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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 Vienna, VA & Great Falls VA 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. Allen Garai & Dr. Karen Tratensek to discover how an individualized treatment plan and a custom appliance can give your child a healthy bite and a lasting smile.

If you’re heading back to classes in the next few weeks, you’re probably getting your gear together now. So let’s talk about some of the items you can pack to make orthodontic care easier during school hours.

• Dental-Healthy Food

Watching what foods you eat is especially important now. If you’re carrying your lunch or snacks in your pack, you want to be sure that they’re approved for braces and aligners.

If you wear braces, avoid foods which are sticky, chewy, or crunchy. They can stick to your teeth (making it easier for cavities to develop) or cause damage to your brackets and wires (making repairs necessary). Your orthodontist will give you a list of braces-friendly foods.

If you have clear aligners, even though you’ll remove them to eat, that sticky rule still applies. You don’t want food trapped in your aligners if you can’t brush right after eating, because that food is also food for the oral bacteria which cause cavities.

Bringing a water bottle with you is a great idea if it’s hard to brush after eating. Rinsing with water is a good way to get rid of loose food particles, and staying hydrated helps maintain normal saliva production—which also helps wash away food debris.

• Toothbrush, Toothpaste, and Floss

It’s best to clean your teeth after every snack and meal if at all possible. A travel-sized brush, toothpaste, and dental floss or picks designed for braces will help you get rid of any unwanted dental leftovers. And a small mirror can help you discover any lingering food particles.

It’s especially important now to practice careful hygiene, so be sure to wash your hands before and after cleaning your teeth or appliances.

• Your Aligner or Retainer Case

Whenever you take off your retainer or aligners to eat, you should always have your case handy. Cases make sure your appliances stay off germy desk and table surfaces—or worse, floors—and protect them from breakage. A case is also a good way to make sure your retainer doesn’t accidentally end up in a trash bin after lunch.

Again, before and after you handle your braces, aligners, or retainer, be sure to wash your hands carefully.

• Dental Wax & Extra Bands

Sometimes a wire comes loose or a bracket irritates the inside of your cheeks or mouth. In this case, dental wax is a great way to protect yourself from irritation and injury. And if a band is lost or breaks, it’s always good to have a spare (or two) handy. As always, handwashing rules apply!

• Your Mouth Guard

If your afterschool activities involve contact sports, a mouthguard is always a good idea, and especially when you wear braces. Dr. Allen Garai & Dr. Karen Tratensek can create a custom guard which will protect your teeth, your delicate mouth tissue, and your braces from many impact injuries.

• Your Orthodontist’s Phone Number

One important item that takes up almost no space in your backpack, locker, or phone is the phone number for our Vienna, VA & Great Falls VA office. If your braces are damaged, or if your aligner or retainer is lost or broken, we will let you know what to do until you can safely visit the office in person.

Talk to our team about how to care for your braces or aligners while you’re at school, and talk to your school about how you can manage your dental care safely during school hours.

We often think of braces as a rite of passage for kids in middle and high school. So you might be surprised when your child’s dentist recommends a visit to see Dr. Allen Garai & Dr. Karen Tratensek years earlier than you anticipated. In fact, dentists and orthodontists generally suggest a visit to the orthodontist by age seven at the latest.

Why see an orthodontist so early?

After all, your child is still growing, and many adult teeth haven’t come in at that age. And that’s the whole point.

Around this age, your child will probably have a mix of both baby and adult teeth, so your orthodontist will be able to assess whether there’s enough room for the permanent teeth to erupt without crowding or spacing problems. And malocclusions, or bad bites, caused by problems with jaw size or symmetry can be addressed while young bones are still forming and developing.

If your child has a first appointment coming up on the calendar, here’s a heads up on what often happens during a first visit, and potential problems your orthodontist will be on the lookout for.

What can you expect at a first visit?

The first visit is designed to evaluate how your child’s teeth and jaws work together now, and to look for potential future problems with tooth alignment and jaw structure and development.

