Herbst | MARA | Twin Block | Orthognathic | Headgear | Tongue Thrusting
Herbst
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.
Wearing a Herbst Appliance
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.
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MARA
The Mandibular Anterior Repositioning Appliance (MARA) is suitable for treating class II malocclusions, which are characterized by protrusion of the upper front teeth or a lower jaw and or teeth that are positioned back in regard to the upper jaw and or teeth. Using MARA, class II malocclusions are treated more effectively. The MARA is reliable and reduces treatment time.
Generally, the appliance is secured to the patient’s first molars via stainless steel crowns, which are easy to fit and retain more, compared to bands. The appliance features no removable parts, which means patient compliance is not an issue. Also, the orthodontist can more accurately predict the length of treatment.
The upper “elbows” can be removed; which facilitates comfort and advanced adjustments. The appliance can be advanced on one side or both sides.
Sore spots are minimal. Initially, it may feel strange to hold your jaw forward while eating, but within two weeks, chewing will become more natural. We recommend you eat soft foods initially. Do not chew on the elbows. Avoiding candy, hard foods, etc. throughout treatment will help prevent breakage of the appliance.
MARA is generally worn between 15 to 18 months. Your improvements will be noticed immediately!
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Twin Block
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.
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Orthognathic Appliances
An orthognathic appliance, or growth appliance, is used to correct discrepancies in the growth patterns of the jaws and/or cleft palate. There are a number of different growth appliances available to correct these problems. Certain appliances are designed to gently encourage the upper 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 for incoming permanent teeth, promote a better bite and/or enhance the facial profile. They are sometimes used for less complex cases that do not require orthognathic surgery.
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Headgear
Headgear is often used to correct an excessive overbite. This is done by placing pressure against the upper teeth and jaw, which would hold the teeth in position or help move them into better positions. 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.
Headgear should never be worn while playing sports and should also be removed while eating or brushing your teeth.
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Tongue Thrusting Appliance
Tongue thrusting occurs when the patient presses his or her tongue against the front teeth, usually when swallowing, speaking or resting the tongue. If thrusting is constant, this can cause problems with teeth alignment and must be fixed.
We prefer to correct tongue thrusting by giving patients a tongue thrusting appliance. This appliance, similar to a mouth guard, is usually worn at night. Other times, a more permanent appliance is prescribed and can be only be adjusted by our office.
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