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Orthodontic treatment involves a lot more than just straightening your teeth. For a healthy smile, your bite must be healthy as well! This means that the upper and lower jaws need to fit together properly and comfortably.

If your bite is out of alignment because of jaw misalignment, orthodontic treatment can help correct the shape and position of your jaws with devices called functional appliances. These appliances are most often used for young patients whose bones are still growing, and are designed to treat malocclusions, or bite problems.

Common malocclusions such as overbites and overjets can occur when the upper teeth protrude further than they should, or the lower jaw is positioned too far back, or both. The Twin Block appliance can be used in such cases to help move your lower jaw and teeth into alignment with your upper jaw.

Why “Twin”? Because the Twin Block appliance is two separate pieces, each made of wire and smooth acrylic. Both pieces are crafted to fit precisely over your upper and lower arches and can be adjusted as your treatment progresses. The top plate can also be adjusted, if necessary, to widen the upper palate.

Why “Block”? Acrylic blocks cover the biting surfaces of several of your upper and lower teeth. These blocks fit together like a 3D puzzle. When you bite down, the upper blocks interlock with the lower blocks, pushing the lower blocks forward just a bit before you can bite down completely. Over time, bit by bit (and bite by bite), the Twin Block appliance advances your lower jaw and teeth to create a balanced, comfortable bite.

For the quickest and best results, you should wear your Twin Block appliance as directed. It’s made to be worn comfortably while you sleep, eat, and otherwise go about your day. (It’s a good idea to check with our New Bedford or Mattapoisett, MA orthodontic team to see about removing it when you’re active, especially for swimming and contact sports.) When it’s time to brush, the Twin Block appliance is removable. This means that you can clean your teeth and your appliance easily.

And, while it’s made to work hard for you, it’s not indestructible. Don’t expose your appliance to heat or hot water, as the plastic may warp. Use the cleaning methods we recommend. Finally, when your appliance is out of your mouth, keep it in its case! You don’t want your appliance to end up carefully wrapped in a napkin in the nearby recycling bin. Or, even worse, in your dog’s mouth instead of yours.

The Twin Block appliance might fit together like a puzzle, but there’s nothing puzzling about how to achieve your best and fastest results. Your success really depends on you. Follow Dr. Neil Oliveira and Dr. Derek Wolkowicz and our team’s advice, wear your appliance as directed, and you’ll be on your way to a healthy, comfortable bite and an attractive, confident smile!

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. Neil Oliveira and Dr. Derek Wolkowicz. 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 New Bedford or Mattapoisett, MA 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. Neil Oliveira and Dr. Derek Wolkowicz 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.

Somewhere in a bathroom drawer or medicine cabinet, we all have one—that little plastic dental floss dispenser. And whether you use your floss every day (yay!), or have completely forgotten it was in there (not so good), just how much do you know about that sturdy string? Let’s find out!

• Flossing has been around for hundreds of years.

FACT: It’s been just over two hundred years since Dr. Levi Spear Parmly, a dentist in New Orleans, suggested his patients use waxed silk thread to clean between their teeth. This is considered the first “official” invention of dental floss, although using some form of tool to get rid of food particles between the teeth has been around since prehistoric times.

• Brushing well is the same as flossing.

FICTION: It’s really not. While brushing does a great job of cleaning food particles, plaque, and bacteria from your enamel, there are some places those bristles can’t… quite… reach. Floss was designed to clean plaque and food from between the teeth and close to the gum line where your brush doesn’t fit.

• There’s more than one way to clean between your teeth.

FACT: Indeed there is! Not only are there many varieties of dental floss (waxed, flavored, round, flat, thick, thin, in a dispenser, attached to miniature floss wands), but you have alternatives if using any kind of floss is difficult for you. Water-flossers direct a pulsing stream of water between and around the teeth and gum line to remove food particles and plaque. Another useful alternative is the interproximal brush, a tiny little cone-shaped brush designed to remove food and plaque from those hard-to-reach spots.

• It’s impossible to floss with braces.

FICTION: Untrue—but it can be more challenging! That’s why there are any number of flossing products designed to work with and around your braces. Stiff strands of floss which work like dental picks, floss threaders, water flossers, and interproximal/interdental brushes can both clean between your teeth and remove food particles and plaque where they collect around your braces. Dr. Neil Oliveira and Dr. Derek Wolkowicz can suggest some great options to work with your individual orthodontic treatment.

• Flossing helps prevent gum disease.

FACT: Scientific studies haven’t provided definitive answers. But dental and periodontal associations strongly recommend daily flossing as one of the most important things you can do to prevent gum disease. Gingivitis, or mild gum disease, is caused by irritated, inflamed gum tissue. Gum tissue becomes irritated and inflamed as a response to the bacteria, plaque, and tartar that stick to your teeth. Anything you can do to help remove these irritants will reduce your risk of gum disease.

• Flossing helps prevent cavities.

