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The Herbst® Appliance

February 23rd, 2022

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 Dr. Cronin. 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 Langley 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. Dr. Cronin 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.

How Long Will My Retainer Last?

February 16th, 2022

You’ve worked hard for your attractive, healthy smile, and now you’re making sure it stays attractive and healthy by wearing your retainer. Since wearing a retainer is usually a matter of years, not months, it’s natural to wonder just how long you can count on that retainer to help you maintain your smile.

That answer depends on the type of retainer you get at our Langley office. A Hawley retainer, a clear retainer, and a fixed wire retainer have different lifespans. Because they each have their own advantages, Dr. Cronin will recommend the retainer that’s right for protecting your individual smile.

So let’s look at the average lifespan for different retainers, and, equally important, some of the common mishaps that can shorten that working life.

The Hawley Retainer

This is the retainer most people picture when they think “retainer.” Made of wire securely attached to an acrylic base, the Hawley retainer keeps the teeth in place, and can even be adjusted, if needed, to improve alignment. They generally last anywhere from three to ten years.

How can you make sure your Hawley retainer keeps working for you as long as possible?

  • Keep it in its case. While some damages to these retainers can be repaired, why take a chance? And it’s much harder to lose a retainer if it’s in its case as opposed to, say, a cafeteria napkin.
  • Keep it away from your pet. Dogs, especially, are tempted by the taste and smell of saliva, but there are safer, less expensive chew toys out there.
  • Keep wearing it. Without your retainer, your teeth can shift. Over time, not only will your retainer fail to fit anymore, but you might need to return for further orthodontic treatment. If you notice your retainer is starting to feel uncomfortable, give your orthodontist a call.

The Clear Retainer

Clear retainers look like clear aligners, and, like clear aligners, are almost invisible. Made of vacuum-formed plastic, they’re designed for a close, comfortable fit, often around the entire arch of your teeth. Also like clear aligners, these retainers aren’t made to last forever. If they become loose, warped, or cracked, they should be replaced. With care, they can last from six months to several years. How to protect them?

  • Protect your retainer from damage. Keep it in its case when you’re not wearing it. You’ll avoid losing it, and you’ll avoid damaging it.
  • Protect it from teeth. And we don’t just mean pets, although they find clear retainers yummy, too. If you grind your teeth, your retainer can suffer. Clear retainers are not the same thing as night guards, so talk to your orthodontist for recommendations.
  • Protect it from heat. Hot surfaces like ovens or heaters, hot dashboards, washers and dryers, even very hot drinks can be a problem. (You should only be drinking water while you wear your clear retainer, so that particular issue shouldn’t arise!)

The Fixed Retainer

A fixed retainer is a small piece of wire that is custom-fit and bonded to the back of specific teeth to prevent any movement from occurring. Because it’s bonded to the inside of the teeth, a fixed retainer is completely invisible when you speak or smile. It can last five years, ten years, and in some cases, even longer. Even though you won’t be exposing this retainer to external dangers like hungry pups or the wash-and-rinse cycle, there are still some situations to watch for:

  • Watch your diet. The same sticky, crunchy, or hard foods that can damage brackets and wires can also loosen a fixed retainer.
  • Watch your dental hygiene. While cleaning around a bonded retainer can be a bit challenging, not cleaning around it can result in plaque and tartar buildup—and your retainer might have to be removed to clean your teeth.
  • Watch for changes. If your teeth start to shift, it could mean your retainer has detached from one or more teeth. Ask your dentist to check the retainer’s bond whenever you have a checkup.

So, how long will that retainer last? Depending on the kind of retainer you have, if you don’t keep it in its case, or if you don’t watch your diet, or if you expose it to heat, the answer is—not nearly long enough. Dr. Cronin will give you the very best tips to keep your retainer clean, safe, and working for as long as possible. Now, it’s up to you!

Valentine Candy: Is It 4 U?

February 9th, 2022

It’s Valentine’s Day. Love and friendship are in the air, and candy is on the gift list. Are there tasty Valentine treats that are safe to eat even with your braces? We have some sweet news for you!

Safe Valentine candy, like the rest of your braces-friendly diet, won’t stick to your braces (potentially causing cavities) or damage them (potentially causing emergency visits to the orthodontist). In other words, foods that aren’t sticky, chewy, hard, or crunchy.

So, which candy treats are on the “Loves Me Not” list?

  • Chewy Candies

Love heart-shaped gummies? Or spicy cinnamon jellies? Or Valentine-pink taffy? These sweet confections might be delicious, but, no matter how delicious, all that sugar sticking to your brackets and wires is not healthy for your teeth and it’s especially hard to brush off. And the chewy nature of these treats can break wires and pull brackets loose from your enamel.

  • Hard Valentine Candies

Do U luv these? R they UR favorites? Whether or not they come in the shape of colorful hearts with clever stamped messages, as crunchy nuts surrounded by chocolate, or as gleaming red hearts on a lollipop stick, hard candies R not 4 U when you wear braces. Biting down on hard foods can damage wires and loosen brackets.

  • Boxes of Assorted Chocolates

The beauty of a heart-shaped box filled with chocolates is its variety. The problem with a heart-shaped box filled with chocolates is its variety. Any pieces with nuts, toffee, or caramel should be left in their little paper cups. Sticky, chewy, and crunchy foods are some of the worst offenders when it comes to damaging your braces. If your candy doesn’t come with descriptions, break open the piece before you indulge to see just what you’re biting into.

