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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 Rockville and Olney, MD 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 Drs. Burk and Flinn to discover how an individualized treatment plan and a custom appliance can give your child a healthy bite and a lasting smile.

What do you imagine when you picture an orthodontic office? Do you see a steady stream of teenagers walking through the doors? Teen magazines in the reception room? Backpacks stowed under every chair? If so, we have an update for you.

In today’s office, you’ll find grade school kids, teens, and adults (and children’s books and games, and even the occasional golf magazine). Today’s orthodontic patients are more diverse than ever before!

Why? Because today, more than ever, more of us can benefit from orthodontic treatment.

Young Children

Even before a child’s adult teeth come in, a visit to Burk & Flinn Orthodontics is a good idea. In fact, dentists and orthodontists recommend an orthodontic exam around the age of seven for every child.

Early intervention can make sure that there’s enough space for those incoming permanent teeth and can help correct jaw alignment problems for a healthy bite.

• Palatal expanders can gently enlarge a small upper dental arch to make room for adult teeth.
• Space maintainers will save room for an adult tooth to erupt in just the right spot if a baby tooth is lost too early.
• Treatment for malocclusions like overbites, open bites, and underbites while young bones are still growing helps create a more comfortable, healthy bite and may prevent more complicated treatment in the future.

Older Adults

If you’ve always wanted straighter teeth or a pain-free bite, don’t let an imaginary age limit prevent you from getting orthodontic treatment! As long as your teeth and gums are healthy, orthodontic treatment is a terrific way to keep them healthy.

• If you have painful bite issues which have never been treated,
• If you’ve always wanted straighter teeth,
• If your teeth have become more crowded over time,

there’s no time like the present to start working toward the smile you’ve always wanted.

Bonus: new technology in braces and aligners makes orthodontic treatment more subtle and discreet than ever before.

• Traditional braces—brackets are smaller than ever, and come in a choice of several materials and colors, including ceramic brackets and tooth-colored and clear brackets.
• Lingual braces—the least visible treatment, because brackets and wires are attached behind the teeth.
• Clear aligners—a removable and almost invisible way to straighten teeth.

Tweens & Teens

Teenagers still make up the majority of patients in orthodontic treatment. Orthodontists often recommend starting treatment between the ages of ten to 14, because:

• Most of the adult teeth have come in, so problems with crowding, spacing, or crooked tooth alignment can be diagnosed and corrected.
• The jawbone is still growing, and the bone is not as dense, so it can be easier to realign teeth and jaws for straighter teeth and a symmetrical bite.

Today’s treatment choices offer more options and are more effective than ever before. Depending on a teen’s orthodontic needs, Drs. Burk and Flinn might suggest:

• Traditional braces or aligners
• Elastics (rubber bands) used with braces to bring the upper and lower teeth into alignment.
• Functional appliances—together with braces or aligners, appliances like the Herbst® appliance, the Forsus™ device, the twin-block appliance, and headgear can work inside and/or outside the mouth to help correct problems with tooth and jaw alignment.

It’s no longer just the middle school and high school crowd you might meet in your orthodontist’s waiting room. Children, teenagers, and adults can all benefit from orthodontic treatment at our Rockville and Olney, MD office. If someone in your family is one of those people, give your orthodontist a call to see just what orthodontic treatment can offer. Welcome in!

We often think of braces as a rite of passage for kids in middle and high school. So you might be surprised when your child’s dentist recommends a visit to see Drs. Burk and Flinn years earlier than you anticipated. In fact, dentists and orthodontists generally suggest a visit to the orthodontist by age seven at the latest.

Why see an orthodontist so early?

After all, your child is still growing, and many adult teeth haven’t come in at that age. And that’s the whole point.

Around this age, your child will probably have a mix of both baby and adult teeth, so your orthodontist will be able to assess whether there’s enough room for the permanent teeth to erupt without crowding or spacing problems. And malocclusions, or bad bites, caused by problems with jaw size or symmetry can be addressed while young bones are still forming and developing.

If your child has a first appointment coming up on the calendar, here’s a heads up on what often happens during a first visit, and potential problems your orthodontist will be on the lookout for.

What can you expect at a first visit?

The first visit is designed to evaluate how your child’s teeth and jaws work together now, and to look for potential future problems with tooth alignment and jaw structure and development.

First, Drs. Burk and Flinn will carefully examine your child’s teeth, jaws, and mouth. Your child will be asked to bite down several times to see how the teeth and jaws fit together, and if there’s any discomfort. Other helpful diagnostic tools could include:

• Scans or X-rays to evaluate jaw structure and the position of teeth which haven’t erupted yet
• Photos of your child’s teeth and face
• An impression of your child’s teeth

If there’s no immediate need for treatment, we might recommend periodic checkups at our Rockville and Olney, MD orthodontic office to follow the growth and development of your child’s teeth and jaws. If interceptive (early) treatment is your child’s best option for a healthy smile, your orthodontist will explain any immediate orthodontic issues and design a treatment plan tailored to your child’s specific needs.

What are the benefits of early treatment?

Interceptive treatment not only helps correct current orthodontic problems, it can help reduce the need for more complicated treatment in the future, when all of the adult teeth have arrived and bones are fully formed. Among its many benefits, early treatment can:

• Prevent crowding

If your child has a small upper palate, it can be gently enlarged while the palate is still growing with the help of a palatal expander. This will give the upper teeth the space they need to come in without crowding.

• Provide space

If primary teeth are lost too early, other teeth can shift out of alignment to fill the empty space. A space maintainer can be custom-made to keep the spot open until the right tooth is ready to erupt. If primary teeth are overstaying their welcome, Drs. Burk and Flinn might recommend extraction to allow the adult teeth to erupt in the proper place.

• Create jaw symmetry

Malocclusions can develop because the upper or lower jaw is too narrow, too far forward, too far back, or the jawbones don’t fit together properly. Drs. Burk and Flinn might suggest the use of a functional appliance such as the Herbst® appliance or headgear to help guide symmetrical bone development while your child’s young bones are still growing and forming.

• Protect teeth

Children with overjets, or protruding upper teeth, are more likely to suffer chips, cracks, and other trauma to those vulnerable front teeth. Functional appliances can help bring the upper and lower jaws into alignment as needed, and braces can move the teeth into alignment.

Every journey to a healthy smile begins with a first visit. And you don’t need to wait until your child is seven. Any time you’re concerned about an orthodontic issue is a good time for a consultation. Talk to Drs. Burk and Flinn about what to expect at your first visit to help create a comfortable experience for your child as you begin this journey together.               

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 Drs. Burk and Flinn 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 Drs. Burk and Flinn 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 Rockville and Olney, MD 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!