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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 Columbus, OH 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. Dennis Johnson to discover how an individualized treatment plan and a custom appliance can give your child a healthy bite and a lasting smile.

You’re biting into something delicious, and, Ouch! You bite into something you didn’t mean to—the inside of your tender cheek.

Painful moments like this happen every now and again. But if you find that more frequent cheek biting means that you’re extra-cautious when eating or speaking, if you wake up with sore cheeks in the morning, or if you catch yourself gnawing on your cheeks during the day, it’s time to see Dr. Dennis Johnson.

Causes of Cheek Biting

Many of us experience the occasional cheek chomp when we’re eating or talking. No fun! Besides the pain, a bite can cause broken skin, inflammation, a canker sore, or a cyst. Luckily, the discomfort from these accidental bites generally resolves after a few days.  

Sometimes, though, biting becomes a more frequent annoyance. Regular bites can be caused by several conditions. One of the most common?

• Orthodontic Misalignment

If you notice that you seem to be biting your cheek a lot when eating or speaking, it could be an orthodontic problem. When your teeth or jaws don’t align properly, if your mouth is small in proportion to your teeth, or if your teeth have shifted over time, your cheeks can feel the consequences! Dr. Dennis Johnson can help you discover if a misaligned bite is the source of your biting problems.

But it’s not just orthodontic problems which can cause painful cheek bites. Other causes can include:

• Bruxism

Bruxism is a medical term for tooth grinding. If you clench or grind your teeth as you sleep, it’s hard on your teeth and on your jaws. And for some people, that nightly gnashing causes cheek biting as well.

• Wisdom Teeth

Most of us don’t have the room to welcome four new—and large—teeth. As the wisdom teeth come in, they can cause bites, especially if they erupt leaning outward toward your cheeks. They can also push your other teeth out of place.

Treatment Options

Why visit our Columbus, OH orthodontic office? A one-time bite can be extremely uncomfortable, and might lead to inflammation or a sore spot inside your mouth. Usually, these reactions fade in a short while.

But what about continuous biting? Regular biting injuries can lead to bigger problems. Tissue can get thicker or erode. Scar tissue can build up inside the mouth. Ulcers and other sores can become larger and more painful.

If you’ve been biting your cheeks more often, your orthodontist can diagnose the cause and offer you treatment options depending on the reason for this frequent biting:

• Orthodontic Treatment

Orthodontic treatment can improve tooth and bite alignment—and can eliminate those painful cheek bites if misalignment is what’s causing them. Today’s orthodontics offers more options than ever before, for both adults and kids.

• Traditional braces are more effective—and more subtle—than ever, with brackets which are smaller or come in clear and ceramic styles.
• Clear aligners are a convenient, almost invisible way to treat misalignment with a series of trays which gradually improve alignment with each new set.
• Lingual braces are attached to the back of the teeth, so there are no visible brackets and wires.
• Functional appliances can improve and correct bite issues which braces or aligners alone can’t treat as effectively.

Whatever the reason for painful cheek biting, you deserve to eat and speak and enjoy your day without constant “Ouch!” moments affecting your comfort and health. If these moments are happening all too often, visit our Columbus, OH office for the answers to your biting problems.

Some experiences are great, and we look forward to enjoying them again and again. Others have wonderful outcomes, but you feel no need for a sequel. If you’re wondering whether you need to revisit orthodontic treatment, you’re probably in this second group.

After all, you put in your time as a teenager. All those days in bands and braces, all the adjustments, all that cleaning with little tiny tools in little tiny places. That was a lot of work, and you reaped the rewards of your conscientious orthodontic habits with beautifully aligned teeth and a healthy, comfortable bite.

But now you’ve started to notice that your teeth aren’t quite as beautifully aligned, or your bite’s not quite as comfortable. So, what’s happened? Let’s look at some possibilities, and whether a return to the orthodontist’s office is in order.

• You’ve Lost a Tooth

If you’ve lost a tooth because of injury or decay, that gap is an open invitation for surrounding teeth to move in to fill the void. Whenever you lose a tooth, consider an implant. Implants function, look, and maintain healthy spacing just like natural teeth.

One thing implants can’t do? Move like our own teeth will during orthodontic treatment. Your natural teeth can move because they are held in place within the bone by flexible periodontal ligaments. Implants, on the other hand, are anchored directly to the bone for stability.

If you’re considering new or further orthodontic work and want to replace a lost tooth with an implant, it’s a good idea to talk to Dr. Dennis Johnson to discover the best timing and scheduling for your procedures.

