Dental Braces Geelong
Activator Functional Appliance
The Activator is a growth-modifying appliance that is worn to promote lower jaw growth to achieve a balance between the jaws. This appliance is designed to improve facial harmony, when there is a discrepancy in the facial and jaw structure and has its greatest impact during a child's growth phase, especially around puberty. After you become accustomed to it, you will find it very comfortable to wear and will be able to speak without any difficulties. We will instruct you on how to wear it so that your orthodontic results are maximised.
Braces - Metal /Clear
Braces consist of four primary components. These are stainless steel bands, brackets, archwires and elastic or metal ties. Firstly there are stainless steel bands which encircle the back teeth or molars, and small brackets are placed on the other teeth.
These brackets and bands act like handles for the archwires which are the active third components that move and straighten the teeth.
The Orthodontist may change or adjust your archwires at each appointment to make sure they apply the proper force to guide teeth into their correct alignment.
The archwire is held tightly into the brackets on your teeth by elastic or metal ties, which are the fourth component. The braces are usually worn for approximately 18-24 months, depending on the amount of tooth movement required. Your co-operation with correct diet and oral hygiene is essential during this treatment to prevent decalcification (white spots) and decay from occurring. Our request to wear auxiliaries such as elastic bands, headgear, etc is extremely important to achieve the excellent result we are aiming for.
There are also self-ligating brackets available (Damon System). The Damon brackets have a built in "sliding door" which engages the wire to replace the use of elastic ligatures. The use of these brackets will be used at the Doctor's discretion for patients who require this prescription of bracket.
** Please note - Clear braces are available on the upper teeth only at an additional fee.**
Cantilever Bite Jumper (CBJ)
In the growing child who has a problem of facial disharmony associated with a small lower jaw it is possible to improve the balance of the jaws with a CBJ appliance.
In your orthodontic situation it is paramount to align the basic supporting jaw bone structure prior to final alignment of the teeth. The final orthodontic result will be greatly enhanced when the teeth, jaw structure, and facial profile are in harmony with each other.
Elastics
Virtually all patients wear elastic bands at some time during their treatment. The purpose of the elastic bands is to move teeth so the upper and lower teeth fit together correctly. Even though the teeth may be straight within each jaw, treatment isn't complete until the bite is locked in and the teeth fit together properly.
The elastic bands may be attached in many different directions and to achieve the desired results the elastic bands must be worn as prescribed and you must follow the instructions you receive regarding their placement and use.
The extra force of elastic bands will usually cause the teeth to be a little sensitive for a few days. The picture shows you one of many ways elastics are worn. When it is time for you to use them, we shall explain how they should be worn to achieve the best results.
Crowding
Extractions may be necessary in certain cases to alleviate crowding where there appears to be too many teeth for the jaw to support. Teeth usually removed are the bicuspid teeth (the fourth or fifth tooth from the front).
Extractions are most often symmetrical in nature, i.e. one from each side of the jaw. Occasionally unilateral extractions are necessary to treat midline discrepancies.
Prominent Teeth
Extractions may also be required when retraction of prominent front teeth is needed to reduce the appearance of "Buck Teeth". These are usually symmetrical in the number and provide the space into which the prominent front teeth may be moved.
Your Orthodontist will direct the number and which teeth need to be removed, to satisfy the case requirements and we will notify your Dentist accordingly.
Headgear (Cervical)
This appliance is used when we have diagnosed a difference in position and rate of growth between the upper and lower jaws, causing an incorrect bite with the upper jaw that is too far forward and prominent (buck) teeth. The headgear can also be utilised to "hold" the upper molar teeth back when teeth are removed to prevent the molars moving forwards and thereby "losing" this extraction space.
The headgear consists of a metal frame (facebow) with an inner and outer set of bows.
