Our Blog

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. Gill. 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 Fargo, Wahpeton, ND 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. Gill 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.

We’re not talking about tearing up at the end of a sad movie, or that uncomfortable scratchy feeling you get from a coarse wool sweater—no shame in that kind of sensitivity! But it is a shame if you’re feeling unpleasant tooth sensitivity, especially while you’re wearing braces. No fear—we have some helpful ideas to make you more comfortable as you create your healthy, confident smile.

What do we mean by tooth sensitivity? You know it if you’ve felt it. Pain when you have a cold drink. Or a hot one. Or a sweet treat. Wincing when a light breeze hits your smile. Discomfort after an adjustment.

Fortunately, these annoying twinges can be avoided or eased with some proactive practices.

Keep Up with Your Brushing and Flossing

The oral bacteria in plaque break down enamel when they’re left on the teeth for too long. The result is a cavity, which leaves your sensitive dentin, the layer of the tooth between the enamel and the inner pulp chamber, exposed to elements which can trigger pain. These all-too-common elements include heat, cold, air, or sweet foods. If you suspect you have a cavity, a visit to the dentist will make sure your tooth is cleaned and filled to prevent further damage.

Better yet, prevent cavities before they cause tooth sensitivity. It can be harder to keep your teeth their cleanest while you’re in braces, but it’s more important than ever. You don’t want to have brackets and wires removed, even temporarily, to treat a cavity! You can keep decay at bay by:

• Brushing after every meal and snack.
• Flossing whenever necessary, making sure to clean around your brackets and wires.
• Using cleaning tools made for braces for the easiest and most effective dental hygiene.

Avoid Aggressive Brushing

If you’re using anything other than a soft toothbrush, time for a shopping trip! Using a stiff bristled brush is almost always too abrasive for even the strongest enamel. And vigorous brushing is more harmful than helpful. Poor tools and poor technique can wear away enamel, and, when enamel is worn away, the more sensitive dentin is exposed. Your gums can also be injured, exposing the tops of your roots—which are more sensitive than the enameled crowns.

If your teeth are sensitive because of abrasive brushing, talk to Dr. Gill about possible solutions for keeping your teeth both clean and strong.

• Use a softer-bristled brush.
• Try toothpaste designed for sensitive teeth.
• Practice proper brushing technique. Gently rub, don’t scrub!

Care for Yourself after Adjustments

Your teeth might be sensitive after an adjustment. This discomfort is normal, and should pass in a few days. In the meantime, treat yourself kindly.

• Brush as usual, taking special care to brush gently.
• Fill your menu with soft and soothing foods. Cool treats like classic ice cream and pudding, or healthier choices like frozen yogurt and fruit smoothies. Comfort foods like cream soups and mashed potatoes. Or all-day breakfasts of oatmeal, pillowy pancakes, or scrambled eggs.
• Take over the counter medication as recommended and as necessary.

Be sensitive to your needs while you’re in braces. If you’re feeling any kind of tooth sensitivity, talk to Dr. Gill at our Fargo, Wahpeton, ND office. We have solutions which will make sure you’re both comfortable and twinge-free on your journey to a healthy, attractive smile!

You might have been one of the lucky few born with perfectly straight teeth and a healthy bite. You might have spent months in orthodontic treatment as a teenager to achieve perfectly straight teeth and a healthy bite. But now that you’re growing older, you might be unhappily surprised to discover that your smile isn’t aging as gracefully as you are.  What’s changed?

That’s a trick question, because our bodies never stop changing, growing, and adapting. And these constant adjustments include the changes taking place in your teeth and mouth. You might begin to notice subtle differences in your smile when you’re in your thirties or forties. After young adulthood, several factors come into play which can cause shifting teeth and a misaligned bite:

• Teeth naturally shift.

Shifting can be a result of the normal changes time brings. The periodontal ligaments which attach our teeth firmly to the jawbone lose some of their strength; the jawbones which hold our teeth in place lose some of their density and begin to narrow. Our teeth also have a natural tendency to move toward the front of the mouth, a phenomenon called “mesial drift.”

Add all of these elements together, and your once straight teeth start to crowd together and even overlap—especially the front bottom teeth.

• Stressful habits stress your teeth.

If you habitually grind or clench your teeth, you’re putting pressure on them. Just like the gentle pressure of braces and aligners can shift teeth into alignment, the more uncontrolled force of grinding can push teeth out of alignment.  