First, Dr. Allen Garai & Dr. Karen Tratensek will carefully examine your child’s teeth, jaws, and mouth. Your child will be asked to bite down several times to see how the teeth and jaws fit together, and if there’s any discomfort. Other helpful diagnostic tools could include:

• Scans or X-rays to evaluate jaw structure and the position of teeth which haven’t erupted yet
• Photos of your child’s teeth and face
• An impression of your child’s teeth

If there’s no immediate need for treatment, we might recommend periodic checkups at our Vienna, VA & Great Falls VA orthodontic office to follow the growth and development of your child’s teeth and jaws. If interceptive (early) treatment is your child’s best option for a healthy smile, your orthodontist will explain any immediate orthodontic issues and design a treatment plan tailored to your child’s specific needs.

What are the benefits of early treatment?

Interceptive treatment not only helps correct current orthodontic problems, it can help reduce the need for more complicated treatment in the future, when all of the adult teeth have arrived and bones are fully formed. Among its many benefits, early treatment can:

• Prevent crowding

If your child has a small upper palate, it can be gently enlarged while the palate is still growing with the help of a palatal expander. This will give the upper teeth the space they need to come in without crowding.

• Provide space

If primary teeth are lost too early, other teeth can shift out of alignment to fill the empty space. A space maintainer can be custom-made to keep the spot open until the right tooth is ready to erupt. If primary teeth are overstaying their welcome, Dr. Allen Garai & Dr. Karen Tratensek might recommend extraction to allow the adult teeth to erupt in the proper place.

• Create jaw symmetry

Malocclusions can develop because the upper or lower jaw is too narrow, too far forward, too far back, or the jawbones don’t fit together properly. Dr. Allen Garai & Dr. Karen Tratensek might suggest the use of a functional appliance such as the Herbst® appliance or headgear to help guide symmetrical bone development while your child’s young bones are still growing and forming.

• Protect teeth

Children with overjets, or protruding upper teeth, are more likely to suffer chips, cracks, and other trauma to those vulnerable front teeth. Functional appliances can help bring the upper and lower jaws into alignment as needed, and braces can move the teeth into alignment.

Every journey to a healthy smile begins with a first visit. And you don’t need to wait until your child is seven. Any time you’re concerned about an orthodontic issue is a good time for a consultation. Talk to Dr. Allen Garai & Dr. Karen Tratensek about what to expect at your first visit to help create a comfortable experience for your child as you begin this journey together.               

You have done a lot of work to get the perfect smile. You wore your Invisalign aligner trays and cared for your teeth, and now your treatment is done. You still need to take care of your teeth to keep your beautiful smile. Keeps these things in mind when you think about your oral care routine.

Retainers

Many patients do require a retainer after Invisalign treatment. This will be based on your unique situation. If a retainer is recommended by Dr. Allen Garai & Dr. Karen Tratensek, use it as directed. Retainers prevent your teeth from shifting back into their original position. You should also avoid hard, crunchy foods for the first couple of weeks as your teeth adjust. For younger patients, retainers are normally used until the wisdom teeth come in or are extracted.

Brushing and Flossing

Brushing and flossing must be part of your daily oral care. Flossing helps remove the plaque, which becomes tartar or calculus. This build up can lead to gingivitis and gum disease. Your gums may be more sensitive for a week or two after your orthodontic work is completed. A warm salt water rinse may relieve discomfort.

Your teeth may be slightly sensitive for a short time. They have been protected by your Invisalign aligner trays and now are fully exposed. You might want to try a sensitive toothpaste to get through the transition. Just ask; we will be glad to recommend the best type for your needs. If your teeth are stained, a professional whitening treatment can be considered.

Regular Dental Checkups

You still need to have regular dental exams. Professional cleanings and X-rays make sure that both your teeth and gums stay healthy so you can keep your teeth for life. If cavities or other problems are found, they can be taken care of quickly.

If you have any questions about how to care for your teeth after your Invisalign program, please ask our Vienna, VA & Great Falls VA team. We want you to keep your healthy smile and enjoy the results of your Invisalign treatment.