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Whenever we bite down, we’re applying force with our jaw muscles. Functional appliances direct these forces to create healthier tooth and jaw alignment. They’re used to help correct bite problems and to encourage symmetrical jaw growth.

Functional appliances aren’t always necessary. Because every child’s teeth and bite are different, orthodontic treatment at our New Bedford or Mattapoisett, MA office is carefully tailored to your child’s individual needs.

• For the child with minor tooth misalignment, traditional braces or aligners might be all that’s needed.
• For the child with a minor malocclusion, or bite problem, an orthodontist might use elastics (rubber bands) to bring teeth into healthy alignment.
• For the child who has a more serious malocclusion, involving both tooth and jaw alignment, an orthodontist might recommend a functional appliance.

A severe Class II malocclusion can be caused when the upper jaw or teeth are positioned too far forward, and/or the lower jaw is too small or positioned too far back. Common Class II malocclusions include:

• Open bite—the front teeth don’t touch when the back teeth bite down, or the back teeth don’t touch when the front teeth close.
• Overbite—some overbite is normal. A deep overbite occurs when the upper teeth significantly overlap the lower teeth.
• Overjet—the upper front teeth protrude further horizontally than they should.

Today’s functional appliances come in a variety of designs to treat Class II malocclusions. They can be fixed or removable. They can be used with or without braces. Some are designed to expand the upper palate to make sure there’s room for all the permanent teeth. What they all do is advance the position of the lower teeth and jaw to create a healthier, more comfortable bite.

Fixed devices are attached to the teeth and meant to be used full-time. These include the Forsus™ device, the Herbst® appliance, and the MARA appliance.

• Forsus Device

This appliance works with braces. A spring coil rod is most often attached to bands on the first molars on the upper jaw. It’s then connected to the arch wire on the lower jaw. Just like elastics—but more effective!—these spring coil rods provide gentle forward pressure that encourages the lower jaw and teeth forward.  

• Herbst Appliance

The Herbst appliance also applies forward pressure to the lower jaw using telescoping rods connecting the upper and lower teeth. The rods expand as the mouth opens, and telescope together as it closes, positioning the lower jaw further forward while the upper jaw is held back. The Herbst can be worn alone or with braces, and can also be used to expand the upper palate.

• MARA Appliance

The MARA (Mandibular Anterior Repositioning Appliance) uses an adjustable “elbow” piece connecting bands on upper and lower molars to guide the lower jaw and teeth forward when the jaw closes.

Removable appliances such as Bionator and Twin Block appliances can also improve Class II malocclusions. They are meant to be worn for a specific number of hours each day, and can be taken out for sports or other activities as needed. Because it’s essential to get all the necessary hours in, removable appliances require commitment!

• Bionators

A bionator is made of wire and acrylic, and it looks a lot like a retainer. The wire fits around the upper front teeth. It’s attached to a smooth piece of acrylic that sits behind the upper teeth and is shaped to guide the lower jaw forward when biting down. The bionator can also be adjusted to expand the upper palate.

• Twin Block Appliance

The twin block appliance uses two separate pieces made of wire and smooth acrylic. Both pieces are modeled to fit precisely over the upper and lower arches. The acrylic “blocks” fit over the biting surfaces of the teeth, working together like a 3D puzzle. When your child bites down, the upper blocks slide into place behind the lower blocks, pushing the lower jaw and teeth forward. The top plate can also be adjusted to expand the upper palate if needed.

Because these appliances are best used while a child’s bones are still growing and developing, dentists and orthodontists recommend an orthodontic evaluation by age seven. Early treatment with a functional appliance can help correct serious bite problems before or together with braces. In some cases, functional appliances may reduce the need for headgear or surgery.

Todays’ orthodontic technology has made functional appliances more comfortable and efficient than ever before. Talk to Dr. Neil Oliveira and Dr. Derek Wolkowicz to discover how an individualized treatment plan and a custom appliance can give your child a healthy bite and a lasting smile.

You have a lot going on. School. Sports. Activities. Family. Friends. Teens lead busy lives and have busy schedules, so you need to budget your time and energy. One thing you don’t want to spend any of your time and energy on? Dealing with gum disease.

