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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 San Diego 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. Allen to discover how an individualized treatment plan and a custom appliance can give your child a healthy bite and a lasting smile.

Orthognathic surgery is surgery to correct a wide variety of abnormalities of our patients' jaw and teeth. The surgery is often done in conjunction with orthodontic treatment. While the patient’s appearance may be significantly improved as a result, the primary purpose of the surgery is to correct functional problems including but not limited to:

• Unbalanced facial appearance
• Protruding jaw
• Open bite (upper and lower teeth don’t overlap properly
• Excessive wearing down of the teeth
• Difficulty with chewing or biting
• Chronic mouth breathing
• Sleeping problems such as sleep apnea
• TMJ pain (jaw joint pain)
• Restoring facial injuries

Knowing when to start the orthodontic treatment in preparation for orthognathic surgery can also be tricky if our team at Davis Orthodontics is treating a teenager. It is important to know when to get started. If orthodontic treatment is initiated too soon and the teenager is still growing, the patient will either need to hold in braces until his or her growth is complete and they are ready for surgery or the braces will have to be removed and then placed again when growth is complete. Neither of these options is attractive since it requires longer time in treatment, which is something all our patients want to avoid. Our team at Davis Orthodontics strives to get all patients finished with treatment as quickly as possible because it is healthier for the teeth and gums and gives them a beautiful smile to enjoy for a lifetime.

If you are considering orthognathic surgery or you have been told that you need jaw surgery, give us a call to schedule your initial consultation today. Dr. Allen and our team at Davis Orthodontics will explain our treatment plan in a way you will understand and we will keep you informed every step of the way.

Let’s see…

Toothbrush? Check.

Fluoride toothpaste? Check.

Floss? Check.

Two minutes of thorough brushing? Check.

Careful cleaning around your brackets and wires? Check.

Wait… there’s something else… it’s right on the tip of your…

Ah! Your tongue! Whenever you brush, morning, evening, or any time in between, if you want the freshest breath and cleanest teeth, don’t forget your tongue.

Why your tongue? Because the tongue is one of the most common sources of bad breath. Let’s examine just why this occurs.

The tongue is made up of a group of muscles that help us speak and chew and swallow. But there’s more to this remarkable organ than mere muscle. The surface of the tongue is covered with mucous membrane, like the smooth tissue which lines our mouths. But the tongue isn’t completely smooth—it’s textured with thousands of tiny bumps called papillae.

These little elevated surfaces have several shapes and functions. Some make the tongue’s surface a bit rough, which helps move food through your mouth. Some are temperature sensitive, letting you know that your slice of pizza is much too hot. And some are covered with thousands of the taste buds, which make eating that pizza so enjoyable.

All of these papillae with their various functions combine to create a textured surface, filled with miniscule nooks and crannies. And if there’s a nook or a cranny where bacteria can collect, no matter how miniscule, it’s a good bet that they will, and the surface of the tongue is no exception. But bacteria aren’t alone—the tongue’s surface can also hide food particles and dead cells.

How does this unappealing accumulation affect you? These elements work together to cause bad breath, especially the bacteria that break down food particles and cell debris to produce volatile sulfur compounds—compounds which create a particularly unpleasant odor. Including your tongue in your brushing routine helps remove one of the main causes of bad breath.

And that’s not the only benefit! Cleaning the tongue helps eliminate the white coating caused by bacterial film, and might even improve the sense of taste. Most important, studies show that regular cleaning noticeably lowers the levels of decay-causing plaque throughout the mouth.

So, how to get rid of that unwanted, unpleasant, and unhealthy debris?

• When you’re done brushing your teeth, use your toothbrush to brush your tongue.

Clean your tongue by brushing gently front to back and then side to side. Rinse your mouth when you’re through. Simple as that! And just like a soft-bristled toothbrush helps protect tooth enamel and gum tissue, we also recommend soft bristles when you brush your tongue. Firm bristles can be too hard on tongue tissue.

• Use a tongue scraper.

Some people find tongue scrapers more effective than brushing. Available in different shapes and materials, these tools are used to gently scrape the surface of the tongue clean of bacteria and debris. Always apply this tool from back to front, and rinse the scraper clean after every stroke. Wash and dry it when you’re through.

• Add a mouthwash or rinse.

As part of your oral hygiene routine, antibacterial mouthwashes and rinses can assist in preventing bad breath. Ask Dr. Allen for a recommendation.

• Don’t brush or scrape too vigorously.

Your tongue is a sturdy, hard-working organ, but tongue tissue is still delicate enough to be injured with over-vigorous cleaning.

Taking a few extra seconds to clean your tongue helps eliminate the bacteria and food particles which contribute to bad breath and plaque formation. Make this practice part of your daily brushing routine—it’s a healthy habit well worth remembering!

Although adolescence is a common time to get braces, there’s no reason for adults of any age to have to deal with crooked teeth, overbite, underbite, or other dental issues. In fact, the American Association of Orthodontists notes that demand for orthodontic treatment in adults continues to grow, with adults representing 20% of new patients.

You’re never too old for braces or other orthodontic appliances, but it’s important to consider the following:

1. Braces don’t have to be as noticeable as the metal brackets of the past. Many adults opt for ceramic or plastic braces, which are bone-colored or clear, respectively. Another option is a lingual appliance, which attaches to the back side of your teeth. These so-called “invisible” braces are much less noticeable than traditional options.
2. By adulthood, bone growth has stopped. This means that certain structural changes can only be achieved by surgery. Although this typically affects people with significant crowding, bite, or jaw problems, Dr. Allen can provide an individualized treatment plan that addresses your unique issues.
3. Treatment may take a bit longer. The length of orthodontic treatment tends to be slightly longer for adults than adolescents. Exact estimates vary by individual, but the average length of time for adult braces wearers is two years, according to the Harvard Medical School.
4. Outcomes are just as good for adults! Many adults worry that it’s too late to treat their orthodontic problems. However, treatment satisfaction tends to be very high, which is a testament to how effective braces can be in middle-aged and older adults.