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Analyzing strong points, looking for potential problems, making comparisons—it’s bracketology time! Nope, not basketball (although we hear they have something similar), but a brief analysis of your orthodontic options when it comes to choosing a winning bracket.

If you’re getting braces, you’re probably already familiar with how they work—brackets are bonded to the teeth to hold an archwire, which provides gentle, controlled pressure to move the teeth into alignment. But within that basic bracket-and-wire system, there are several different bracket designs available to you at our Philadelphia, PA orthodontic office. Let’s see what the scouting report has turned up on our final four, pointing out their distinct advantages as well as some potential mismatches.

Traditional metal brackets

Advantages:

• Traditional braces with metal brackets are effective for more than just straightening teeth. They can be used to correct rotated teeth, differences in tooth height, and bite problems. For severe bite and alignment problems, traditional braces are most often the right choice.
• Metal construction makes these brackets able to handle the controlled pressure needed to treat serious malocclusions.
• Cost-effective. These are usually the least expensive option.

Potential Disadvantage:

Clear/Ceramic Brackets

Advantages:

• Lack of visibility! Whether you go for clear brackets or brackets tinted to match your enamel, you’ll be keeping a low-profile with this choice.
• Stronger and more stain-resistant than ever before, using the latest in ceramic, porcelain, or plastic materials.

Potential Disadvantages:

• Not as durable. Unlike metal, these clear brackets can crack or break. If you play a contact sport, these might not be for you.
• Some ceramic brackets are larger than other choices, so might be recommended only for the top teeth.
• Clear or tinted brackets can be more expensive.

Self-Ligating Brackets

Advantages:

• These brackets use a clip or trapdoor mechanism to hold your archwire without the need of bands. Ceramic options are available if you want an even more discreet appearance.
• Can be more comfortable with less friction between wire and bracket.

Potential Disadvantages:

• Self-ligating braces are generally more expensive.

Lingual Braces

Advantages:

• Lingual braces use metal brackets, but they attach to the back of each tooth for almost invisible bite correction.
• Custom-made. Lingual brackets can be designed and fabricated to fit your individual teeth perfectly.

Potential Disadvantages:

• Trickier to clean because of their placement behind teeth.
• Might not be suitable for a deep bite if there’s not enough clearance between top and bottom teeth.
• Initial discomfort caused by the tongue’s contact with the braces when you speak and eat.
• Custom-made brackets are more expensive.

So that’s a brief rundown of your bracket choices. But, unlike sports bracketology, there are no losers here! Dr. Joseph Brogan can give you the pros and cons of each bracket design, so you can make an informed decision based on the kind of braces which will work best for you. With coaching like that, no matter which bracket option you choose, the final result is the same—a winning smile!

Some experiences are great, and we look forward to enjoying them again and again. Others have wonderful outcomes, but you feel no need for a sequel. If you’re wondering whether you need to revisit orthodontic treatment, you’re probably in this second group.

After all, you put in your time as a teenager. All those days in bands and braces, all the adjustments, all that cleaning with little tiny tools in little tiny places. That was a lot of work, and you reaped the rewards of your conscientious orthodontic habits with beautifully aligned teeth and a healthy, comfortable bite.

But now you’ve started to notice that your teeth aren’t quite as beautifully aligned, or your bite’s not quite as comfortable. So, what’s happened? Let’s look at some possibilities, and whether a return to the orthodontist’s office is in order.

• You’ve Lost a Tooth

If you’ve lost a tooth because of injury or decay, that gap is an open invitation for surrounding teeth to move in to fill the void. Whenever you lose a tooth, consider an implant. Implants function, look, and maintain healthy spacing just like natural teeth.

One thing implants can’t do? Move like our own teeth will during orthodontic treatment. Your natural teeth can move because they are held in place within the bone by flexible periodontal ligaments. Implants, on the other hand, are anchored directly to the bone for stability.

If you’re considering new or further orthodontic work and want to replace a lost tooth with an implant, it’s a good idea to talk to Dr. Joseph Brogan to discover the best timing and scheduling for your procedures.

• You’ve Gained a Tooth

Problems with your alignment can also arise if you add a tooth or teeth. If you’re in your late teens or early twenties, wisdom teeth could be in your near future. And a new tooth can throw off the spacing and alignment of your existing teeth.

Talk to Dr. Joseph Brogan about your options if your wisdom teeth are about to make an appearance, and if it looks like your tooth and bite alignment might be affected.

• You’re Getting Older

Our teeth naturally tend to shift as we age. Teeth move forward, causing crowded or crooked front teeth—especially on the lower jaw. There’s even a medical term for this phenomenon: mesial drift. While we don’t know exactly why this drifting occurs, we can treat it.

Adults make up a large—and growing—segment of orthodontic patients. If your teeth have lost their ideal alignment over time, a visit to our Philadelphia, PA office is a great way to bring your youthful smile back. And you’ll probably find your treatment much shorter and more comfortable than it was decades earlier!

• You Haven’t Been Wearing Your Retainer

Remember that word “conscientious” in the second paragraph? You need to wear your retainer conscientiously, for as often and for as long as recommended by Dr. Joseph Brogan.

If you’ve been ignoring a damaged retainer, or you keep forgetting to look for your lost retainer, or you have a perfect, undamaged retainer sitting unworn on your dresser, your teeth can start to shift out of their hard-won alignment within a short time.

