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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. Quas, Dr. Wiater and Dr. Kang. 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 Bend, Redmond, Prineville, La Pine or Sisters OR 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. Quas, Dr. Wiater and Dr. Kang 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.

Analyzing strong points, looking for potential problems, making comparisons—it’s bracketology time! Nope, not basketball (although we hear they have something similar), but a brief analysis of your orthodontic options when it comes to choosing a winning bracket.

If you’re getting braces, you’re probably already familiar with how they work—brackets are bonded to the teeth to hold an archwire, which provides gentle, controlled pressure to move the teeth into alignment. But within that basic bracket-and-wire system, there are several different bracket designs available to you at our Bend, Redmond, Prineville, La Pine or Sisters OR orthodontic office. Let’s see what the scouting report has turned up on our final four, pointing out their distinct advantages as well as some potential mismatches.

Traditional metal brackets

Advantages:

• Traditional braces with metal brackets are effective for more than just straightening teeth. They can be used to correct rotated teeth, differences in tooth height, and bite problems. For severe bite and alignment problems, traditional braces are most often the right choice.
• Metal construction makes these brackets able to handle the controlled pressure needed to treat serious malocclusions.
• Cost-effective. These are usually the least expensive option.

Potential Disadvantage:

Clear/Ceramic Brackets

Advantages:

• Lack of visibility! Whether you go for clear brackets or brackets tinted to match your enamel, you’ll be keeping a low-profile with this choice.
• Stronger and more stain-resistant than ever before, using the latest in ceramic, porcelain, or plastic materials.

Potential Disadvantages:

• Not as durable. Unlike metal, these clear brackets can crack or break. If you play a contact sport, these might not be for you.
• Some ceramic brackets are larger than other choices, so might be recommended only for the top teeth.
• Clear or tinted brackets can be more expensive.

Self-Ligating Brackets

Advantages:

• These brackets use a clip or trapdoor mechanism to hold your archwire without the need of bands. Ceramic options are available if you want an even more discreet appearance.
• Can be more comfortable with less friction between wire and bracket.

Potential Disadvantages:

• Self-ligating braces are generally more expensive.

Lingual Braces

Advantages:

• Lingual braces use metal brackets, but they attach to the back of each tooth for almost invisible bite correction.
• Custom-made. Lingual brackets can be designed and fabricated to fit your individual teeth perfectly.

Potential Disadvantages:

• Trickier to clean because of their placement behind teeth.
• Might not be suitable for a deep bite if there’s not enough clearance between top and bottom teeth.
• Initial discomfort caused by the tongue’s contact with the braces when you speak and eat.
• Custom-made brackets are more expensive.

So that’s a brief rundown of your bracket choices. But, unlike sports bracketology, there are no losers here! Dr. Quas, Dr. Wiater and Dr. Kang can give you the pros and cons of each bracket design, so you can make an informed decision based on the kind of braces which will work best for you. With coaching like that, no matter which bracket option you choose, the final result is the same—a winning smile!

Congratulations! You’ve done the hard work necessary to create your beautiful smile! You’ve carefully completed all the steps needed to reach the end of your orthodontic journey. Well, nearly all the steps. We can’t forget that last step which will ensure that all your hard work is rewarded.

When you first began orthodontic treatment, Dr. Quas, Dr. Wiater and Dr. Kang decided on the best plan for straightening your teeth and perfecting your bite, whether you wore traditional braces, lingual braces, aligners, or other orthodontic appliances. And now that you’re finishing treatment, there’s one more option to consider—your retainer.

Why do I need a retainer?

While you’ve spent time in treatment, more has changed than just the position of your teeth. The periodontal ligament, the connective tissue that connects the teeth to the jawbone, is stretched as the teeth shift. The bone in your jaw changes, too, reforming and rebuilding around the roots of your teeth as they move to their ideal locations.

These changes happen because your braces or aligners apply gentle, constant pressure to move your teeth. When you’ve finished wearing these appliances, the pressure stops. Ligaments will try to return to their original shape, which can shift teeth back toward their old positions. And the rebuilding bone isn’t dense enough yet to stop teeth from shifting due to the normal, everyday pressures of eating, chewing, and smiling.

A retainer prevents your teeth from moving back, or “relapsing,” by giving your bones and ligaments time to stabilize and rebuild. The process takes months, so keeping your teeth in place as bones rebuild and grow denser is crucial. This is especially important for patients with more serious misalignments. Dr. Quas, Dr. Wiater and Dr. Kang will let you know which kind of retainer will be best for you and just how long you’ll need to wear your retainer.

