The Twin Block Appliance

March 16th, 2022

Orthodontic treatment involves a lot more than just straightening your teeth. For a healthy smile, your bite must be healthy as well! This means that the upper and lower jaws need to fit together properly and comfortably.

If your bite is out of alignment because of jaw misalignment, orthodontic treatment can help correct the shape and position of your jaws with devices called functional appliances. These appliances are most often used for young patients whose bones are still growing, and are designed to treat malocclusions, or bite problems.

Common malocclusions such as overbites and overjets can occur when the upper teeth protrude further than they should, or the lower jaw is positioned too far back, or both. The Twin Block appliance can be used in such cases to help move your lower jaw and teeth into alignment with your upper jaw.

Why “Twin”? Because the Twin Block appliance is two separate pieces, each made of wire and smooth acrylic. Both pieces are crafted to fit precisely over your upper and lower arches and can be adjusted as your treatment progresses. The top plate can also be adjusted, if necessary, to widen the upper palate.

Why “Block”? Acrylic blocks cover the biting surfaces of several of your upper and lower teeth. These blocks fit together like a 3D puzzle. When you bite down, the upper blocks interlock with the lower blocks, pushing the lower blocks forward just a bit before you can bite down completely. Over time, bit by bit (and bite by bite), the Twin Block appliance advances your lower jaw and teeth to create a balanced, comfortable bite.

For the quickest and best results, you should wear your Twin Block appliance as directed. It’s made to be worn comfortably while you sleep, eat, and otherwise go about your day. (It’s a good idea to check with our Philadelphia, PA orthodontic team to see about removing it when you’re active, especially for swimming and contact sports.) When it’s time to brush, the Twin Block appliance is removable. This means that you can clean your teeth and your appliance easily.

And, while it’s made to work hard for you, it’s not indestructible. Don’t expose your appliance to heat or hot water, as the plastic may warp. Use the cleaning methods we recommend. Finally, when your appliance is out of your mouth, keep it in its case! You don’t want your appliance to end up carefully wrapped in a napkin in the nearby recycling bin. Or, even worse, in your dog’s mouth instead of yours.

The Twin Block appliance might fit together like a puzzle, but there’s nothing puzzling about how to achieve your best and fastest results. Your success really depends on you. Follow Dr. Joseph Brogan and our team’s advice, wear your appliance as directed, and you’ll be on your way to a healthy, comfortable bite and an attractive, confident smile!

Overbite Overview

March 9th, 2022

An overbite is one of the most common malocclusions. If Dr. Joseph Brogan and our team have diagnosed you with an overbite, you probably have lots of questions. Let’s try to answer some of them!

Just what is an “overbite”?

A malocclusion is another way of saying that you have a problem with your bite, which is the way your jaws and teeth fit together when you bite down. In a healthy bite, the front top teeth project slightly beyond, and slightly overlap, the bottom teeth. A normal overlap is generally considered one or two millimeters.

An overbite is a Class II malocclusion, and means that the upper front teeth cover more of the lower teeth than they should. But that’s a very general definition, and we will diagnose and treat your own, very specific, bite and teeth alignment.

Because overbites aren’t all alike. They might be barely noticeable. Upper teeth might overlap lowers by an extra millimeter or two. In more severe overbites, the upper teeth might cover the lower teeth completely. The amount of overlap and the cause of the overbite will determine your treatment.

What causes an overbite?

Overbites can be dental, caused by tooth alignment, or skeletal, caused by bone development, or a combination of both. They are usually hereditary, so, most often, an overbite is something you’re born with.

The size and position of your jaws, the shape and position of your teeth, all affect your bite alignment. But early oral habits, such as prolonged and vigorous thumb-sucking or pacifier use can contribute to overbite development. Missing teeth and bruxism, or tooth grinding, can also affect the alignment of your bite.

How do we treat an overbite?

There are many types of treatment available. Dr. Joseph Brogan will recommend a treatment plan based on the type and severity of your overbite. Because some treatments are effective while bones are still growing, your age plays a part as well.

  • Braces and Aligners

If dental issues are the main reason for your overbite, braces or clear aligners can be very effective. Rubber bands are commonly used to help bring teeth and jaw into alignment.

