Children and adults often feel confused and a little frightened because of the various metal tools and appliances used for orthodontic treatment. Knowing the applications of such devices can help ease a patient's mind when undergoing treatment. Dentofacial orthopedics is a specialty that uses appliances to adjust the jaws for ideal compatibility. The American Association of Orthodontists recommends these treatment options for children between the ages of eight and 12 to make adjustments during developmental stages. Adults also experience dental changes throughout their lives and can benefit from dentofacial orthopedic appliances. Some common problems with jaw alignment or development include:

• Underdeveloped lower jaw
• Protrusion of upper teeth
• Malocclusions
• Crossbite
• Overbite

Orthodontic Appliances for Correcting Jaw Growth Problems

Jaw-correcting appliances are either fixed or removable. Fixed appliances are applied to the teeth with the use of cement. Removable appliances require dedication from the patient to wear the devices as instructed. You will receive better results by wearing your orthodontic gear and following the treatment plan designed for your specific needs. Understanding the potential results will help you stay motivated, and parents can help their children to follow recommendations. Some appliances can cause slight discomfort during adjustment periods, but wearing them regularly will help shorten the time frame for treatment. Here are some of the most common appliances for correcting jaw growth problems.

• Headgear: This appliance is removable and consists of a stainless steel facebow and fabric safety strap. The orthodontist fixes metal bands to your upper-back teeth where you attach the facebow. The safety strap wraps around your head and secures the facebow. Headgear affects jaw growth and tooth movement by applying pressure to the upper teeth and maxilla.
• Herbst® Appliance: Typically permanent, these appliances attach to the upper and lower molars to hold the mandible forward. The purpose of this type of treatment is to eliminate an overbite. With expansion screws, the Herbst can also widen the jaw.
• Mara: This appliance pushes the mandible forward to reduce overbite. Crowns are placed on your top and bottom molars, and a metal elbow connects the crowns.
• Bite Corrector: This appliance is combined with braces to correct different malocclusions. Metal bars with enclosed springs apply pressure to both the upper and lower jaws. The placement of such bars will depend on the bite type.
• Bionator: This removable appliance guides the lower jaw so that it grows in proportion to the upper jaw. Children can develop aligned bites by wearing bionators.
• Palatal Expansion: There are two options for placement, fixed, or removable palatal expansions, to fix crossbites. The appliance attaches to the upper-back teeth and widens the jaw.

You will get used to the feeling of most appliances within one month, and the adjustment period is easier if you follow the treatment plan that our staff designs. The average time it takes to correct jaw problems is 12 months, so you can expect to see a more beautiful smile in about one year.

Are you thinking about orthodontic treatment to straighten teeth or correct jaw alignment?  Consider making your first step an orthodontic consultation. During the consultation we will address your questions, concerns, and talk about a treatment plan that would best suit your situation.

We want you to feel prepared and in charge of your orthodontic treatment decisions, so keep these questions in mind when you come in for your appointment.

• If I do need some adjustments to my teeth, what options will I have besides braces?
  (This will help you determine what approaches we use to straighten your teeth.)
• What kind of preparation is needed to get braces? How many visits will it take?
  (It’s important to know how many appointments may be needed and what you will need to do between appointments to be ready for braces.)
• Can I expect any pain when getting braces?
  (Ask about the ways we address pain management.)
• What determines how long I have to wear braces?
  (The length of treatment will vary from patient to patient.  During your consultation we can evaluate your teeth and jaw alignment to determine the correct course and length of treatment.)
• How will braces affect my lifestyle? Foods I can eat? Activities I can do?
  (You may find that little needs to change in your daily routine to have a successful orthodontic outcome. We can discuss and address any changes so you can be prepared before you get your braces.)
• Who will be involved in the orthodontic work?  Whom can I expect to see during my adjustment visits?
• What will my orthodontic work cost? What is the ”average” cost and what could be the maximum?
  (Make sure you are clear about what your insurance covers, who contacts the insurance company for pre-authorization, who files the insurance forms, and what flexibility there is to pay the remaining amount not covered.)

