Our Blog

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 Santa Cruz, Aptos, or Watsonville, CA 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. Don Connolly and Dr. Stanley Sokolow to discover how an individualized treatment plan and a custom appliance can give your child a healthy bite and a lasting smile.

There are many great reasons to see an orthodontist. For a healthier bite. For straighter teeth. For a more confident smile. So why are you hesitating? If the visibility of traditional braces is what’s holding you back, ask Dr. Don Connolly and Dr. Stanley Sokolow about lingual braces.

With regular braces, brackets are bonded to the front of each tooth with a special adhesive. Ligatures around each bracket or bracket clips grip an archwire, which does the work of moving the teeth. The gentle pressure from the wire guides the teeth into alignment in gradual stages. Every adjustment moves the teeth to their perfect positions. These braces are quite effective—and they are usually quite visible.

Lingual braces, on the other hand, are virtually invisible. Lingual means “toward the tongue,” and this placement is the difference between lingual braces and more traditional types of orthodontic braces.

Lingual braces are custom designed to be applied to the inside of your teeth. Specially designed brackets are attached to the backs of the teeth. Individually crafted archwires are used to guide your teeth to their best alignment.

Lingual braces can be the solution to many orthodontic concerns:

• If you need or want invisible braces for personal or professional reasons, lingual braces are a great option. Because they are behind your teeth, they are even less noticeable than clear aligners—and you don’t need to keep track of your hours wearing them.
• Lingual braces keep the front of your teeth braces-free for playing a brass or reed instrument, or for participating in sports. (Just remember, a mouthguard is always a good idea for athletic activities, and especially when you wear braces.)
• Both brackets and wires can be customized to fit your teeth perfectly, and new lingual brackets and wires are more comfortable than ever.

You might be a good candidate for lingual braces if:

• You have a large enough tooth surface to place a bracket. Adults with small teeth—or children—might not be have enough room on the back of each tooth to hold a bracket.
• You don’t have a major malocclusion (bite problem) which would make lingual braces impractical. A deep overbite, for example, could cause the wires and brackets behind the upper teeth to come loose or detach as they come in contact with lower teeth.
• You are dedicated to keeping up with your oral hygiene. Because wires and brackets are behind the teeth, it can be harder to keep them free from food particles and plaque.

Finally, even if lingual braces aren’t the perfect match for your orthodontic needs, there are other options that can work for you. Smaller metal brackets, ceramic brackets that blend in with your enamel, and clear aligners mean today’s orthodontic work is more subtle and discreet than ever before.

For a healthier bite, for straighter teeth, for a more confident smile—don’t hesitate. Contact our Santa Cruz, Aptos, or Watsonville, CA office to discuss the many great options you have available to give you the smile you’ve always wanted—front and center.

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 Santa Cruz, Aptos, or Watsonville, CA 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. Don Connolly and Dr. Stanley Sokolow 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!

Great question! Tooth movement is your body’s natural response to light pressure applied by braces over a period of time (usually two years). Braces work by using brackets that are glued onto your teeth; these brackets have small slots, and that is where Dr. Don Connolly and Dr. Stanley Sokolow and our team insert orthodontic wires. These wires are held in place by small elastic ties that fit around the brackets. As time passes during your treatment, these wires apply pressure on your teeth, which sets in motion the movement of your teeth into their desired positions. Each of your teeth has a different size and shape to them, as do the brackets. Each bracket is custom-made for the particular tooth on which it’s supposed to fit.

Not long ago, orthodontists had stainless steel wires and that was about it. Today, however, we have a number of different high-tech wires at our disposal to move your teeth faster and more comfortably.

When you first get your braces on, the first wire or two will typically be very flexible, but still strong enough to apply a constant force on your teeth. As your teeth straighten out over time, however, Dr. Don Connolly and Dr. Stanley Sokolow will use progressively thicker and firmer wires to help move your teeth in place for an ideal bite.

Every time you visit our office for an adjustment, we will swap out the wires in order to keep putting pressure on your teeth, which is why it’s so important for you to keep your adjustment visits during your treatment. Most adjustment appointments are scheduled four to eight weeks apart to give your teeth time to move.

As for rubber bands and elastics, most of our patients will need to wear elastics or rubber bands at some point during their treatments. These elastics typically go from one or more of the upper braces to one or more of the lower braces, and pull on your teeth to move them in the direction they need to move in order to achieve an optimal bite.

If you have any questions about wires, brackets, or elastics, or have any general questions about your treatment, please give us a call at our Santa Cruz, Aptos, or Watsonville, CA office.