When we remove your braces, we will begin the retention stage of your treatment. The retention phase lasts for a minimum of 24 months. Your final orthodontic result depends on your retainers, so follow through with the hard work you’ve put in so far. Remember to remove your retainer before brushing, and brush your retainer before placing it back in your mouth.
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 helps this happen.
Even though the Herbst appliance encourages forward growth of the lower jaw, opening and closing movements 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.
Sucking is a natural reflex that relaxes and comforts babies and toddlers. Children usually cease thumb sucking when the permanent front teeth are ready to erupt. Typically, children stop between the ages of 2 and 4 years. Thumb sucking that persists beyond the eruption of primary teeth can cause improper growth of the mouth and misalignment of the teeth. If you notice prolonged and/or vigorous thumb (or finger) sucking behavior in your child, talk to your dentist.
One solution to thumb sucking is an appliance called a “fixed palatal crib.” This appliance is put on the child’s upper teeth by an orthodontist. It’s placed behind on the upper teeth on the roof of the mouth. The appliance fits behind the child’s upper front teeth, and is barely visible. The crib usually stops the habit of thumb sucking within the first few weeks of use.
An orthognathic appliance, or growth appliance, is used to correct discrepancies in the growth patterns of the jaws. There are a number of different growth appliances available to correct these problems. Certain appliances are designed to gently encourage the palate to expand allowing for more room for the permanent teeth to grow in, while others are designed to correct overbites that occur due to growth problems. Orthognathic (growth) appliances are designed to create more room by encouraging favorable growth for incoming permanent teeth, promote a better bite and/or enhance the facial profile.
The Carriere Motion Appliance is used to help limit extractions and correct a class II bite where the upper teeth are too far forward. The Carriere Motion Appliance allows for greater comfort and shorter treatments! The appliance is used at the beginning of treatment to help correct the patient’s bite prior to the application of regular braces.
Headgear is often used to correct an excessive overbite. This is done by placing pressure against the upper teeth and jaw, slowing growth of the upper jaw allowing the lower jaw to “catch up.” The severity of the problem determines the length of time headgear needs to be worn. The key to success with your headgear appliance is consistency. Headgear must be worn a certain number of hours per day, and if not, it must be made up the following day.
A facemask is used to protract, or pull the upper jaw forward in those individuals with an underbite. This accomplished by attaching the facemask to an intra-oral appliance, such as an expander or Nance appliance, with elastics.
Headgear/facemasks should never be worn while playing sports and should also be removed while eating or brushing your teeth.
The Distal Jet Appliance is a fixed (non-removable) appliance that is placed on the palate and is attached to the upper teeth. The Distal Jet, as the name implies, distalizes. This appliance pushes the upper molars back creating room for erupting teeth and/or a place to move the front teeth back, eliminating an overbite.
The Distal Jet Appliance uses a solid track wire and two sets of locking screws on each side. The appliance is self-limiting by design. The Distal Jet can be converted to a Nance Appliance by your orthodontist, once the ideal molar position has been established.
The Nance Appliance is used to hold the upper molar position and to prevent upper molars from rotating or moving. Some patients wear the Nance Appliance while they are awaiting their bicuspids to grow into place.
The appliance is made of two bands that are cemented onto the first molars and a wire spans the roof of the mouth from one molar to the other. An acrylic pad or “button” covers the wire that touches the roof of your mouth directly behind your front teeth.
Patients should always brush around the bands daily. Do not eat sticky, chewy candy as it can loosen your appliance.
Interproximal recontouring refers to a procedure in which Dr. Kesselman will reshape your teeth by sculpting the sides of the teeth creating room for alignment. This can create space where minimal space is needed and extractions would lead to excessive space creation.