• Losing a tooth affects surrounding teeth.

Nature abhors a vacuum, and so does your smile. If you lose a tooth, your other teeth will automatically start to drift into the space left open by the missing tooth.

• A neglected retainer is gathering dust in a drawer somewhere.

You might have spent time as a teenager in orthodontic treatment, with a beautiful smile to show for all your hard work. And, back in the day, your orthodontist no doubt let you know that you needed to keep wearing your retainer at night once your treatment was completed.

If that’s one healthy habit you abandoned as you got older, don’t be surprised if your teeth start to migrate back to their old, less-than-perfect positions.

Between normal biological changes and the wear and tear of daily life, you might find one day that your smile isn’t that same beaming smile you’re used to seeing in the mirror. And it’s not just an aesthetic concern.

Crooked teeth are harder to clean, and built-up plaque means more decay and gum disease. Shifting teeth can cause malocclusions, or bite problems, which can bring you jaw pain, headaches, and chipped or cracked teeth.

If your smile has changed over time, it’s time to give Dr. Gill a call. There are many discreet options which can return your smile to you, including:

• Clear aligners—comfortable, removable, and often unnoticeable.
• Traditional braces—brackets are smaller than ever, and you can choose ceramic brackets which are color-matched to blend in with your enamel.
• Lingual braces—these braces are attached to the inside of the teeth, for complete invisibility.

And what if you’ve never been as confident in your smile as you wanted to be? There’s good news here as well—it’s never too late to see an orthodontist. Make an appointment at our Fargo, Wahpeton, ND office to discover how you can make sure your smile looks just as young as you feel!

Even though it’s called a “permanent retainer,” your fixed retainer isn’t necessarily meant to last a lifetime. But with care, it should last just as long as you need it, keeping your teeth perfectly aligned after your orthodontic treatment is complete. Why is this retainer the one to choose for challenging alignments?

A fixed retainer is often used for teeth which were very crowded or had large gaps before treatment, especially along the bottom teeth, which tend to shift more. With a permanent retainer, a custom fitted wire is attached with a bonding adhesive to the back of each of the selected teeth. This design makes sure that the teeth can’t shift out of place while your bones and ligaments strengthen around them.

Occasionally, though, your permanent retainer isn’t quite as permanent as it should be. If you think your fixed retainer is becoming “unfixed,” what clues should you look for?

• Broken wire

A clearly broken wire can be obvious, or you might discover it when you notice pain or irritation caused by the end of a wire poking around your tongue or mouth.

• Loose bond

The orthodontic adhesive used to bond the wire to each tooth can come loose as the result of an accident, an unfortunately chewy treat, or simply with the passage of time.

• Shifting teeth

You might not notice anything wrong with your retainer, but what you do notice is that your once-straight teeth have started shifting back to their old positions. If you see any movement in your teeth, your retainer might need repair.

What should you do?

• Give our Fargo, Wahpeton, ND orthodontic office a call! It’s important to act promptly to prevent further retainer damage, oral discomfort, and tooth misalignment.
• Rinse with warm water if your mouth is irritated.
• If a wire is poking you, call us for advice on gently pushing it back into place.
• Orthodontic wax can protect your teeth and tissue from detached wires.
• If you have a clear retainer, wear it until you can come in. If you don’t have one, and you can’t see us immediately, ask if an over the counter moldable retainer is a good idea to help keep your teeth aligned in the meantime.

One benefit of a fixed retainer is that it’s almost invisible because it’s behind your teeth. But this hidden location can also make it difficult to notice potential problems. Fortunately, there are some proactive steps you can take to help your permanent retainer—and your bite—stay healthy:

• Avoid foods which are sticky, hard, or chewy. If a food can damage traditional braces, it can damage your retainer.
• Wear protective gear like mouthguards and helmets when you’re active—they protect more than just your retainer!
• Ask your dentist to examine your retainer adhesive’s staying power whenever you have a checkup.

If you notice a detached wire or loose adhesive or see your teeth shifting, give Dr. Gill a call. It’s important to act promptly to fix a fixed retainer, because your teeth and bite alignment are in jeopardy when you delay. And always bring your retainer (or retainer pieces) with you in case we can repair it.

Permanent retainers don’t necessarily last forever. But whether your fixed retainer is going to be with you long-term, or whether you’re going to transition to a removable retainer in the future, let’s make sure your permanent retainer is just as “permanent” as it needs to be!