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Did you know that February is Gum Disease Awareness Month? 

Gum disease is a common dental issue that affects many people. Some signs of gum disease include bleeding when flossing, redness, and swelling. You can prevent gum disease by regularly brushing and flossing your teeth.

At our practice, we monitor oral hygiene at each appointment to spread awareness and educate patients. It’s important to note that gum disease has also been linked to other health issues, such as heart disease and diabetes. You can help prevent and treat gum disease by regularly brushing and flossing your teeth and having regular dental cleanings and check-ups. 

We look forward to seeing you soon and helping you achieve the healthiest and happiest smile! 

Traditional braces and oral piercings—does the inevitable meeting of metals pose any risks? Let’s look at some of the potential problems with oral piercings, and you and Dr. Kathleen Chan and Dr. Ivy Chen can decide if you should take a break from jewelry while you’re in treatment.

• Tooth Damage

Enamel is the strongest substance in our bodies, but when up against constant contact with metal? It’s not a fair fight.

Tongue piercings, especially, cause problems for your teeth. Whenever you speak or eat—even while you’re sleeping!—your tongue is making contact with your teeth. This continual tapping of metal on enamel can chip and crack teeth and damage fillings. A serious fracture could mean a root canal.

You’re getting braces to create a more attractive, healthy smile, so keeping your teeth intact is a priority.

• Gum Problems

Your gums are affected by orthodontic treatment. As the teeth move, the gums, ligaments, and bone around them adapt and even reshape over time. You might notice when you first get your braces, or when you go in for an adjustment, that you have a few days of swollen, sensitive gums afterward. You might also find that you are at greater risk of gingivitis, because it can be harder to keep plaque away from your gumline until you perfect your brushing and flossing skills.

Oral piercings bring their own gingival dangers. Jewelry in the tongue or lip can rub against gum tissue, especially around your lower front teeth. As the gum tissue continues to be irritated and inflamed, it pulls away from the teeth. This process is called gum recession.

Receding gums expose the tops of your roots to cavity-causing bacteria. They make you more sensitive to hot or cold foods. Pockets between gums and teeth can harbor infections that threaten the tooth itself.

Caring for your gums during braces is important for your dental health. Since people with oral piercings have a much higher rate of gum recession that those without, why add one more risk factor to your oral health?

• Metal vs Metal

Lip and tongue piercings can make contact with traditional brackets and wires, especially if you have a habit of playing with them. And let’s not forget lingual braces! Lingual braces are almost invisible because their brackets and wires are custom fitted to the back of your teeth. Whenever you speak or eat, you’ll be taking the chance that a tongue piercing will damage these custom-made appliances.

Dr. Kathleen Chan and Dr. Ivy Chen can tell you if your piercings are in any danger of interfering with your braces, but even if you’re planning on aligners, there are additional reasons to consider retiring your oral jewelry. Dental associations and medical associations discourage oral piercings because they can damage teeth and gums. And there’s more. Oral piercings can lead to swelling, bleeding, allergic reactions, infection, and nerve damage.

The reason you’re considering braces is because you want a healthy, attractive smile. Don’t let a tiny piece of jewelry make your life and your treatment more difficult! Do some research and talk to our Andover team about your oral piercings, and come up with a solution that’s best for your health and best for your smile.

Bite problems are so common that most of us know someone who’s worn braces. So perhaps you’re already familiar with the terms “overbite” and “underbite”—but if you’ve been diagnosed with an “overjet,” that just might be an orthodontic diagnosis that is new to you. If so, here are a few questions and answers to help promote overjet understanding.

Just what is an “overjet”?

An overjet is a type of malocclusion, which means that there’s a problem with your bite, 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. The key word here is “slightly.”

An overjet is a Class II malocclusion, which means that the upper front teeth project further beyond the lower teeth than they should. Overjets and overbites are both Class II malocclusions, and the words are often used interchangeably, but there’s a notable difference between the two conditions.

An overbite occurs when the top teeth overlap the bottom teeth too far vertically, and you can’t see as much of the lower teeth as you should when you bite down.

An overjet is considered more horizontal in nature, where the top teeth project at an outward angle toward the lips instead of pointing straight down toward the bottom teeth. This condition is sometimes called protruding or buck teeth.

What causes an overjet?

The reason for your overjet might be dental (caused by tooth alignment), or skeletal (caused by bone development), or a combination of both.

Overjets can run in families. They can also be caused by the size and position of your jaws and the shape and position of your teeth, all of which affect your bite alignment. But early oral habits, such as prolonged and vigorous thumb-sucking or pacifier use, can also contribute to overjet development.

How do we treat an overjet?

There are many types of treatment available. Dr. Kathleen Chan and Dr. Ivy Chen will recommend a treatment plan based on the cause and severity of your overjet. Because some treatments are effective while bones are still growing, age plays a part as well.

• Braces and Aligners

If you have a mild overjet, and minor dental issues are the main cause of the malocclusion, braces or clear aligners can effective.

• Functional Appliances

If the overjet 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 which can help correct an overjet. Some, such as the Twin Block and the Forsus Spring appliances, 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 malocclusion is skeletal in nature as well as dental, surgical treatment might be necessary to reshape the jawbone itself.

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

Why treat your overjet?

A serious, moderate, or even mild overjet can lead to many dental and medical problems, including:

• Concerns about facial and dental appearance
• Front teeth which are more at risk for injury
• Difficulty closing the lips
• Problems speaking or chewing
• Headaches, facial, and temporomandibular (jaw) joint pain

When you work with our Andover team to correct your overjet, you’re not just correcting a problem. You’re also creating something—a healthy, comfortable bite, and an attractive, confident smile. We can talk about general answers to your overjet questions, but when it comes to understanding your very individual smile, Dr. Kathleen Chan and Dr. Ivy Chen will have all the answers you need to make that healthy bite and that confident smile a reality! 

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 Andover 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. Kathleen Chan and Dr. Ivy Chen to discover how an individualized treatment plan and a custom appliance can give your child a healthy bite and a lasting smile.