FACT: Dentists strongly recommend daily flossing to remove the food particles and plaque that lead to cavities. Brushing removes cavity-causing plaque from the outer surfaces of your teeth. But there’s a lot of enamel between your teeth as well. Flossing removes plaque from these hidden spots, helping to prevent interproximal (“between the teeth”) cavities from forming.

• Bleeding when you floss is normal.

FICTION: Bleeding isn’t a typical reaction to flossing. Bleeding gums could be an early sign of gum disease caused by plaque and tartar buildup. On the other hand, if you floss too hard, or go too deeply below the gum line, you can make delicate gum tissue bleed. Ask Dr. Neil Oliveira and Dr. Derek Wolkowicz for tips on perfect flossing technique.

• You need to floss after every meal.

FICTION: Dental professionals generally recommend brushing twice a day and flossing at least once each day. But this suggestion comes with some exceptions. Since you have braces, Dr. Neil Oliveira and Dr. Derek Wolkowicz might recommend flossing whenever you have a meal or snack.

• Your dentist will never know that you haven’t been flossing.

FICTION: Nope. Sure, you can miss flossing a few times and catch up before your appointment at our New Bedford or Mattapoisett, MA office. But built-up plaque between the teeth, red, swollen, or bleeding gums, and gingivitis and interproximal cavities let both you and your dentist know that you’ve been neglecting good dental habits.

• It’s never too late to start flossing!

FACT: Flossing is a simple, quick, and inexpensive way to maintain tooth and gum health. If you haven’t had much luck flossing in the past, ask Dr. Neil Oliveira and Dr. Derek Wolkowicz for flossing tools and techniques that will work for your specific needs. Start now, and see what a difference it will make at your next checkup!

If you had all these flossing facts at your fingertips, congratulations! But if you didn’t, no need to worry, because the real test of your knowledge is in its application. Flossing properly at least once each day will give you something far more rewarding than blog-quiz kudos—you’ll see that regular flossing rewarded with healthier teeth and gums!

When we think of sports and dental damage, we naturally think of hockey and football. But when it comes to the actual number of dental injuries suffered each year, vying for top seed is the game of basketball.

How is this possible? After all, football and hockey are categorized as “collision sports”! But along with the helmets, shin guards, and padding, these teams quite often require mouthguards—and this makes all the difference. Studies have shown that an increase in the number of players wearing mouthguards means a decrease in the number of oral traumas.

And while basketball isn’t considered a collision sport, it is a contact sport. Basketball is a combination of running, jumping, hard surfaces, and solid bodies. And elbows. We can’t forget elbows. So a broken or even a knocked out tooth isn’t, unfortunately, all that unusual when bodies in motion meet hard surfaces—or other players. But there are other dental dangers as well. Besides tooth injuries, oral injuries can involve:

• The ligaments and bone structures holding teeth in place
• Bones in the upper and lower jaw
• Delicate gum, tongue, and mouth tissue.

You need a solid defensive strategy to reduce the severity of oral injuries or to prevent them from happening altogether, especially when you wear braces. The best play in your playbook? Wearing a mouthguard!

Choosing the right guard is key. There are three common options, and you can choose the model which works best for you:

• Stock guards, which are ready-made guards in pre-formed shapes and sizes. You can buy them over the counter in drug stores and sporting goods stores. Because these guards aren’t shaped to fit your teeth and mouth specifically, they can be less protective (and harder to speak around).
• “Boil-and-bite” guards can also be purchased, and can provide a closer fit. After warming the guard in hot water as directed, you place it in your mouth and bite down firmly to mold it to your teeth.
• Dr. Neil Oliveira and Dr. Derek Wolkowicz can make you a mouthguard that is designed and crafted specifically for your use. Because this guard is custom-fitted, it provides better protection for your teeth and mouth. Patients often find custom guards much more comfortable and more durable as well.

Mouthguards are most effective when you wear them on the court and care for them off the court. This means avoiding a few flagrant fouls.

• Dirty play

All those moist nooks and crannies inside your mouthguard are a perfect environment for bacteria, mold, and plaque buildup. You should clean your mouthguard carefully every time you wear it, and let it air dry before popping it back in the case. Ask Dr. Neil Oliveira and Dr. Derek Wolkowicz for advice on getting your guard and its case their cleanest.

• Failure to sub out in a timely fashion

Mouthguards don’t work if they’re damaged. If you notice any warping, breakage, or jagged or sharp edges, contact our New Bedford or Mattapoisett, MA office for a replacement. If a guard doesn’t fit you properly, it doesn’t protect you, and sharp edges can irritate or injure delicate mouth tissue.

• Unnecessary roughness

Your mouthguard protects you, so don’t forget to protect it! Keep your guard in its case when you’re not wearing it to save it from dirt, damage, and disappearance.

If you know your basketball, you know your guard game can make all the difference. Even though a mouthguard might not be mandatory on your team, that doesn’t mean it’s not essential. Remember that basketball is a contact sport, and protect your teeth, your mouth, and your braces with a mouthguard whenever you play.