Our Blog

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. Kathleen Tavarez. 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 Menlo Park or San Carlos, CA 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. Kathleen Tavarez 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.

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 Menlo Park or San Carlos, CA 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. Kathleen Tavarez 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!

If Dr. Kathleen Tavarez and our team recommend a Hawley retainer to complete your orthodontic treatment, you’re getting a classic. This retainer, invented by Dr. Charles Hawley, has been in use since the early decades of the twentieth century.

But this isn’t your great grandmother’s pink plastic retainer! The look of today’s Hawley retainer has really evolved from its early days as the “Hawley bite plate”—and pink is now a choice instead of an inevitability. In fact, you can choose from any number of colors, patterns, and designs to create a retainer that is uniquely you.

Each Hawley retainer is customized to fit your mouth and teeth perfectly. Wire clasps and a labial bow wire are securely attached to an acrylic base based on a model made from your teeth and mouth.

Your retainer is designed for function—the bow wire makes sure your teeth stay in the perfect position while your bones and ligaments get strong enough to hold them in place. The acrylic base, of course, is also functional—but that doesn’t mean you can’t have fun with it!

Retainer bases can be formed in different ways.  One type of retainer model uses pre-formed acrylic discs for the base, and these are available in many pre-formed colors and patterns. Another type of retainer builds the base by alternating several applications of liquid and powder acrylics, layer after layer. This process allows the retainer technician to create one-of-a-kind designs.

What are some of the ways to make your retainer uniquely yours?

• Color—whether deep tones, pastels, electrics, neon, or metallic, you can find an appealing shade in the color chart. Or, if you want your retainer to keep a low profile, choose a clear or a color-coordinated pink tone.
• Glow in the Dark—if you don’t want your retainer to keep a low profile, this might be just the look for you!
• Glitter—accessorize your sparkling smile with a sparkling retainer.
• Patterns—stripes, polka dots, geometric shapes—even animal patterns are possible.
• Color Combinations—why choose one color when you can have a marbled swirl of your favorites? Or a tie-dye look? Or team colors?
• Acrylic Designs—a colorful design that captures your personality is available with some creative acrylic artistry. Rainbows and flags, hearts and flowers, ladybugs, and spider webs are just some of the options on hand.
• Picture Perfect—for that special hobby, pet, team, or other personal favorite, decals or pictures can be applied under a layer of clear acrylic.

Hawley retainers are made to last, so choose your design with years of use in mind. Talk to our Menlo Park or San Carlos, CA team about the custom looks which are available to celebrate your unique personality. After all, there’s nothing more personal than your smile!

You might have been one of the lucky few born with perfectly straight teeth and a healthy bite. You might have spent months in orthodontic treatment as a teenager to achieve perfectly straight teeth and a healthy bite. But now that you’re growing older, you might be unhappily surprised to discover that your smile isn’t aging as gracefully as you are.  What’s changed?

That’s a trick question, because our bodies never stop changing, growing, and adapting. And these constant adjustments include the changes taking place in your teeth and mouth. You might begin to notice subtle differences in your smile when you’re in your thirties or forties. After young adulthood, several factors come into play which can cause shifting teeth and a misaligned bite:

• Teeth naturally shift.

Shifting can be a result of the normal changes time brings. The periodontal ligaments which attach our teeth firmly to the jawbone lose some of their strength; the jawbones which hold our teeth in place lose some of their density and begin to narrow. Our teeth also have a natural tendency to move toward the front of the mouth, a phenomenon called “mesial drift.”

Add all of these elements together, and your once straight teeth start to crowd together and even overlap—especially the front bottom teeth.

• Stressful habits stress your teeth.

If you habitually grind or clench your teeth, you’re putting pressure on them. Just like the gentle pressure of braces and aligners can shift teeth into alignment, the more uncontrolled force of grinding can push teeth out of alignment.  

• Losing a tooth affects surrounding teeth.

Nature abhors a vacuum, and so does your smile. If you lose a tooth, your other teeth will automatically start to drift into the space left open by the missing tooth.

• A neglected retainer is gathering dust in a drawer somewhere.

You might have spent time as a teenager in orthodontic treatment, with a beautiful smile to show for all your hard work. And, back in the day, your orthodontist no doubt let you know that you needed to keep wearing your retainer at night once your treatment was completed.

If that’s one healthy habit you abandoned as you got older, don’t be surprised if your teeth start to migrate back to their old, less-than-perfect positions.

Between normal biological changes and the wear and tear of daily life, you might find one day that your smile isn’t that same beaming smile you’re used to seeing in the mirror. And it’s not just an aesthetic concern.

Crooked teeth are harder to clean, and built-up plaque means more decay and gum disease. Shifting teeth can cause malocclusions, or bite problems, which can bring you jaw pain, headaches, and chipped or cracked teeth.

If your smile has changed over time, it’s time to give Dr. Kathleen Tavarez a call. There are many discreet options which can return your smile to you, including:

• Clear aligners—comfortable, removable, and often unnoticeable.
• Traditional braces—brackets are smaller than ever, and you can choose ceramic brackets which are color-matched to blend in with your enamel.
• Lingual braces—these braces are attached to the inside of the teeth, for complete invisibility.

And what if you’ve never been as confident in your smile as you wanted to be? There’s good news here as well—it’s never too late to see an orthodontist. Make an appointment at our Menlo Park or San Carlos, CA office to discover how you can make sure your smile looks just as young as you feel!