The inner bow inserts into an attachment on the bands cemented around the upper molar teeth and the outer bow sits along the outside of the cheeks. A neckstrap is attached to the outer arm on one side of the facebow, around the back of the neck and onto the other arm. It is the elastic neckstrap that provides the force to pull the upper teeth back, thereby creating space. The headgear is typically worn 12 - 14 hours per day (approximately 8 sleeping and 4 waking hours), but is not worn to school or social events.
Proper wear of the headgear will help ensure that the orthodontic treatment will be completed on time and with the best result possible.
Headgear (High Pull)
This appliance is used when we have diagnosed a difference in position and rate of growth between the upper and lower jaws, causing an incorrect bite with the upper jaw that is too far forward and prominent (buck) teeth.
The highpull headgear is designed to control not only the forward growth, but the downward growth of the top jaw. A headcap consisting of two material straps, sits over the head and attaches to the outer arms of the facebow with elastic bands.
It's the elastic that pulls from the headcap attachments that provides the force controling growth of the top jaw. The headgear is typically worn 12 - 14 hours per day (approximately 8 sleeping and 4 waking hours), but is not worn to school or social events.
Proper wear of the headgear will help ensure that the orthodontic treatment will be completed on time and with the best result possible.
Headgear (Reverse Facemask)
In some instances, it is necessary to wear a type of headgear that brings the upper jaw forward while holding the lower jaw back.
The usual indication for a facemask type of headgear would be a need to advance the upper jaw position by allowing its growth to express itself in a more forward direction.
This is also the headgear of choice when the growing patient shows a condition that is referred to as an underbite: that is, when closing, the upper front teeth are behind the lower front teeth.
In these instances it is important to encourage the forward growth of the upper teeth and jaw (hence, the forward direction pull for the facemask) in order to allow the correct overlap of the lower teeth. The facemask is typically worn 12 - 14 hours per day (approximately 8 sleeping hours and 4 waking hours), but is not worn to school or social events.
The reverse headgear is simple to use and comfortable to wear after a short adjustment period.
Hilgers (Pendulum) Appliance
The Hilgers appliance is utilised in treatment to correct the relationship of the upper and lower posterior (back) teeth with each other and at the same time creating space needed to move teeth into their proper position in the mouth, where minimal crowding is present.
This appliance is fixed to the upper teeth and active parts positioned on the posterior teeth with the express purpose of pushing these teeth into their correct position.
This appliance utilises the roof of the mouth and is bonded to the side teeth for support as the posterior (back) teeth are moved into their correct position. As the appliance is activated it also creates space to help the Orthodontist move those crowded teeth so the upper and lower teeth fit together correctly.
The Hilgers appliance is cemented in place and hence worn permanently for 6-9 months until the desired result is achieved. The active appliance may then be removed and replaced by a space maintainer to hold the corrected result or a second phase treatment consisting of braces may commence to detail tooth position.
Lower Lingual Fixed Appliance
When the mouth is in a transitory period where primary or baby teeth are being lost and replaced by erupting permanent teeth, a lower lingual arch is sometimes needed. This is used to hold or gain critical space and correct the position of the lower front teeth when severe crowding is evident.
This appliance serves to hold space in the back of the mouth when the permanent teeth replace baby teeth. It also serves to hold the lower front teeth in the correct position when baby teeth have been removed to make space for crowded front teeth.
If the lingual arch is not placed the front teeth have a tendency to drift backward and use the space that is being saved for erupting permanent teeth. This simple device is one of the main ways of gaining and maintaining space in the developing mouth.
The lower lingual arch consists of two bands cemented to the back molars and a wire that is soldered to the bands. The wire is bent into position and touches behind the lower front teeth preventing them from drifting. After a short adjustment period, the lower lingual arch is quite comfortable to wear.
Lower Removable Appliance
A removable appliance is a small orthodontic plate worn to correct early developing problems. It achieves the necessary tooth movement required by tipping teeth using springs, wires and expansion screws that push the teeth into their correct position.
