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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 Drs. Trevor Bonilla and David Falls. 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 Rockwall, TX 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. Drs. Trevor Bonilla and David Falls 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.

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.
• Drs. Trevor Bonilla and David Falls 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 Drs. Trevor Bonilla and David Falls 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 Rockwall, TX 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.

At Rockwall Orthodontics, we prefer our patients to practice good oral hygiene between office visits. Part of that process includes flossing, which Drs. Trevor Bonilla and David Falls will tell you, is the process of cleaning between the teeth to remove food and debris from the areas that are hard to reach with a toothbrush. When food is allowed to remain between the teeth, it provides a breeding ground for bacteria, which can cause periodontal disease.

Should you floss before or after brushing?

You can floss either before or after brushing, according to your own preference. By flossing first, you can brush away dislodged food debris afterward. On the other hand, brushing first allows you to loosen plaque between the teeth, making it easier to floss more effectively.

Whichever you choose, the most important goal is to floss thoroughly. That means using a fresh strand of dental floss each day, and carefully pulling it back and forth between all of the teeth. Do not skip flossing because your teeth look or feel clean.

When to Floss

Unlike brushing, you need only floss between your teeth once per day. Although you may choose to do it in the morning or afternoon, many prefer to floss at night to prevent food and debris from remaining in the crevices of the teeth overnight. This could prevent the build-up of plaque too, which is a cause of tooth decay.

Help with Flossing

If you have questions about your flossing technique or what type of floss is best for your teeth, contact our office. Our staff will be more than happy to assist you in perfecting your home hygiene regimen. In most cases, you can choose between interdental cleaning picks or flexible floss strands to perform your daily flossing routine. If you have permanent oral appliances or restorations, be sure to follow the flossing instructions provided to you, and contact our Rockwall, TX office with any questions.

If you’re heading back to classes in the next few weeks, you’re probably getting your gear together now. So let’s talk about some of the items you can pack to make orthodontic care easier during school hours.

• Dental-Healthy Food

Watching what foods you eat is especially important now. If you’re carrying your lunch or snacks in your pack, you want to be sure that they’re approved for braces and aligners.

If you wear braces, avoid foods which are sticky, chewy, or crunchy. They can stick to your teeth (making it easier for cavities to develop) or cause damage to your brackets and wires (making repairs necessary). Your orthodontist will give you a list of braces-friendly foods.

If you have clear aligners, even though you’ll remove them to eat, that sticky rule still applies. You don’t want food trapped in your aligners if you can’t brush right after eating, because that food is also food for the oral bacteria which cause cavities.

Bringing a water bottle with you is a great idea if it’s hard to brush after eating. Rinsing with water is a good way to get rid of loose food particles, and staying hydrated helps maintain normal saliva production—which also helps wash away food debris.

• Toothbrush, Toothpaste, and Floss

It’s best to clean your teeth after every snack and meal if at all possible. A travel-sized brush, toothpaste, and dental floss or picks designed for braces will help you get rid of any unwanted dental leftovers. And a small mirror can help you discover any lingering food particles.

It’s especially important now to practice careful hygiene, so be sure to wash your hands before and after cleaning your teeth or appliances.

• Your Aligner or Retainer Case

Whenever you take off your retainer or aligners to eat, you should always have your case handy. Cases make sure your appliances stay off germy desk and table surfaces—or worse, floors—and protect them from breakage. A case is also a good way to make sure your retainer doesn’t accidentally end up in a trash bin after lunch.

Again, before and after you handle your braces, aligners, or retainer, be sure to wash your hands carefully.

• Dental Wax & Extra Bands

Sometimes a wire comes loose or a bracket irritates the inside of your cheeks or mouth. In this case, dental wax is a great way to protect yourself from irritation and injury. And if a band is lost or breaks, it’s always good to have a spare (or two) handy. As always, handwashing rules apply!

• Your Mouth Guard

If your afterschool activities involve contact sports, a mouthguard is always a good idea, and especially when you wear braces. Drs. Trevor Bonilla and David Falls can create a custom guard which will protect your teeth, your delicate mouth tissue, and your braces from many impact injuries.

• Your Orthodontist’s Phone Number

One important item that takes up almost no space in your backpack, locker, or phone is the phone number for our Rockwall, TX office. If your braces are damaged, or if your aligner or retainer is lost or broken, we will let you know what to do until you can safely visit the office in person.

Talk to our team about how to care for your braces or aligners while you’re at school, and talk to your school about how you can manage your dental care safely during school hours.