Gum disease most often begins as a reaction to plaque and tartar. The bacteria in plaque produce acids which irritate gum tissue, causing inflammation, swelling, and bleeding. This is gingivitis, the early stage of gum disease.

Left untreated, early gum disease can become periodontitis. Periodontitis is a serious gum infection which can cause receding gums, loose teeth, and even tooth and bone loss.

We usually think about gum disease as something that only older adults worry about. But the unfortunate fact is that children and teens are also at risk for gum disease—and the teen years bring special risks. Why?

• Braces

The teen years are the most common years for orthodontic treatment. Wearing traditional or lingual braces can make removing plaque from around brackets and wires, between the teeth, and near the gum line more challenging, and gum disease can be the result. When you’ve been working so hard to create a healthy attractive smile, you don’t want to delay your orthodontic progress to treat gum disease.

• Less-than-Nutritious Snacking

When you have after school commitments like sports practices, play rehearsals, or work, you probably carry a snack to give you the energy you need until dinner. Popular snacks like energy drinks, chips, or candy bars are common go-to choices, but they contain acids, simple carbs, and sugars which are bad for both gums and tooth enamel.

• Hormones

Increased hormone levels during puberty can make the gums more sensitive and more easily irritated.

• Your Busy Life

Maybe you’re not getting enough sleep. Or eating as well as you could. Or you’re feeling anxious. Lack of sleep, poor nutrition, and stress can affect your body’s immune system and your ability to fight off infection. And if you’re also not brushing and flossing regularly, your gum health can really suffer.

How do you know if you have gum disease? Good question! Sometimes the early stages of gum disease aren’t obvious. Perhaps you’ve noticed changes in your gums, such as:

• Redness
• Swelling
• Soreness
• Bleeding
• Bad breath even after brushing

Any of these changes can be symptoms of gum disease and are a good reason to give our New Bedford or Mattapoisett, MA office a call, since time is important when treating gum disease.

Caught early, gingivitis is usually very treatable—in fact, you can often reverse early gingivitis by paying more attention to your daily dental hygiene. If gingivitis is more advanced, or if periodontitis develops, you need professional dental care to prevent serious damage to your gums, teeth, and bone.

Preventing gum disease from ever developing is always best, though, so let’s look at what you can do to keep gum disease from becoming a problem.

• Keep Up with Healthy Dental Habits

Even though you’re leading a busy life, take time for your dental care. Brushing twice a day for at least two minutes per session and flossing once a day take just a bit of your time and are the best way to keep your gums healthy. If you wear braces or have a tendency toward cavities and gum disease, Dr. Neil Oliveira and Dr. Derek Wolkowicz might recommend brushing or flossing more often.

• Use the Right Tools

Using the right tools makes a big difference. You should always choose a toothbrush with soft bristles to protect your delicate gum tissue—especially if it’s extra sensitive. Too-harsh brushing can damage even your super-hard tooth enamel, so you can imagine what it can do to your gums! Change out your brush every three to four months when it starts to get frayed and worn.

If you wear braces, ask Dr. Neil Oliveira and Dr. Derek Wolkowicz to recommend the best kind of floss to clean between your teeth and around your brackets and wires. The right tools will make flossing a lot easier, and will help you keep your gums healthy and your orthodontic treatment on track.

• No Matter How Busy You Are, Treat Yourself Well

Watch your diet. Drinking water to hydrate is a healthy (and inexpensive) alternative to sugary and acidic drinks. When you know you have after-school commitments, pack yourself a healthy snack. After snacking, it’s a good idea to rinse with water when you can’t brush to remove any food particles sticking around your teeth and gums.

And even though your schedule is demanding, caring for your mind and body should be a priority. If you have difficulties with sleep or stress, or questions about a nutritious diet, talk to your doctor for some valuable tips to make your daily life healthier and more enjoyable.

With so much going on in your active life, gum problems are problems you really don’t need. Make room in your schedule now for careful daily brushing and flossing, a healthy lifestyle, and regular visits to Orthodontic Specialists of Southeastern Massachusetts, and you’ll be living that active life with a beautiful, healthy smile!