  • Functional Appliances

If the overbite is caused by a problem with upper and lower jaw development, devices called functional appliances can be used to help guide the growth of the jawbones while a child’s bones are still forming.

For young patients, there are several appliances that can help correct an overbite. Some, like the Herbst appliance, work inside the mouth, while others, like headgear, are worn externally. Your orthodontist will recommend the most effective appliance for your needs.

  • Surgical treatment

In some cases, where the problem is skeletal rather than dental, surgical treatment might be necessary to reshape the jawbone itself. This is especially true for adults, whose bones have finished forming.

If we recommend surgery, oral and maxillofacial surgeons are experts in surgical procedures designed to create a healthy and symmetrical jaw alignment. Dr. Joseph Brogan will work with your surgeon to design a treatment plan, which will usually include braces or other appliances following surgery.

Why treat your overbite?

Sometimes, a very slight overbite won’t require treatment. A serious, moderate, or even mild overbite, though, can lead to many dental and medical problems, including:

  • Crooked, crowded teeth
  • Worn teeth and enamel
  • Problems speaking or chewing
  • Difficulty sleeping
  • Headaches, facial, and temporomandibular (jaw) joint pain

When you work with our Philadelphia, PA team to correct your overbite, you’ll not only prevent these unpleasant consequences, but you’ll achieve major benefits as well—a healthy, comfortable bite, and an attractive, confident smile. If you’d like more than an overbite overview, Dr. Joseph Brogan can provide the specific information and treatment plan you need to make that healthy bite and that confident smile a reality!  

Overbite or Overjet?

March 2nd, 2022

The words “overbite” and “overjet” certainly sound similar. Both conditions concern your front teeth. Both conditions fall under the same category of bite problems—Class II malocclusions, if you want to be technical. So it’s not surprising that they’re often used interchangeably. But while there are similarities, overbite and overjet are also distinctly different.

  • Overbite/Overjet Geometry

In a healthy bite, the front top teeth project slightly beyond, and slightly overlap, the bottom teeth. The key word here is “slightly.” With a Class II malocclusion, the upper front teeth project further beyond the lower teeth than they should.

Of course, teeth and bites are as individual as we are, so there are variations in just how and just how much the overlap occurs. In diagnosing an overbite vs. an overjet, the difference comes down to a matter of vertical vs. horizontal.

An overbite, or deep bite, occurs when the top teeth vertically overlap the bottom teeth more than they should for a healthy bite. Generally, when a person’s top teeth cover more than a quarter of the bottom teeth when biting down, or more than two to three millimeters, that person is said to have an overbite.

An overjet, commonly known as protruding or buck teeth, is the result of a horizontal overlap that is broader than normal. This causes the top teeth to project outward toward the lips more than they do in a typical bite. An overjet is usually diagnosed when the horizontal distance between the top and bottom teeth exceeds two to three millimeters.

  • Overbite/Overjet Causes

The causes for both an overbite and an overjet might be dental (caused by tooth alignment), or skeletal (caused by bone development), or a combination of both. These bite problems can run in families. They are also affected by the size and position of the jaws and the shape and position of the teeth.

Early oral habits, such as prolonged and vigorous thumb-sucking or pacifier use, can also contribute to the development of a Class II malocclusion, particularly an overjet. Consistent pressure from thump or pacifier pushes the teeth outward as they erupt, which encourages them to protrude. These oral habits can affect the shape of the palate and jaw, too.

  • Overbite/Overjet Treatments

There are many types of treatment available to correct teeth and bite misalignments. Dr. Joseph Brogan will tailor your treatment to your specific malocclusion for the best orthodontic outcome.

If you have a mild malocclusion, and minor dental issues are the main cause of that malocclusion, either braces or clear aligners can be effective for an overjet or an overbite. Elastics (rubber bands) are often used as part of this treatment.

If the malocclusion is due to bite problems caused by uneven upper and lower jaw development, devices called functional appliances can be used with braces to help guide the growth of the jawbones while young patients’ bones are still forming. These include appliances that work inside the mouth to help the upper and lower jaws grow proportionally, and external appliances such as headgear.

