Our Blog

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 Philadelphia, PA 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. Joseph Brogan to discover how an individualized treatment plan and a custom appliance can give your child a healthy bite and a lasting smile.

Perhaps you’ve heard from parents or older relatives what braces used to be like years ago—obvious, uncomfortable, hard to clean, and with inevitable tooth extractions to start off the whole lengthy process.

Today, brackets are much smaller and wires are more pliable. You can even choose ceramic brackets or clear aligners for an almost invisible effect. New tools make cleaning your braces easier than ever. And new braces technology means that treatment is often shorter. But what about extractions? Are they still inevitable?

For orthodontists like Dr. Joseph Brogan, the objective is saving teeth. And modern practices and technology have made this goal more attainable than ever before. There are several ways that modern treatment procedures can help avoid extractions.

• Early Intervention

We recommend that children visit our Philadelphia, PA office for an orthodontic evaluation by age seven. Because a child’s jaw is still forming at this age, early intervention can lead to orthodontic treatment that expands the jaw in order to make room for permanent teeth, or starts correcting bite problems before they become more serious.

• High-Tech Planning

Today’s technology allows us to map out the progression of your treatment before we begin. Scanners, X-rays, and computer programs help us to design a treatment plan which will accurately predict how best to move your teeth and correct your bite, taking into account the size and development of your teeth and jaw.

• Surgical Options

By the time you reach your late teen years, the jaw bones have stopped growing and it’s no longer possible to expand them without surgery. Oral surgery can treat serious jaw problems that impact your teeth and bite, usually as part of a combined treatment plan designed by your orthodontist and your oral surgeon.

Because we always work to keep teeth intact—using these methods and others—you can be sure that, if we recommend extraction, it is absolutely necessary. What could make an extraction necessary?

• Severe overcrowding. Sometimes, there’s just not enough room in the jaw for all of your teeth.
• A tooth or teeth that prevent us from correcting a problem with your bite.
• Wisdom teeth. Usually, orthodontic work takes place before a patient’s wisdom teeth start to erupt. If yours do make an appearance before or during treatment, we can adapt our treatment plan accordingly.
• An extra tooth. It’s rare, but an extra, or supernumerary, tooth sometimes develops, and your jaw is not designed to accommodate extras!

It’s important that you talk to Dr. Joseph Brogan about every step of your treatment, including extractions. We want you to understand the treatment plan which will give you your best outcome. If we recommend extraction, it is because this decision is the best way to achieve a healthy bite and alignment, creating your beautiful smile—and protecting it—for a lifetime.

One of the sure signs that summer has arrived is the unmistakable aroma of barbecue drifting over backyards across the country.

If you’re new to braces, you might be wondering just how many of your favorite outdoor treats can still go on your plate. Good news! You have a lot of braces-friendly options available—with a little extra planning on your part. Two things to remember: tools and textures.

• BBQ Tools

We’re not talking about spatulas and tongs and skewers—the barbecue tools we’re talking about here are your knife and fork. Sure, many classic BBQ dishes are finger foods, but those are the very dishes which can cause problems for your braces.

Eating savory ribs or chicken legs, juicy burgers or hot dogs, or delicious corn on the cob the traditional way means biting into these foods with your front teeth. That biting puts a lot of pressure on your braces and can lead to bent wires and loose or broken brackets.

But there’s a way to get around this without giving up on your tasty favorites! There’s no rule against using your knife and fork at a BBQ, and there’s no need to bite into foods when you can cut them up into small, manageable pieces.

If you remove meat from bones before eating, if you deconstruct your grilled burger or brat by cutting it up into smaller pieces, if you slice the kernels off your corn on the cob, you can chew with your back teeth and avoid any damage to your brackets and wires. Cut grilled foods into manageable bites just like you do with your regular meals, and you won’t be leaving the party early!  

• BBQ Textures

Now let’s talk texture. Crunchy, hard, and sticky foods should never be on the menu when you’re wearing braces. These foods can damage your wires and brackets or get stuck between your braces and your teeth.

This is a time for clever substitutions. Exchange the corn chips for soft potato or pasta salad. Trade crusty and seeded buns for softer, seedless versions. Skip the grilled sticky s’mores and enjoy creamy, soft ice cream instead—but without nuts or other crunchy, sticky additions, please!

Dr. Joseph Brogan and our team are happy to offer suggestions for what to eat and how to eat it safely while you’re in braces at our Philadelphia, PA orthodontic office. There are unavoidable events that can put a damper on outdoor activities. Pouring rain and insect pests—not much we can do about those. But taking simple precautions with your braces means no bent wires and broken brackets to ruin your BBQ fun. Now, dig in!

We’re not talking about tearing up at the end of a sad movie, or that uncomfortable scratchy feeling you get from a coarse wool sweater—no shame in that kind of sensitivity! But it is a shame if you’re feeling unpleasant tooth sensitivity, especially while you’re wearing braces. No fear—we have some helpful ideas to make you more comfortable as you create your healthy, confident smile.

What do we mean by tooth sensitivity? You know it if you’ve felt it. Pain when you have a cold drink. Or a hot one. Or a sweet treat. Wincing when a light breeze hits your smile. Discomfort after an adjustment.

Fortunately, these annoying twinges can be avoided or eased with some proactive practices.

Keep Up with Your Brushing and Flossing

The oral bacteria in plaque break down enamel when they’re left on the teeth for too long. The result is a cavity, which leaves your sensitive dentin, the layer of the tooth between the enamel and the inner pulp chamber, exposed to elements which can trigger pain. These all-too-common elements include heat, cold, air, or sweet foods. If you suspect you have a cavity, a visit to the dentist will make sure your tooth is cleaned and filled to prevent further damage.

Better yet, prevent cavities before they cause tooth sensitivity. It can be harder to keep your teeth their cleanest while you’re in braces, but it’s more important than ever. You don’t want to have brackets and wires removed, even temporarily, to treat a cavity! You can keep decay at bay by:

• Brushing after every meal and snack.
• Flossing whenever necessary, making sure to clean around your brackets and wires.
• Using cleaning tools made for braces for the easiest and most effective dental hygiene.

Avoid Aggressive Brushing

If you’re using anything other than a soft toothbrush, time for a shopping trip! Using a stiff bristled brush is almost always too abrasive for even the strongest enamel. And vigorous brushing is more harmful than helpful. Poor tools and poor technique can wear away enamel, and, when enamel is worn away, the more sensitive dentin is exposed. Your gums can also be injured, exposing the tops of your roots—which are more sensitive than the enameled crowns.

If your teeth are sensitive because of abrasive brushing, talk to Dr. Joseph Brogan about possible solutions for keeping your teeth both clean and strong.

• Use a softer-bristled brush.
• Try toothpaste designed for sensitive teeth.
• Practice proper brushing technique. Gently rub, don’t scrub!

Care for Yourself after Adjustments

Your teeth might be sensitive after an adjustment. This discomfort is normal, and should pass in a few days. In the meantime, treat yourself kindly.

• Brush as usual, taking special care to brush gently.
• Fill your menu with soft and soothing foods. Cool treats like classic ice cream and pudding, or healthier choices like frozen yogurt and fruit smoothies. Comfort foods like cream soups and mashed potatoes. Or all-day breakfasts of oatmeal, pillowy pancakes, or scrambled eggs.
• Take over the counter medication as recommended and as necessary.

Be sensitive to your needs while you’re in braces. If you’re feeling any kind of tooth sensitivity, talk to Dr. Joseph Brogan at our Philadelphia, PA office. We have solutions which will make sure you’re both comfortable and twinge-free on your journey to a healthy, attractive smile!