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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 Murfreesboro, TN 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. Pack to discover how an individualized treatment plan and a custom appliance can give your child a healthy bite and a lasting smile.

You’re biting into something delicious, and, Ouch! You bite into something you didn’t mean to—the inside of your tender cheek.

Painful moments like this happen every now and again. But if you find that more frequent cheek biting means that you’re extra-cautious when eating or speaking, if you wake up with sore cheeks in the morning, or if you catch yourself gnawing on your cheeks during the day, it’s time to see Dr. Pack.

Causes of Cheek Biting

Many of us experience the occasional cheek chomp when we’re eating or talking. No fun! Besides the pain, a bite can cause broken skin, inflammation, a canker sore, or a cyst. Luckily, the discomfort from these accidental bites generally resolves after a few days.  

Sometimes, though, biting becomes a more frequent annoyance. Regular bites can be caused by several conditions. One of the most common?

• Orthodontic Misalignment

If you notice that you seem to be biting your cheek a lot when eating or speaking, it could be an orthodontic problem. When your teeth or jaws don’t align properly, if your mouth is small in proportion to your teeth, or if your teeth have shifted over time, your cheeks can feel the consequences! Dr. Pack can help you discover if a misaligned bite is the source of your biting problems.

But it’s not just orthodontic problems which can cause painful cheek bites. Other causes can include:

• Bruxism

Bruxism is a medical term for tooth grinding. If you clench or grind your teeth as you sleep, it’s hard on your teeth and on your jaws. And for some people, that nightly gnashing causes cheek biting as well.

• Wisdom Teeth

Most of us don’t have the room to welcome four new—and large—teeth. As the wisdom teeth come in, they can cause bites, especially if they erupt leaning outward toward your cheeks. They can also push your other teeth out of place.

Treatment Options

Why visit our Murfreesboro, TN orthodontic office? A one-time bite can be extremely uncomfortable, and might lead to inflammation or a sore spot inside your mouth. Usually, these reactions fade in a short while.

But what about continuous biting? Regular biting injuries can lead to bigger problems. Tissue can get thicker or erode. Scar tissue can build up inside the mouth. Ulcers and other sores can become larger and more painful.

If you’ve been biting your cheeks more often, your orthodontist can diagnose the cause and offer you treatment options depending on the reason for this frequent biting:

• Orthodontic Treatment

Orthodontic treatment can improve tooth and bite alignment—and can eliminate those painful cheek bites if misalignment is what’s causing them. Today’s orthodontics offers more options than ever before, for both adults and kids.

• Traditional braces are more effective—and more subtle—than ever, with brackets which are smaller or come in clear and ceramic styles.
• Clear aligners are a convenient, almost invisible way to treat misalignment with a series of trays which gradually improve alignment with each new set.
• Lingual braces are attached to the back of the teeth, so there are no visible brackets and wires.
• Functional appliances can improve and correct bite issues which braces or aligners alone can’t treat as effectively.

Whatever the reason for painful cheek biting, you deserve to eat and speak and enjoy your day without constant “Ouch!” moments affecting your comfort and health. If these moments are happening all too often, visit our Murfreesboro, TN office for the answers to your biting problems.

Orthodontists do everything they can to save teeth, but sometimes, a tooth is so damaged by accident, injury, infection, or decay that extraction is the only option. Or perhaps your child’s wisdom teeth are starting to come in—and starting to cause problems. Or, when this is the healthiest alternative, an extraction might be necessary for orthodontic reasons.

While there are several possible reasons an extraction might be necessary, one thing is true for any extraction: you want to make sure that your child is as comfortable as possible and heals as quickly as possible after the procedure.

Aftercare and recovery time isn’t exactly the same for every extraction. Whether your child’s tooth is a baby tooth or a permanent one, whether it’s a single tooth or several, whether it’s erupted or impacted, whether a local anesthetic or sedation is recommended—these factors and more can make a difference in recovery time.

Dr. Pack will provide you with clear, specific instructions for helping your child to a speedy recovery after an extraction. We’d also like to offer you some general aftercare ideas to make sure your child is as comfortable as possible while recovering.

• Bleeding

Some bleeding is normal after an extraction. Follow your dentist or oral surgeon’s instructions carefully to minimize bleeding at the extraction site. Your child will probably need to keep a gauze pack in place for as long as directed to reduce bleeding and to help a clot form. If bleeding is heavier than expected or goes on longer than expected, call our Murfreesboro, TN office.

• Swelling

Swelling is a normal response to extractions. Your dentist might suggest cold compresses to help reduce swelling immediately after the extraction. If you don’t have an ice pack, ask whether a bag of frozen peas or corn can substitute.

With any cold compress, it’s important to protect your child’s skin from injury. Follow your dentist’s suggestions for application and be sure not to exceed the time limits recommended. And don’t apply a compress directly to your child’s face—wrap a towel or cloth around the bag or pack to protect the skin.

• Careful Cleaning

The area around the extraction shouldn’t be disturbed or touched. The blood clot that forms after an extraction protects the area from irritation and infection caused by food particles and bacteria. If a clot is dislodged accidentally, it can lead to a condition called dry socket, which can be very painful.