• You’ve Gained a Tooth

Problems with your alignment can also arise if you add a tooth or teeth. If you’re in your late teens or early twenties, wisdom teeth could be in your near future. And a new tooth can throw off the spacing and alignment of your existing teeth.

Talk to Dr. Dennis Johnson about your options if your wisdom teeth are about to make an appearance, and if it looks like your tooth and bite alignment might be affected.

• You’re Getting Older

Our teeth naturally tend to shift as we age. Teeth move forward, causing crowded or crooked front teeth—especially on the lower jaw. There’s even a medical term for this phenomenon: mesial drift. While we don’t know exactly why this drifting occurs, we can treat it.

Adults make up a large—and growing—segment of orthodontic patients. If your teeth have lost their ideal alignment over time, a visit to our Columbus, OH office is a great way to bring your youthful smile back. And you’ll probably find your treatment much shorter and more comfortable than it was decades earlier!

• You Haven’t Been Wearing Your Retainer

Remember that word “conscientious” in the second paragraph? You need to wear your retainer conscientiously, for as often and for as long as recommended by Dr. Dennis Johnson.

If you’ve been ignoring a damaged retainer, or you keep forgetting to look for your lost retainer, or you have a perfect, undamaged retainer sitting unworn on your dresser, your teeth can start to shift out of their hard-won alignment within a short time.

Does this mean it’s back to months of bands and adjustments and appointments? Maybe not! See us as soon as you notice any changes in your teeth or bite. When caught early, shifting teeth can be treated much more easily.

What can we do to help you regain your best smile? A lot!

• Treatment Planning

When you need to accommodate implants, wisdom teeth, or other dental work which could affect your tooth alignment, Dr. Dennis Johnson can work with your dentist to make sure your alignment isn’t disturbed in the process. They can also map out a treatment schedule which coordinates your other procedures with any orthodontic treatment.

• Retainer Evaluation/Adjustment

Your retainer is probably a passive retainer, meaning it keeps your teeth in place instead of moving them. If you notice your alignment shifting, or if your retainer is uncomfortable when you try to put it on after a lapse in nightly wear, ask us about a replacement.

• Active Retainers

An active retainer helps move teeth into alignment rather than simply keeping them in place. A new active retainer might be just what you need to correct a slight shift.

• Aligners or Braces

If you have some serious shifting going on, we might recommend a second round of treatment with clear aligners or braces. But there’s good news here, as well! Treatment to correct an orthodontic relapse usually takes less time than it did originally, and treatment options are more comfortable and less noticeable than ever before.

Talk to Dr. Dennis Johnson about an orthodontic sequel if you have any concerns about changes in your bite or alignment. You might need only a simple retainer adjustment or a short time in clear aligners or traditional braces to make your smile its best and healthiest once again. And this time, remember to wear your retainer to make sure there’s no need for Orthodontics—Part III!

You have done a lot of work to get the perfect smile. You wore your Invisalign aligner trays and cared for your teeth, and now your treatment is done. You still need to take care of your teeth to keep your beautiful smile. Keeps these things in mind when you think about your oral care routine.

Retainers

Many patients do require a retainer after Invisalign treatment. This will be based on your unique situation. If a retainer is recommended by Dr. Dennis Johnson, use it as directed. Retainers prevent your teeth from shifting back into their original position. You should also avoid hard, crunchy foods for the first couple of weeks as your teeth adjust. For younger patients, retainers are normally used until the wisdom teeth come in or are extracted.

Brushing and Flossing

Brushing and flossing must be part of your daily oral care. Flossing helps remove the plaque, which becomes tartar or calculus. This build up can lead to gingivitis and gum disease. Your gums may be more sensitive for a week or two after your orthodontic work is completed. A warm salt water rinse may relieve discomfort.

Your teeth may be slightly sensitive for a short time. They have been protected by your Invisalign aligner trays and now are fully exposed. You might want to try a sensitive toothpaste to get through the transition. Just ask; we will be glad to recommend the best type for your needs. If your teeth are stained, a professional whitening treatment can be considered.

Regular Dental Checkups

You still need to have regular dental exams. Professional cleanings and X-rays make sure that both your teeth and gums stay healthy so you can keep your teeth for life. If cavities or other problems are found, they can be taken care of quickly.

If you have any questions about how to care for your teeth after your Invisalign program, please ask our Columbus, OH team. We want you to keep your healthy smile and enjoy the results of your Invisalign treatment.