And if you notice an unpleasant taste or odor, it probably means that germs and bacteria have made themselves at home and are growing in and on your appliance.

You don’t want old plaque or new bacteria in your mouth! Here are some ways to keep your retainer clean and fresh:

• After wearing it, you can clean your retainer with a toothbrush, but don’t brush too vigorously. You might scratch it. Use a soft or even extra-soft brush to clean out all the nooks and crannies, and then rinse.
• Use cleaning products which have been recommended by Dr. Todd Hamilton and Dr. Bryan Whitecotton if your retainer needs a deeper clean. Denture cleaners, retainer cleaners, and even toothpastes can be too abrasive or cause discoloration, so use the products made for your specific retainer.
• Let your retainer dry before storing it in a dry place after cleaning. Shutting a damp retainer into a closed case provides bacteria with the damp, dark environment they thrive in. (PS—clean your case regularly, too!)
• One of the benefits of a clear retainer is that it’s almost invisible. And you can help keep it that way by removing it whenever you eat or drink. Your retainer can become stained from colored foods or liquids.

Fixed Retainers

A permanent retainer is a small piece of wire that is custom-fit and bonded to the inside of selected teeth to keep them from shifting. Because food particles and plaque can accumulate around a fixed retainer, brushing after meals and at least twice a day is recommended. Bacteria and plaque cause bad breath, cavities, and tartar buildup, and removing tartar might require removing your retainer.

While a fixed retainer can be tricky to clean, there are techniques and products that make cleaning easier and more effective:

• An orthodontic toothbrush with a smaller head might reach behind your teeth more comfortably.
• Don’t forget to floss! Using a floss threader will help you get that wriggly floss behind the retainer and between your teeth.
• Try a water flosser. These handy devices direct a stream of water right into hard-to-reach places for more thorough cleaning.

If you’re having trouble keeping your retainer clean, our Denver, NC orthodontic team can teach you all you need to know about tools and techniques to keep your retainer—and your teeth and gums—healthy. An attractive smile is a great thing. A healthy, attractive smile is even better!