This means no brushing near the extraction site, and no heavy rinsing or spitting for as long as directed. If your child is younger, you might need to help with brushing over the days following to make sure those sturdy bristles don’t get close to the extraction site before it’s healed.

• Soothing Foods

Have a supply of your child’s favorite comfort foods handy while healing, such as cream soups, mashed potatoes, scrambled eggs, gelatin, yogurt, and smoothies. Hot and cold foods can be irritating, so stick to cool or lukewarm foods for the first few days. Encourage your child to drink lots of liquids, but nothing carbonated. And do wait until any numbness wears off before giving your child chewable foods to avoid biting tongue or cheeks.

Remove spicy favorites from the menu, which can be irritating, as well as chewy, crunchy, or jagged foods like crackers, since tiny, sharp bits of food can make their way inside the site. Remind your child to chew on the side of the mouth opposite from the extraction site. And, since suction is an all-too-easy way to dislodge the clot over the extraction site, no straws!

• Schedule Recovery Time

Make sure your child rests and takes it easy after the procedure. Exercise, lifting, even bending over can dislodge a protective clot, so re-schedule any physically demanding sports and activities until your child is given the dental all clear.

• Medication

If your child has been given a prescription for pain medication or antibiotics, follow the instructions as directed. Dr. Pack might recommend age-appropriate over the counter pain relievers to have on hand. For severe or continuing pain, call your orthodontist or oral surgeon right away.

• Coordinate Dental Schedules

Orthodontic extractions, if needed, will be scheduled into your child’s orthodontic treatment plan. Treatment can begin or resume when the extraction site has healed.

If an emergency extraction is necessary, call our Murfreesboro, TN office so we can be aware of the situation and can coordinate with your child’s dentist or oral surgeon to keep treatment on track as much as possible.

An extraction can be worrying for both patient and parent, so talk to your orthodontist for the best ways to make this experience a positive one for your child before, during, and after treatment.

Just like that, it’s almost summertime. As the spring season ends, perhaps these lighter, brighter days are inspiring you to do a bit of last-minute spring cleaning. Or perhaps they’re not. No judgment here!

What Dr. Pack can recommend wholeheartedly is finishing the season with a clean, sparkling smile. And we have some bright ideas for you!

Refresh Your Cleaning Technique

Tooth brushing can become so automatic that we don’t think about the basics anymore. And suddenly, we’ve finished brushing in half the time we used to, and, hey, how long has that floss been sitting on the counter, anyway?

Now that you’re in orthodontic treatment, it’s more important than ever to keep your teeth their cleanest:

• Plaque acids can strip minerals from your teeth. If you don’t clean around your brackets thoroughly, plaque buildup can leave discolored spots on your enamel.
• If a cavity develops, treatment could require removing part of your braces. This means extra appointments and a delay in your orthodontic schedule.

So, let’s review the brushing basics for a clean and healthy smile.

• Spend two minutes brushing, at least twice each day. Dr. Pack might suggest brushing after every meal to make sure food doesn’t stick to your teeth and braces.
• Make sure you reach all the surfaces of your teeth, inside, outside, and on top of your molars.
• Use short, gentle brush strokes, covering a tooth or two at a time.
• Angle your brush to clean along the gum line. Plaque around the gums leads to irritation and inflammation, and is a common cause of gum disease.
• Use vertical strokes to clean the inside of your front teeth.
• Floss at least once each day, or as recommended by your orthodontist.

Special Jobs Require Special Tools

Since we’re tidying up, let’s talk about some helpful cleaning tools. The right tools make removing plaque a lot easier.

• Toothbrushes

There are toothbrushes designed especially for braces, with angled heads, longer handles, and different bristle arrangements. Whether you try a new design, or stick with your old favorite, replace your brush whenever necessary.

After three to four months of brushing, your toothbrush bristles start to break down. Frayed and matted bristles can’t clean as effectively as a toothbrush in top shape. Electric toothbrush heads can wear down more quickly because they often have shorter bristles. Each change of season is a good time to remind yourself to change brushes.

Extra tip: Buy a brush with soft bristles. Even medium bristles can cause enamel abrasion.

• Floss Upgrades

If you wear braces, check out the floss options made just for you. Floss threaders help you thread floss under wires. Or try floss which comes in pre-cut strands with a stiff tip to thread the floss through wires more easily. You might find that an orthodontic flosser, a small piece of floss attached to a thin plastic handle, is the easiest way to clean between your teeth. Experiment until you find your most convenient and effective floss.

• Interproximal Brushes

These tiny cone-shaped brushes fit snugly and comfortably between the spaces of your teeth to remove plaque.

• Water Flossers

Water flossers are high-tech tools that use a pulsing stream of water to clean between and around the teeth. They’re particularly helpful if you have traditional or lingual braces.

Your Dr. Pack can suggest the best tools for the cleanest teeth. And speaking of your dental team . . .

Some Cleaning Jobs Require Professional Help

Wearing braces doesn’t mean you should skip cleanings—in fact, it’s more important than ever to make sure that all the plaque that has built up around brackets and wires is removed. Your hygienist knows how to work with your braces for an effective and braces-friendly cleaning.

Spring’s coming to an end, but taking care of your dental health is always in season! A clean smile isn’t just a more confident smile, it’s a healthier one. Talk to our Murfreesboro, TN team for more tips to create your best and brightest smile at any time of year.