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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 Yuba City 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. Adam Hoybjerg to discover how an individualized treatment plan and a custom appliance can give your child a healthy bite and a lasting smile.

By and large, the human body is a marvel of symmetry. But, of course, no one is perfect. You might have noticed one ear is a bit higher than the other. That you wear a shoe a half-size bigger on your left foot. That one shirtsleeve always looks longer.

Or that your smile looks off-center. This dental asymmetry could be caused by a condition known as “midline misalignment,” and, unlike that left foot, you can do something about it!

The dividing line between our center teeth, upper and lower, is called the midline. If we draw an imaginary line down the middle of a face, from the forehead to the nose to the midpoint of the chin, that line should go right between the front teeth. When it doesn’t, because the teeth have shifted past the midpoint, it’s often due to a condition called midline misalignment.

This kind of misalignment, also known as a deviated midline, can have several causes:

• Baby teeth that are lost too early

Baby teeth do more than promote healthy eating and speech development. They also reserve space for permanent teeth. If a primary tooth is lost too early, permanent teeth might “drift” to fill the empty space, causing the midline to move as well.

• Thumb sucking that goes on too long

As a child gets older, and certainly when by the time permanent teeth start to arrive, aggressive thumb sucking can lead to numerous orthodontic problems, including a deviated midline, as the teeth shift in response to that continuous pressure.

• Missing adult teeth

When you lose a tooth through decay or trauma, or when an adult tooth simply never develops, the remaining teeth can shift over to fill the open spot.

• Spacing issues

Crowded teeth, teeth with significant gaps between them, very large teeth, very small teeth—all of these issues can affect spacing and midline alignment.

• Crossbite

A crossbite is a kind of malocclusion, or bite problem. When you have a crossbite, the teeth don’t fit together properly, with upper teeth fitting inside lower teeth, instead of aligning on the outside where they belong. A deviated midline can indicate a posterior crossbite, where the top back teeth slant inwards or fit inside the bottom back teeth.

A tiny bit of midline shift one way or the other might be nothing to worry about, but if one front tooth is literally the center of attention, or if your teeth are noticeably out of alignment, it’s a good idea to talk to our Yuba City orthodontic team.

Because there are several potential causes for midline misalignment, Dr. Adam Hoybjerg will carefully analyze your individual situation to determine where the problem lies: with the teeth, the bite, or, rarely, the jaw itself.

Dr. Adam Hoybjerg will also offer you your best dental treatment options. A shift of a few millimeters might be treated with clear aligners or traditional braces. A crossbite could require braces or aligners coupled with elastics (rubber bands) to bring your bite into alignment. A palatal expander can help correct a serious crossbite.

Why visit Hoybjerg Orthodontics because of a little asymmetry? Because a deviated midline is more than a cosmetic concern. If you have a malocclusion to begin with, or if your misalignment leads to changes in chewing habits, which cause new bite problems, you might be facing jaw pain, chipped and cracked teeth, headaches, and all the other unpleasant consequences of malocclusion.

By and large, perfect symmetry in life is unattainable. But if you want a smile that is well-balanced and healthy, talk to us about all the treatments available to make sure your smile—and not a single tooth—is the center of attention.

Although using mouthwash is certainly not the equal of brushing and flossing, it does have benefits for your dental hygiene. If you use mouthwash regularly, you should find out which type is best suited for your needs. Here are some things to think about the next time you’re at the store.

The first item to weigh is why you want to use mouthwash. If the reason involves a high risk for cavities, you should focus on a mouthwash that contains fluoride. Make sure to double-check the label, because some mouthwashes do not necessarily include fluoride.

If you’re looking for a mouthwash to fight gingivitis, select an oral rinse with antibacterial properties. Make sure to read labels and avoid picking one that contains alcohol. Antibacterial mouthwash would also be best for a patient who has periodontal disease.

Another option is prescription mouthwash. These should be discussed with Dr. Adam Hoybjerg and/or your pharmacist in order to avoid negative side effects. Pay close attention to the directions regarding how much to use and for how long. Keep in mind that some brands may lose their effectiveness if you use them on an ongoing basis.

For children, you can find a mouthwash that changes the color of plaque on their teeth. This is a fun way to help them understand how well they are brushing, and what areas they need to focus on. It can even be a tool for adults who have trouble reaching certain areas of their mouth.

While mouthwash is generally considered as a safe means to improve your oral health, you need to keep certain things in mind. Avoid using any mouthwash that has alcohol in it. If you are using a strong one, it can reduce your sense of taste over time. Be wary of a mouthwash that claims it can loosen plaque; this is not accurate and can mislead consumers.

We hope these simple suggestions will help you the next time you’re at the store. Make sure you pick the right mouthwash to keep that healthy smile! Feel free to contact Dr. Adam Hoybjerg at our Yuba City with any questions you may have.

Well, of course you can chew gum and wear braces. But, should you chew gum and wear braces? That can be a sticky question.

For many years, the answer was a firm “No.” Not only did our favorite chewables literally gum up the (dental) works, but they were filled with loads of the sugar that cavity-causing bacteria love to feed on. The result? A much better chance of damage to your orthodontic work, and a higher risk of cavities near your brackets and wires.

But times, and gum recipes, change. Today’s sugar-free gum provides us with some new ideas to chew over.

• Sugarless gum is much less sticky than regular gum, so it is much less likely to stick to your appliance. If there is any chance that gum will damage your wires or brackets, we’ll let you know that it’s best to wait until your braces are off to indulge.
• Some orthodontic patients find that their jaws and ligaments are less sore if they chew gum for a few minutes after an adjustment.
• Most important, studies suggest that chewing sugarless gum might actually help prevent cavities from forming. How is that possible?

Because chewing gum increases our production of saliva! Okay, we don’t normally find saliva an exciting, exclamation-point-worthy topic, but let’s look at the dental benefits:

• Saliva washes away food particles and bacteria. And because braces can trap food when we eat, it’s great to have some help washing away any meal-time souvenirs.
• Saliva helps neutralize acids in the mouth. The acids found in foods and produced by oral bacteria lead to cavities, so diluting and neutralizing their effects provide important protection for our enamel.
• Saliva helps bathe the teeth in minerals that can actually rebuild weakened enamel. Acids in the mouth attack minerals in the enamel such as the calcium and phosphate that strengthen our teeth. Fortunately, saliva provides calcium, phosphate, and fluoride that can actually help rebuild weakened enamel.

So, should you chew gum and wear braces? The real question is, should you chew gum while you’re in braces? Dr. Adam Hoybjerg and our team are more than happy to provide the right answer for you! Talk to us at your next visit to our Yuba City office about the potential benefits and drawbacks of dentist-approved sugarless gum. Depending on the kind of gum you choose and the kind of orthodontic work you are having done, the answer just might surprise you.