Is this list a bit depressing? Take heart! There are several Valentine’s options that are safe for your braces.

  • Soft Chocolates

Any kind of soft chocolate should leave your braces intact—and if you choose dark chocolate, you’ll be enjoying less sugar and more minerals and antioxidants.

  • Chocolate-Covered Peanut Butter Candies

These treats are also soft enough to be harmless to your brackets and wires. And if they’re molded into hearts? Bonus!

  • Boxes of Assorted Candies

The problem with a heart-shaped box filled with chocolates is its variety. The beauty of a heart-shaped box filled with chocolates is its variety. Nestled among all the sticky, chewy, and crunchy chocolates are the safer soft cream centers. Choose the braces-friendly options and share the rest.

Whether you’re buying a candy gift for someone in braces, or you’re the lucky giftee, choose candies that will make Valentine’s Day memorable for all the right reasons! Don’t be afraid to think out of the (heart-shaped) box—pink milkshakes or smoothies, sweetly decorated cupcakes, and creamy pastel ice creams and frozen yogurts are soft, smooth, and safe holiday treats.

Of course, after indulging in any Valentine treat, be sure to clean your teeth and braces carefully. Cavities are never fun, and especially not when you’re in braces. Brush and floss after eating, and make sure your brackets and wires are clear of any sticky, sugary souvenirs. If you do have a problem with damaged wires or brackets, be sure to call our Langley office right away to keep your treatment plan on track. Valentine’s Day comes once a year, but your beautiful, healthy smile? You want it to last 4ever!

Hot Day? Three Drinks to Leave Home When You’re Packing the Cooler

February 2nd, 2022

Whew! It’s a hot one! And whenever the temperature soars, you need to stay hydrated, especially when you’re outside or exercising. But all cold drinks aren’t equal when it comes to healthy hydration. Which beverages shouldn’t have a prime spot in your cooler when you’re wearing braces or aligners?

  • Soft Drinks

You’re probably not surprised to find soft drinks at the top of the list. After all, sugar is a) a big part of what makes soda so popular, and b) not a healthy choice for your teeth.

Sugar is a favorite food source for the oral bacteria that make up plaque. These bacteria convert sugar into acids, and these acids attack the surface of your tooth enamel. Over time, the minerals which keep enamel strong begin to erode, and weakened, eroded enamel is a lot more susceptible to cavities.

So, what about sugar-free drinks? Does this make soft drinks a better choice? Unfortunately, you can take the sugar out of many sodas, but you can’t take the acids out. Most soft drinks are very acidic, even without sugar, and will cause enamel erosion just like the acids created by bacteria will.

  • Fruit Drinks

Fruit juice provides us with vitamins, which is great, but it’s also full of natural sugars and acids. And blended fruit drinks and fruit punches often contain added sugars and added citric acids. Best to choose 100% fruit content and check the labels before you buy. (And you can always get refreshing fruit flavor by adding a slice of fruit to a glass of water.)

  • Sports Drinks

You might be surprised to see these on the list—after all, they promise healthy hydration while you’re working out. And hydration is healthy—but sugars and acids aren’t. Even when the label tells you there’s no added sugar, that same label will often reveal high amounts of citric acid. In fact, some sports drinks are more acidic than sodas.

We’ll make an exception, though, for thirsty people who participate in sports or activities that require a lot of physical exercise and produce a lot of sweat. When we sweat, we lose electrolytes, those ionized minerals which help regulate many vital bodily functions. Talk to Dr. Cronin about which sports drinks are best for you if you need to replenish your electrolytes when working out.

So, what’s your best hydration choice on a hot day? Water! It not only hydrates you, it cleans your teeth, it helps you produce saliva, and it often contains tooth-strengthening fluoride. But if you only have sports drinks in the cooler, or if you just want to enjoy a soft drink or a bottle of juice from time to time, no need to go thirsty. We have some ways to make sure your teeth are safer, even with this tricky trio:

  • Rinse with water after you drink a sugary or acidic drink. And remember to brush when you get home.
  • Be choosy. Check labels for added sugars and acids.
  • Don’t sip your drinks all day long. Saliva actually helps neutralize acids in the mouth, but sipping acidic beverages throughout the day doesn’t give saliva a chance to work.
  • Use a straw to avoid washing your enamel in sugars and acids.

While sugar and acids are never good for your teeth, it’s especially important to reduce your exposure while you’re in braces or aligners.

  • Increased sugar means increased plaque and bacteria, which can collect around your brackets. When plaque isn’t cleaned away, bacterial acids cause mineral erosion, which shows up as white spots on your enamel. You don’t want to see a collection of white spots when those brackets come off!
  • Filling a cavity might require the (temporary) removal of part of your braces.
  • There’s a reason Dr. Cronin and our team recommend that you only drink water with your aligners on. If you wear them while you drink sugary and acidic beverages, the liquid collects in your aligner tray, literally bathing your teeth in sugar and acid—and speeding up the process of erosion and decay.

You need to keep hydrated when it’s hot. When you’re packing your cooler, choose drinks that are healthy for your entire body, including your teeth and gums. Ask our Langley team for the best choices in cold drinks to make sure you’re getting the hydration you need—without the sugar and acids you don’t!