We are so happy with Dr. Talbot and his staff. They are so good, and so patient with my little Sam! The office is clean and a fun environment. Now the rest of the family can't wait for their teeth to be ready for Dr. Talbot!! Thanks guys, keep up the good work!!
Thank you for being so kind to us today!! First experience with braces and you all made us feel so welcome and informed. THANK YOU!!!
One of the most common problems orthodontics treat is the discrepancy that occurs when the upper teeth protrude beyond the lower. Ordinarily, when we see a patient with the upper teeth protruding, we tend to think that the upper jaw and teeth are too far forward; but, more often than not, this condition is due to a small lower jaw that is further back than it should be. With these patients, we would like to encourage the lower jaw to catch up in growth, and braces like the Herbst appliance help this happen.
Even though the Herbst appliance prevents the lower jaw from moving backward, opening and closing movement still occur easily, and patients do not have any problems learning to chew their food with their lower jaw in this new position.
As with all kinds of braces, patients with Herbst appliances need to be careful about what they eat. For instance, cold foods such as ice slushes, Popsicles and ice will freeze the cement and make the brace loosen. Sticky foods such as caramels, bubble gum and candy suckers will pull the brace away from the teeth. Hard foods like crisp vegetables and hard candies will bend and loosen the Herbst appliance, too. So stay away from these foods during your orthodontic treatment.
Your Herbst appliance will be checked and adjusted at your appointments. If, sometimes between appointments, you develop some sore areas on the inside of your cheeks, please do not try to adjust the appliance yourself. Call for an appointment so that the necessary adjustments can be made.
Wearing a Herbst Appliance
At first, your mouth will feel unusually full and speaking will be awkward. But if you practice reading aloud, your ordinary speech will return quickly. You may also notice more saliva than normal, but this will decrease as you become accustomed to the appliance.
Many patients have a narrow palate, which can cause crowding and the back teeth may not fit together properly. The Rapid Palatal Expander, or RPE is used to widen the upper arch to create more space, correct crossbite of the back teeth, and coordinate the shape of the upper arch with the shape of the lower arch. The expander can either be glued in or be removable. Both types have a special screw for activating the appliance. Each turn of the screw creates a small amount of widening. The widening is done over a period of weeks, so discomfort is very mild. Unlike using just braces and elastics for widening, which have a tendency to only tip the teeth, the RPE normally achieves true widening of the upper jaw, which makes the expansion less likely to relapse.
Instructions for Turning RPE
1- Hold the blue key so that the white tab is toward the patient’s left ear.
2- Place the key in the hole in the middle of the expander all the way in until it hits the bend in the key.
3- Push the key toward the back of the throat until you can see the next hole appear in the front of the RPE.
4- Pull the key straight out the back without moving the screw so that the front hole is still visible.
5- If the screw ever becomes stick between holes so that you are not able to insert the key in the front, you will need to find the back hole and finish off the turn.
6- If you have further questions, please give us a call.
Mandibular Anterior Repositioning Appliance/MARA
The Mandibular Anterior Repositioning Appliance, or MARA, is an appliance that is also used for “overbite” correction. It works by posturing the lower jaw forward, similar to the Herbst. The arms in the back prevent the lower jaw from biting in the backward position, holding the jaw forward at all times. Over time this permanently corrects the overbite through tooth movement and remodeling of the joints and muscles.