Modern dentistry has made the most of today’s technological innovations. And we’ve come a long way from the fraying sticks our ancestors used as toothbrushes.

On the other hand, while it’s a lot better than a fraying stick, the manual toothbrush model you’ve used for years might be ready for an upgrade. Should you take this opportunity to try out some new technology offering all the bells and whistles? Let’s answer that question by asking a few more questions.

Happy with your manual brush?

If you like your manual toothbrush and it’s doing the job, by all means, stick with it. But even your old familiar brush can evolve:

• There are lots of bristle options, but soft bristles are almost always the way to go. Medium and hard bristles can be too abrasive for your enamel.
• Heads come in a variety of sizes, so make sure the head size is comfortable. You want to be able to maneuver to reach every tooth surface, which a too-large brush head just can’t do.
• Try a different handle shape if you’re having trouble maneuvering and keeping a firm grip.
• Change your brush regularly. Brushes are effective for about three months before the bristles start to fray and breakdown. This is a good opportunity to experiment with different brands and styles.

Does your old brush suit your current needs?

Different types of manual toothbrushes are available for effective and comfortable brushing when you need options that a typical brush doesn’t provide:

• Special orthodontic toothbrushes are designed with bristles trimmed to fit around brackets and wires and smaller heads to reach into tight places.
• For those with mobility issues, brushes with larger or easy-grip handles make cleaning more comfortable.
• Brushes with extra-soft bristles are available if you have enamel erosion or sensitive gums.
• Because many women find their gums become especially sensitive during pregnancy, there are brushes designed especially for moms-to-be.

Is it time to go electric?

If you haven’t tried an electric toothbrush before, you might find that getting braces is a great reason to give one a spin.

• Electric toothbrushes can outperform manual models. A dedicated brusher might manage hundreds of brushstrokes for each minute of brushing, while an electric brush can provide thousands. If, despite your regular brushing, you have plaque build-up, an electric brush might be a good alternative to your manual brush.
• Models are available which can alert you when you’re brushing too hard—which is important for your enamel if you’re a heavy-handed brusher.
• If you tend to *think* you’ve brushed for the recommended two minutes, but have *actually* brushed 32 seconds, some electric brushes come with timers!
• There are tapered electric orthodontic brush heads designed just for people with braces.
• Electric brushes have bigger handles and can be easier to grip.

Is your current brush doing the job?

So, should you stick with the familiar toothbrush that’s worked for you all these years, or take this opportunity to try out some new technology that offers all the bells and whistles? The answer is clear: the right brush for you is the one that works!

If your regular checkups show that plaque is under control, you’re doing just fine with the brush in hand. If you or Dr. Neil Oliveira and Dr. Derek Wolkowicz notice plaque buildup, it’s time to consider making some changes. Whether it’s a question of tools, techniques, or time spent brushing, your New Bedford or Mattapoisett, MA dental team has the answers you need for state-of-the-art dental hygiene.

Sometimes real life is stranger and more interesting that any made-up story. These weird and interesting facts about braces will amuse you … and make you glad you didn’t have to get braces “way back when.”

Mummies with braces: Archaeologists have discovered mummies with crude bands of metal wrapped around their teeth. The metal was wrapped around each individual tooth, and it is believed that ancient dentists used catgut to guide the teeth and close the gaps.

First “official” braces: The first official braces were constructed in 1728 by Pierre Fauchard. They consisted of flat strips of metal. String was used to connect the metal to the teeth.

Early rubber bands: In 1850, Tucker began making rubber bands out of rubber tubing.

Brackets are better: Brackets were invented by Edward Angle in 1915. They were not bonded to the teeth directly, but instead were attached to bands that went around the teeth.

Wiring by NASA: As braces have become more modern, the technology has improved by leaps and bounds. You may know that some braces wire contains nickel titanium. What you may not know is that this metal was developed by NASA and has special shape memory that is activated by pressure or body heat.

Over 60 with braces: Actress Faye Dunaway got braces at the age of 61, which shows you are never too old to look more fabulous!

Oh, and one more thing that didn’t quite make our list, but is interesting all the same. Did you know that almost 25 percent of patients who get braces have to get them again because they wouldn’t wear their retainers? So suck it up, buttercup, and use that retainer!