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 Chestnut Hill, Massachusetts 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 Drs. Cartsos and Zavras to discover how an individualized treatment plan and a custom appliance can give your child a healthy bite and a lasting smile.

When you replace your old toothbrush every three or four months with a new model, you accomplish three things:

• You keep your teeth cleaner (frayed brushes don’t clean as well)
• You protect your gums (you won’t be scrubbing harder to get your teeth clean)
• You add another toothbrush to your growing collection of used brushes

If creative recycling is one of your talents, you might have already discovered how handy repurposed brushes are for cleaning delicate or hard-to-reach spaces around the house. But those old brushes don’t have to spend their entire existence cleaning! Here are some ideas from Drs. Cartsos and Zavras to give a new, artistic life to your old, uninspired toothbrush.

• Splatter Painting

As your bathroom mirror can confirm, toothbrushes are great for splattering. Why not put those bristles to creative use by adding color bursts to canvas, wooden picture frames or boxes, fabric, cards, gift wrap and more? Just dip the tips of the bristles into the paint, point them toward your surface, and brush your finger over the head. For more formal effects, splatter paint over your favorite stencils on paper or fabric. Or work your magic by splattering around a stencil for a dramatic silhouette.

• Children’s Painting

Your child might find it great fun to use an old toothbrush to create new works of art. The easy-to-grip handle and wide bristles are perfect for painting those first masterpieces. Splatter painting is also a wonderful art activity for children—but be prepared for some clean-up!

Texturizing Clay Pieces

Whether you work in potter’s clay, polymer clay, or Play-Doh, an old toothbrush can provide any number of interesting textures to your piece. Press the bristles into the clay for a sophisticated stippled background, or brush long gentle strokes for a striated effect.

• Carpentry

Wood glue creates strong bonds when you are joining edges, mitering corners, or fitting mortise and tenon joints. It also creates a sticky mess when you use your fingers, a wood or plastic spreader, or one of your good paint brushes. For any gluing jobs or joinery, try a toothbrush for greater control and easy application.

• Jewelry Making

If you work with jewelry pieces, you know that sometimes there are nooks and crannies that are almost impossible to clean or polish. Try a gentle brush with an old toothbrush and the recommended polish for your piece—but do keep brushes away from the delicate surface of pearls. And for the boldly creative, why not use your toothbrush itself as jewelry? There are online instructions out there for transforming that old brush into a colorful bangle bracelet.

In turns out that there’s a second career waiting for your toothbrush after all! Make sure to clean your toothbrushes thoroughly before using them in another role. After that, let your creativity run wild—including your creative recycling! It’s just another way you are crafting a more beautiful environment for all of us.

Drs. Cartsos and Zavras and our team recommend always wearing a protective mouthguard to participate in most physical sports. We especially encourage this if you have braces that can potentially cut your mouth or cause damage to your teeth. You have various choices to consider when you’re looking for a protective mouthguard.

One option is a full facial guard, which is often used for contact sports, such as football or hockey. This type offers full protection of the face from external impact. You should also consider an additional mouthguard to protect yourself from cuts inside your mouth, and avoid possible damage to your braces.

Boil-and-bites are another version of mouthguard that can be used for more physical sports. This type is used just the way its name implies: You warm the mouthguard in water to soften the material, then bite down gently once it’s at the correct temperature to form it into the shape of your mouth. These are fine to use temporarily, but they don’t always provide the best protection if they don’t fit properly.

Another option is to have Drs. Cartsos and Zavras make a custom mouthguard for you. The mouthguard will be designed with built-in layers to protect both your teeth and braces when it’s worn. Having Drs. Cartsos and Zavras create a custom-fitted mouthguard will ensure optimal protection and a comfortable fit whenever you participate in physical activities.

Protecting your teeth and braces is essential when you compete in sports. Accidents happen, and having a preventive mouthguard can potentially save you from oral pain and damaged braces. Our Chestnut Hill, Massachusetts office is happy to assist you in creating a custom-made mouthguard for any sports activities you want to pursue.

If you’ve experienced a mouth injury that has caused damage to your braces, please contact us immediately so we can fix the problem right away. Remember, prevention is key when it comes to your oral health!

February is Gum Disease Awareness month, a timely reminder that preventing gum disease is one of the best ways to protect our oral health. 