The Orthodontist uses this appliance to guide your natural growth process. The appliance is generally worn all the time until otherwise directed.
There is generally a breaking in period with some slight discomfort as you start to get used to your plate, but after a day or two it will become part of you. Speech will be affected for a few days but will quickly return to normal.
Nance Button Appliance
During treatment we need to control the position of the upper back molar teeth. To achieve this we use a Nance button. This comprises metal bands that are cemented to the molar teeth with a wire structure originating from the palatal side of the bands, finishing in a button of plastic on the roof of the mouth.
This button uses the roof of the mouth as an anchor to hold back the molar teeth, thereby preventing them from drifting forward and maintaining valuable space.
This anchor also allows the front teeth to be retracted without the molar teeth moving forward.
Quad Helix
One of the symptoms of your orthodontic condition is a narrow upper jaw. The Orthodontist will use a Quad Helix appliance to widen your jaw by guiding your natural growth process.
The Quad Helix consists of two metal bands cemented to the upper molar teeth, with the activation coming from the four loops in the frame (hence the name "quad helix"). The appliance is expanded in size when inserted and cemented in the mouth and can be activated in the mouth by the Orthodontist.
The Quad Helix is designed to expand the back teeth and in doing so, also creates space. This may be sufficient to relieve any crowding that may present itself so that teeth fit together properly.
The Quad Helix is simple to use and comfortable to wear after a short adjustment period.
Rapid Maxillary Expander (RME)
This appliance is used where the upper jaw is too narrow and the relationship of the back teeth is reversed, with the lower teeth biting on the outside of the upper teeth.
Whilst you are still growing or at a stage where the bones of the body are still immature, it is possible to use a Rapid Maxillary Expander (RME) to guide the natural growth process to widen the jaw and in doing so, correct the relationship of the posterior teeth and at the same time creating space for us to straighten the teeth.
The RME's action utilises the fact that there is a seam that divides the upper jaw into two parts. This seam (suture) remains patent until it fuses after about the early twenties. The RME consists of metal bands placed and cemented around the back molar teeth. It uses specially designed screws to gently widen the seam in the upper arch by moving the two halves apart.
The appliance has a screw that is turned each day with a small key until the desired width is achieved.
The RME is simple to use and comfortable to wear after a short adjustment period.
Rapid Palatal Expander (RPE)
This appliance is used where the upper jaw is too narrow and the relationship of the back teeth is reversed, with the lower teeth biting on the outside of the upper teeth.
Whilst you are still growing, or at a stage where the bones of the body are still immature, it is possible to use an RPE to guide the natural growth process to widen the jaw and in doing so, correct the relationship of the posterior teeth and at the same time creating space for us to straighten the teeth.
The RPE's action utilises the fact that there is a seam that divides the upper jaw into two parts. This seam (suture) remains patent until it fuses after about the early twenties. The RPE consists of acrylic (plastic) coverage over the upper back teeth which uses specially designed screws to gently widen the seam in the upper arch by moving the two halves apart. The appliance is cemented and fixed in place and cannot be removed by the patient.
The appliance has a screw that is turned each day with a small key until the desired width is achieved.
The RPE is simple to use and comfortable to wear after a short adjustment period.
Retainers
When the braces are removed an impression of the teeth will be taken. Retainers are made from these impressions and are fitted to support the teeth in their correct position. The Retainers on your upper and/or lower teeth are monitored and adjusted for a period of 18 months, as outlined in your initial contract.
* It is the patient's responsibility to keep their teeth straight by wearing the retainers as instructed by their Orthodontist. Failure to do so may result in tooth movement, which may necessitate a remake of retainers and an extended retention period. This will incur an additional fee.
Retention is the most important part of treatment, as the bone must stabilise around the roots of your teeth so it can properly maintain and support the teeth in their new position.
There are many types of retainers, some removable and some fixed. At the end of your active treatment we shall select the retainer that will work best for you and we'll explain how they should be worn to achieve the best results.