Are there different kinds of retainers?

There are! Retainers can be removable or fixed, visible or nearly invisible, metal, plastic, or metal and plastic. Three of the most popular retainer options include:

• Hawley Retainers—the traditional removable retainer, which uses a molded acrylic plate with wires attached to keep your teeth properly aligned and to hold your retainer in place.
• Clear Plastic Retainers—a removable retainer made of custom vacuum-formed plastic, which fits over the teeth like a clear aligner.
• Fixed Retainers—a small single wire bonded to the back of specific teeth, which holds them in place and prevents any movement.

Dr. Quas, Dr. Wiater and Dr. Kang will let you know whether a removable or fixed retainer is best for making sure your teeth don’t start to relapse, and fill you in on the benefits and care of each type of retainer.

How long do I need to wear a retainer?

There’s no standard answer to this question. Just like your retainer is custom-built to fit your individual teeth, the amount of time you’ll spend in that retainer depends on your individual needs. Retainers might be worn fulltime for months or years, be worn only at night after several months of daily wear, or be worn long-term to make sure your orthodontic work lasts.

Because you’ve done the hard work already, and your beautiful, healthy smile is the result. Talk to a member of our Bend, Redmond, Prineville, La Pine or Sisters OR team about which retainer option will be best for making sure that this smile lasts a lifetime.

If this is your first winter with braces, you might be wondering how to make the best of the holiday season. Dr. Quas, Dr. Wiater and Dr. Kang and our team have some suggestions for happy and healthy holiday smiles.

Treat Yourself

Winter means tasty holiday treats, and just because you wear braces doesn’t mean you need to step away from the holiday table! You can enjoy your favorites if you remember to check your list for the usual problem foods. Hard, crunchy, chewy, and sticky items? Naughty list.

• Crunchy vegetables on the appetizer plate
• Nuts
• Hard rolls
• Candy canes and other hard sugar treats
• Caramels, Toffee and other sticky candies
• Pecan pie
• Fruit cake

Luckily, there are plenty of nice alternatives.

• Turkey and ham—remember, small pieces are best
• Dressing and stuffing
• Mashed potatoes
• Soft breads and rolls
• Pumpkin pie—but skip a tough crust!
• Cheesecake
• Soft cookies and cakes
• Soft chocolates

We’re happy to provide recommendations for braces-friendly holiday foods. And we don’t expect you to turn down every sweet treat this season.  Just be sure that if you enjoy something sugary, brush carefully after indulging.

Express Yourself

While you’re decking the halls, or pinning up the New Year’s balloons and streamers, or even choosing a great holiday outfit, don't forget that your ligatures can be decorative as well as functional.

• Celebrating Christmas? Red and green bands around your brackets are jolly and traditional.
• How about Hanukkah? Try blue and white!
• Love the season? Icy silvers and pale blues are a frosty statement—and can have the benefit of making your teeth look whiter, as well. Snowy white? The arctic idea is great, but white bands can sometimes make teeth look more yellow, or become stained themselves.
• Glam New Year? Gold adds sparkle to your smile, but can bring out any yellow tones in your teeth. Silver might be the perfect choice, because it is generally neutral with enamel shades.

Check out our ligature colors for the best possible choices for your teeth and coloring. Take advantage of these options to create a fresh, confident look for the season. Give others the gift of your smile!

Look After Yourself

Winter comes with some special reminders about your dental health.

• Winter sports are a great way to celebrate the snow and ice, but be sure to protect your teeth and braces. If you enjoy skiing, snowboarding, ice skating, hockey, or any other winter activities, talk to us about why a mouth guard is so important.
• While you enjoy your winter break, don’t forget to keep up with your dental routine. And because ‘tis the season for holiday treats, be especially careful to clean your teeth and braces after sweet desserts and snacks. Don’t forget to floss!
• What do cold breezes and hot chocolate have in common? They can both trigger tooth sensitivity! While some sensitivity is normal after an adjustment, if you find you are experiencing tooth sensitivity more often or more strongly than you usually do, give us a call. It might be something as simple as brushing habits, or you might need to see your dentist.

If you have any questions about your braces, in this season or any other, just ask when you visit our Bend, Redmond, Prineville, La Pine or Sisters OR office. Your beautiful, healthy, and confident smile can make this the most wonderful time of the year!