Gum disease is easily treated in its earliest stages. Left untreated, the progressive nature of gum disease makes it one of the leading causes of tooth loss in adults. 

And while we often think of gum disease as an older person’s disease, the fact is that teens and young adults can suffer from gum disease, too. Irregular brushing and flossing habits, hormone fluctuations, family history, and even orthodontic treatment can make people of any age more vulnerable to gum disease.

Let’s take a moment in this shortest month of the year to discuss how understanding, treating, and, above all, preventing gum disease can help us enjoy long-lasting healthy smiles.

How Gum Disease Develops

Gingivitis is the first, mild stage of gum disease. 

• Gingivitis begins with plaque. 
• Plaque irritates gum tissue, causing inflammation, which is the body’s reaction to injury or infection. 
• Typical symptoms include gums which are swollen or red. The gums might feel tender or bleed easily when you brush or floss. You could develop persistent bad breath. 

With proper care, gingivitis is reversible. Because gingivitis symptoms can be very mild, they’re sometimes overlooked. That’s why it’s important to keep up with regular checkups to discover and treat the disease in its earliest stages. 

Periodontitis is a serious gum disease which is destructive to the structures which support our teeth: gums, connective tissue, and bone. 

• Plaque, when it’s not removed, hardens into tartar, which can form on the tooth above and below the gumline. 
• The gums pull away from plaque and tartar deposits, creating a space between the gum tissue and tooth roots. 
• As the gums continue to recede, pockets form between the teeth and gums.
• Infection-causing oral bacteria thrive in these pockets. Gum infections can lead to painful abscesses—but gum disease is not just an infection.
• The body normally responds to bacterial infection with inflammation. With periodontitis, this inflammation becomes destructive chronic inflammation. 
• Over time, chronic inflammation and infection break down the gum tissue, bone, and connective tissue holding teeth in place. Teeth become loose or shift out of alignment.

The tooth’s support structure eventually becomes so compromised that extraction is the only option. That’s why prompt treatment is essential.

Treating Gum Disease

Several options are available to treat gum disease, depending on its severity.

Treatment for gingivitis can be as simple as paying more careful attention to your brushing and flossing and, if necessary, seeing your dentist for a professional cleaning. In some cases, your dentist might recommend an antimicrobial mouthwash or rinse.

Periodontitis requires specialized treatment from your dentist or periodontist, and this treatment will be based on how advanced the condition is:

• Topical, oral, or time-release medications treat infection.
• Non-surgical deep cleaning procedures called scaling and root planing remove plaque and tartar above and below the gumline, allowing gum tissue to reattach to the tooth. 
• Flap surgery treats more advanced gum infection by reducing pocket depth and re-securing the gums snugly around the teeth.
• If needed, bone grafts, gum grafts, and other regenerative procedures are available which help repair and restore damaged tissue.

Preventing Gum Disease

What many people aren’t aware of is just how preventable gum disease is! Because wearing braces can make brushing and flossing more challenging, it’s especially important during these months to stay on top of your dental hygiene and be on the lookout for signs of gingivitis.

• Brush twice a day for two minutes each time, after every meal, or more often if your orthodontist recommends it. 
  • Use proper brushing technique, angling your brush toward the gums to gently clean around and below the gum line. Be sure to brush around your brackets and under your wires. Use a soft-bristled brush to protect both gum tissue and tooth enamel.
• Floss once each day, after every meal, or as directed by Drs. Cartsos and Zavras. 
• There are specialized brushes and flossers available to make cleaning around brackets and wires much easier. Electric toothbrushes and water flossers can also be helpful in removing hard-to-reach plaque. Ask Drs. Cartsos and Zavras to recommend the flossing tools and techniques which will work best for you.
• See your dentist regularly. Gum disease can be invisible in its beginning stages. Discovered early, treatment is simple and effective. 
• Having your teeth cleaned every six months, or as recommended, will remove tartar buildup which brushing alone can’t handle. 

Your dental hygienist is experienced in cleaning teeth when patients wear braces. And you can get tips for better brushing and flossing techniques from the team at Convivial Dental in Chestnut Hill, Massachusetts, too!

Even when it seems like there aren’t enough days in the month or hours in the day, it takes just a few minutes daily to care for your gums and teeth. And when you’re aware of just how much those few minutes mean to a healthy smile, it’s time well spent!