Separators
Before we can place braces or other fixed appliances on your teeth we have to prepare them with separators.
Separators are small springs or elastics rings that are placed between the contact points of certain teeth to create a small amount of space so that bands, which are the metal rings can be fitted easily and comfortably and finally cemented into place.
These springs are placed in the mouth for around 5 - 10 days, or until enough space has been made. As the separators move the teeth slightly, they may feel a little bit tight and the teeth tender for a few days. You will need to make sure they stay in place by avoiding sticky and chewy foods such as chewing gum, toffees or sticky lollies and not flossing between the teeth where the separators are placed, as these can accidentally be displaced.
Splints
Splints are plastic appliances that cover either the upper or lower teeth, to provide relief to patients who are suffering Temporomandibular Joint symptoms. The splints take the upper and lower teeth out of contact with each other to allow the muscles of the face and jaws to relax and to work in harmony with the jaw joints.
Temporomandibular Joint Disorders (TMJ) often result when a disharmony occurs between chewing muscles, an incorrect bite and the jaw joint position. Providing splint therapy involves the establishment of correct muscle activity by overlaying the teeth with plastic. This is the most effective way of treating TMJ symptoms. Following splint therapy, which in most cases is palliative, further treatment may be necessary to establish a functionally correct bite with normal muscle and joint functions.
Surgery Options
surgery class II (a)
(a) pre-treatment
The illustration shows prominent upper teeth and a retruded lower jaw which appears deficient in the facial profile. The following images show the desired results of a single and two jaw surgery.
surgery class II (b)
(b) single jaw surgery
This case shows how the lower jaw is positioned forward surgically, improving both the way the teeth fit together and the facial profile.
surgery class II (c)
(c) two jaw surgery
Depending on where the skeletal discrepancy lies, it may be necessary to reduce the prominence of the upper jaw as well as advance the lower jaw to enhance the functional aspects of the way the teeth fit together as well as the facial profile.
surgery class III (a)
(a) pre-treatment
An orthodontic problem that gives the appearance of having too many teeth and not enough room for them.
surgery class III (b)
(b) single jaw surgery
The case shows how the lower jaw has been set back surgically. This improvement is manifested in a correct relationship of the front teeth and marked reduction in the lower jaw profile.
surgery class III (c)
(c) two jaw surgery
Depending on where the skeletal discrepancy lies, it may be necessary to advance the midface or top jaw as well as setting the lower jaw backwards to enhance the functional aspects of the way the teeth relate to each other and improve the facial profile and balance.
Tongue / Thumb Guard
Occasionally specific habits interfere with the normal eruption of the permanent teeth into their normal position in the mouth, resulting in prominent upper front teeth with a large horizontal space between the upper and lower front teeth.
These habits are generally a result of either finger or thumb sucking or an anterior tongue thrust where the tongue darts constantly between the front teeth especially when swallowing and this impedance prevents the teeth from assuming their normal position. If the habit is discontinued before the age of six, the condition generally resolves itself, but if it persists it needs to be treated.
A thumb guard can be either a fixed or removable appliance. The Orthodontist will decide which appliance is the best to suit the patients’ needs. The "habit appliance" is placed to discourage the digit from finding a "comfort position" so the symptoms either correct themselves or are treatable long-term. If active treatment is successful but the habit persists the condition will return.
Upper Removable Appliance (URA)
A removable appliance is a small orthodontic plate worn to correct early developing problems. It achieves the necessary tooth movement required by tipping teeth using springs, wires and expansion screws that push the teeth into their correct position.
The Orthodontist uses this appliance to guide your natural growth process. The appliance is generally worn all the time until otherwise directed.
There is generally a "breaking in" period, with some slight discomfort, as you start to get used to your plate, but after a day or two it will become part of you. Speech will be affected for a few days but will quickly return to normal.