Your initial orthodontic consultation may just be the first step in relieving a lot of pain and discomfort in your life. Going in with the right questions will help you to understand the entire process and prepare you to do your part for your own dental health. Be sure to bring a list of your questions!

Orthodontic treatments vary from dental treatment, in that they primarily address malocclusions, jaw spacing and tooth alignment, rather than the actual health of the teeth. That is why it is often more difficult for parents to determine when a child needs orthodontic treatment rather than dental treatment. So how can you know it is time to take your child to the orthodontist?
• Bad Bite - As the adult teeth begin to replace primary teeth, bite occlusions can develop. These often become visible to parents between middle childhood and the pre-teen years, although an orthodontist can identify a bad bite with early evaluation.
• Visible Tooth Crowding - If your child's newly emerging teeth are already crowded, you should make an appointment with our office to discuss braces.
• Tooth Grinding (Bruxism) - Children who grind their teeth at night may do so unconsciously, but the condition requires treatment to prevent the development of headaches, TMJ, and tooth damage. Oral appliances are available to correct nighttime tooth grinding.
• Difficulty Chewing, Biting, or Speaking - If your child is displaying difficulty speaking or eating, or if he or she often experiences cheek biting, schedule an orthodontic consultation.
• Asymmetry - If your child's face is asymmetrical, or if his or her teeth do not meet together in a natural way, orthodontic treatment may be necessary.
Evaluation and Preventive Care
Even if your child has no visible tooth or jaw alignment problems, the American Association of Orthodontists recommends that every child visit the orthodontist for an initial examination no later than age seven. The reason for early evaluation is because orthodontists are capable of finding subtle problems with the jaw and teeth growth and spacing before they become more pronounced and also more difficult to treat.

By bringing your child in for an evaluation, you may be able to treat orthodontic conditions with shorter and more simplified treatments that are also more affordable than treatment during the teenage and adult years.

Orthodontic treatments are used to correct malocclusion, a condition more commonly known as a bad bite. The length of treatment time varies depending on the severity of the bite problem.

What is a "bad bite"?
A bad bite occurs when spacing or alignment problems are present. This often includes teeth that are protruding, crowded, or crooked. Sometimes teeth appear straight, but have an uneven bite because the upper and lower jaws do not align properly. Teeth that are irregularly spaced - either too far apart or too close together - can also cause bite problems.

Frequent causes of bite problems:

• Heredity
• Thumb-sucking
• Premature tooth loss
• Accidents

Benefits of orthodontic treatment:

Appearance -
Correcting a bad bite often creates a more attractive smile, which frequently raises the patient's self esteem.

Preventing Decay -
It also results in a healthier mouth. It is much more difficult to thoroughly clean teeth that are crooked, protruding, overlapped, or crowed. This may allow plaque to build up, which can lead to gum disease, tooth decay and even tooth loss. Orthodontic treatment corrects these conditions, so cleaning can be more efficient.

Avoiding Alignment Issues -
An uneven bite can interfere with the motions of chewing and speaking. This can cause abnormal wear to tooth enamel, which may require pricey cosmetic restorative treatments, such as crowns or veneers, to correct. It can also lead to problems with the jaws. Orthodontic treatment lessens the likelihood of those issues, as well.

Types of orthodontic treatment:

- Braces: Metal or ceramic brackets are bonded to the front of teeth. Wires and elastics are attached to the brackets to straighten teeth.

- Invisalign®: Advanced 3D computer images of the patients' mouth are used to create clear, custom aligners that slowly move teeth. They are nearly invisible and are more comfortable than traditional braces. They are also removable, which makes it possible to continue with normal brushing and flossing.

- Retainers: A retainer is a removable piece worn inside the mouth that uses pressure to force teeth to move into proper alignment. They are used after braces are removed.

Length of orthodontic treatment:
Treatment typically ranges from 12 to 36 months. Factors include the age, cooperation level, and growth occurrence of the patient. The complexity of the case also impacts the treatment time.