In some cases, where the malocclusion is skeletal in nature as well as dental, surgical treatment might be necessary to reshape the jawbone itself. Orthodontic treatment is usually needed as well both before and after surgery.

  • Overbite/Overjet Consequences

Over time, a deep overbite can cause damaged gum tissue, worn enamel, and fractured teeth. When teeth protrude because of an overjet, they can lead to self-consciousness and are more at risk for injury. Both malocclusions share dental and medical consequences, including concerns about facial and jaw appearance, problems speaking or chewing, headaches, and face and jaw pain.

Class II malocclusions aren’t all the same, and orthodontic patients aren’t all the same either. You may have a minor malocclusion or a significant one. You may have an overbite, or an overjet, or a combination of different bite and alignment concerns. Your malocclusion may not bother you at all, or it may cause pain, discomfort, or self-consciousness.

That’s why every overbite or overjet should be evaluated by an orthodontist. When you visit our Philadelphia, PA orthodontic office, Dr. Joseph Brogan will be able to diagnose the exact nature of your malocclusion, the reason for it, and your best individualized treatment plan. An overbite and an overjet are different malocclusions, but you and your orthodontist want the same outcome for each: a healthy, attractive, and confident smile!

Orthodontics and Implants

February 23rd, 2022

Maybe you’ve wanted braces since childhood. Maybe you had them, but your teeth have shifted over time. Maybe you’re tired of living with an uncomfortable bite. Good news! If you’re not happy with your adult smile, that doesn’t mean you’ve missed the opportunity to have the healthy, attractive smile you’ve always dreamed of.

While there are many benefits to having orthodontic work done as a child, there’s a lot to be said for orthodontic treatment as an adult. After all, you know exactly what you want. You’re dedicated to following your treatment plan. You have plenty of discreet orthodontic options available now, from clear aligners to lingual braces, to make your treatment as inconspicuous as possible.

But, on occasion, adult treatment does come with some adult baggage. Worried about your crowns, fillings, or veneers? If these restorations are part of your dental history, we can generally work with them. Dental implants? Those might fall into a slightly different category.

Implants are a great way to restore your smile because they function like your natural teeth. They are designed to look just like natural teeth, and they allow you to speak, chew, and bite with confidence. Implants even stimulate the jawbone when we chew just as natural teeth do, helping to prevent bone loss in the jaw as we age.

But there is one important difference between implants and natural teeth: implants are firmly anchored in the jaw, while your natural teeth can change position.

Why is this a concern? Because tooth movement is one of the basics of orthodontic treatment. Unlike implants, our teeth aren’t firmly anchored in our jaws. They are held in their sockets by a ligament which cushions them and connects the tooth to the bone.

When braces or aligners gently apply consistent pressure to the teeth, the ligaments and eventually the bones holding the teeth reshape themselves in response to this pressure, and then become stable again during the retainer phase of treatment.

Implants, on the other hand, are crowns attached to a metal cylinder or screw that is surgically implanted into the jawbone. After several months, osseointegration takes place—which is a technical way of saying that the metal base fuses with the bone. This means that there won’t be any movement taking place—good when you’re chewing, but not helpful for realignment!

If you haven’t yet replaced a missing tooth with an implant, it’s often best to wait before starting orthodontic work. We can design treatment around a missing tooth, leaving room to accommodate an implant in just the right spot when your orthodontic treatment is finished.

If you have an implant already, the placement of your implant will help determine your treatment:

  • If your implant is already perfectly placed for your future alignment, braces or aligners can be designed to work with and around your implant.
  • If the placement is almost ideal, you might find a very small degree of misalignment acceptable, and we can plan your treatment around your existing implant.
  • If it’s not possible to work with your implant where it’s presently located, it is possible to remove an implant. You would then have the implant procedure redone after your orthodontic work is complete.

Talk to Dr. Joseph Brogan about your treatment possibilities. By analyzing your orthodontic goals and working with your dental history, we can let you know exactly what can be done for your teeth and bite—even if you have an implant.

True, there are many benefits to having orthodontic work done in your childhood, but there’s a lot to be said for orthodontic treatment as an adult. And the greatest benefit of all? You’ll finally have the healthy, self-confident smile you’ve always dreamed of. Talk to our Philadelphia, PA team about making that smile a reality.

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