Does this mean it’s back to months of bands and adjustments and appointments? Maybe not! See us as soon as you notice any changes in your teeth or bite. When caught early, shifting teeth can be treated much more easily.

What can we do to help you regain your best smile? A lot!

• Treatment Planning

When you need to accommodate implants, wisdom teeth, or other dental work which could affect your tooth alignment, Dr. Joseph Brogan can work with your dentist to make sure your alignment isn’t disturbed in the process. They can also map out a treatment schedule which coordinates your other procedures with any orthodontic treatment.

• Retainer Evaluation/Adjustment

Your retainer is probably a passive retainer, meaning it keeps your teeth in place instead of moving them. If you notice your alignment shifting, or if your retainer is uncomfortable when you try to put it on after a lapse in nightly wear, ask us about a replacement.

• Active Retainers

An active retainer helps move teeth into alignment rather than simply keeping them in place. A new active retainer might be just what you need to correct a slight shift.

• Aligners or Braces

If you have some serious shifting going on, we might recommend a second round of treatment with clear aligners or braces. But there’s good news here, as well! Treatment to correct an orthodontic relapse usually takes less time than it did originally, and treatment options are more comfortable and less noticeable than ever before.

Talk to Dr. Joseph Brogan about an orthodontic sequel if you have any concerns about changes in your bite or alignment. You might need only a simple retainer adjustment or a short time in clear aligners or traditional braces to make your smile its best and healthiest once again. And this time, remember to wear your retainer to make sure there’s no need for Orthodontics—Part III!

You’ve worked hard for your attractive, healthy smile, and now you’re making sure it stays attractive and healthy by wearing your retainer. Since wearing a retainer is usually a matter of years, not months, it’s natural to wonder just how long you can count on that retainer to help you maintain your smile.

That answer depends on the type of retainer you get at our Philadelphia, PA office. A Hawley retainer, a clear retainer, and a fixed wire retainer have different lifespans. Because they each have their own advantages, Dr. Joseph Brogan will recommend the retainer that’s right for protecting your individual smile.

So let’s look at the average lifespan for different retainers, and, equally important, some of the common mishaps that can shorten that working life.

The Hawley Retainer

This is the retainer most people picture when they think “retainer.” Made of wire securely attached to an acrylic base, the Hawley retainer keeps the teeth in place, and can even be adjusted, if needed, to improve alignment. They generally last anywhere from three to ten years.

How can you make sure your Hawley retainer keeps working for you as long as possible?

• Keep it in its case. While some damages to these retainers can be repaired, why take a chance? And it’s much harder to lose a retainer if it’s in its case as opposed to, say, a cafeteria napkin.
• Keep it away from your pet. Dogs, especially, are tempted by the taste and smell of saliva, but there are safer, less expensive chew toys out there.
• Keep wearing it. Without your retainer, your teeth can shift. Over time, not only will your retainer fail to fit anymore, but you might need to return for further orthodontic treatment. If you notice your retainer is starting to feel uncomfortable, give your orthodontist a call.

The Clear Retainer

Clear retainers look like clear aligners, and, like clear aligners, are almost invisible. Made of vacuum-formed plastic, they’re designed for a close, comfortable fit, often around the entire arch of your teeth. Also like clear aligners, these retainers aren’t made to last forever. If they become loose, warped, or cracked, they should be replaced. With care, they can last from six months to several years. How to protect them?

• Protect your retainer from damage. Keep it in its case when you’re not wearing it. You’ll avoid losing it, and you’ll avoid damaging it.
• Protect it from teeth. And we don’t just mean pets, although they find clear retainers yummy, too. If you grind your teeth, your retainer can suffer. Clear retainers are not the same thing as night guards, so talk to your orthodontist for recommendations.
• Protect it from heat. Hot surfaces like ovens or heaters, hot dashboards, washers and dryers, even very hot drinks can be a problem. (You should only be drinking water while you wear your clear retainer, so that particular issue shouldn’t arise!)

The Fixed Retainer

A fixed retainer is a small piece of wire that is custom-fit and bonded to the back of specific teeth to prevent any movement from occurring. Because it’s bonded to the inside of the teeth, a fixed retainer is completely invisible when you speak or smile. It can last five years, ten years, and in some cases, even longer. Even though you won’t be exposing this retainer to external dangers like hungry pups or the wash-and-rinse cycle, there are still some situations to watch for:

• Watch your diet. The same sticky, crunchy, or hard foods that can damage brackets and wires can also loosen a fixed retainer.
• Watch your dental hygiene. While cleaning around a bonded retainer can be a bit challenging, not cleaning around it can result in plaque and tartar buildup—and your retainer might have to be removed to clean your teeth.
• Watch for changes. If your teeth start to shift, it could mean your retainer has detached from one or more teeth. Ask your dentist to check the retainer’s bond whenever you have a checkup.

So, how long will that retainer last? Depending on the kind of retainer you have, if you don’t keep it in its case, or if you don’t watch your diet, or if you expose it to heat, the answer is—not nearly long enough. Dr. Joseph Brogan will give you the very best tips to keep your retainer clean, safe, and working for as long as possible. Now, it’s up to you!

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. Joseph Brogan. 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 Philadelphia, PA 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. Joseph Brogan 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.