Double Duty

February 1st, 2023

If you play a contact sport, you know about mouthguards. You know about the cushioning protection they provide for your teeth. And not just your teeth—mouthguards also help protect your lips, tongue, and jaw, helping you avoid or minimize many of the injuries caused by collisions.

But you don’t have to be part of the defensive line or face off on center ice to wear a mouthguard. It pays to be proactive with your oral health in any activity where impact is a possibility. Whether you play a team sport, practice gymnastics, ride a bike, ski, skateboard, or participate in other athletic pastimes, there’s almost always the risk of impact—with a ball, with the mat, with the sidewalk, with another person.

So, how do mouthguards protect your teeth and mouth? It’s a combination of materials and design. Mouthguards are made of a strong, cushioning material such as plastic or silicone which helps absorb and distribute the force of impact, usually in the form of a horseshoe-shaped piece which fits over your upper teeth. The specific design can be tailored to the sport or activity you’ll be using it for.

And now that you’re wearing braces? Working toward an attractive, healthy smile doesn’t mean you can’t be active or find a mouthguard which will work for you. In fact, when you wear braces, mouthguards do double duty—they protect your mouth and teeth, and they protect your braces, too!

Even minor impacts can damage wires and brackets, and damaged braces means more time at the orthodontist and lost treatment time. More important, your guard not only helps protect your brackets and wires from impact injury, it protects your delicate mouth tissue from trauma caused by impact with your brackets and wires.

Because you probably have braces on both upper and lower teeth, the usual mouthguard design might not work for you. To make sure you’re completely protected, you may need a guard which covers both upper and lower arches.

There are over-the-counter mouth guards designed for braces, and even for covering both your upper and lower teeth. These might be one-size-fits-all or fit-it-yourself guards, or models which should be used only after a fitting at our Hanover, NH orthodontic office. While some of these guards are better than others, the best option for your teeth—and your braces—might be a custom mouthguard.

What are the benefits of a custom guard for orthodontic patients? They:

  • Provide a perfect fit around teeth and braces
  • Protect better because they fit better
  • Are designed for easy breathing and speaking
  • Are less bulky
  • Are more durable
  • Fit more comfortably
  • Can accommodate orthodontic adjustments
  • Can be tailored to your specific sport or activity.

Custom mouthguards are more expensive, because they are individually crafted for your teeth and braces, but in terms of effectiveness, they are the best guards out there—because they are individually crafted for your teeth and braces. If cost is an issue, Dr. Donald Neely can let you know whether an over-the-counter option might work for you.

An active life should mean proactive dental care. Wearing a mouthguard when you’re wearing braces protects both your body and your orthodontics. Whichever guard option you choose, it’s a good idea to check out the fit with Dr. Donald Neely to make sure you’re getting all the protection you need for both when your mouthguard is doing double duty.

The Herbst® Appliance

January 25th, 2023

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. Donald Neely. 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 Hanover, NH 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. Donald Neely 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.

Bells and Whistles for Your Bristles?

January 18th, 2023

Modern dentistry has made the most of today’s technological innovations. And we’ve come a long way from the fraying sticks our ancestors used as toothbrushes.

On the other hand, while it’s a lot better than a fraying stick, the manual toothbrush model you’ve used for years might be ready for an upgrade. Should you take this opportunity to try out some new technology offering all the bells and whistles? Let’s answer that question by asking a few more questions.

Happy with your manual brush?

If you like your manual toothbrush and it’s doing the job, by all means, stick with it. But even your old familiar brush can evolve:

  • There are lots of bristle options, but soft bristles are almost always the way to go. Medium and hard bristles can be too abrasive for your enamel.
  • Heads come in a variety of sizes, so make sure the head size is comfortable. You want to be able to maneuver to reach every tooth surface, which a too-large brush head just can’t do.
  • Try a different handle shape if you’re having trouble maneuvering and keeping a firm grip.
  • Change your brush regularly. Brushes are effective for about three months before the bristles start to fray and breakdown. This is a good opportunity to experiment with different brands and styles.

Does your old brush suit your current needs?

Different types of manual toothbrushes are available for effective and comfortable brushing when you need options that a typical brush doesn’t provide:

  • Special orthodontic toothbrushes are designed with bristles trimmed to fit around brackets and wires and smaller heads to reach into tight places.
  • For those with mobility issues, brushes with larger or easy-grip handles make cleaning more comfortable.
  • Brushes with extra-soft bristles are available if you have enamel erosion or sensitive gums.
  • Because many women find their gums become especially sensitive during pregnancy, there are brushes designed especially for moms-to-be.

Is it time to go electric?

If you haven’t tried an electric toothbrush before, you might find that getting braces is a great reason to give one a spin.

  • Electric toothbrushes can outperform manual models. A dedicated brusher might manage hundreds of brushstrokes for each minute of brushing, while an electric brush can provide thousands. If, despite your regular brushing, you have plaque build-up, an electric brush might be a good alternative to your manual brush.
  • Models are available which can alert you when you’re brushing too hard—which is important for your enamel if you’re a heavy-handed brusher.
  • If you tend to *think* you’ve brushed for the recommended two minutes, but have *actually* brushed 32 seconds, some electric brushes come with timers!
  • There are tapered electric orthodontic brush heads designed just for people with braces.
  • Electric brushes have bigger handles and can be easier to grip.

Is your current brush doing the job?

So, should you stick with the familiar toothbrush that’s worked for you all these years, or take this opportunity to try out some new technology that offers all the bells and whistles? The answer is clear: the right brush for you is the one that works!

If your regular checkups show that plaque is under control, you’re doing just fine with the brush in hand. If you or Dr. Donald Neely notice plaque buildup, it’s time to consider making some changes. Whether it’s a question of tools, techniques, or time spent brushing, your Hanover, NH dental team has the answers you need for state-of-the-art dental hygiene.

Retainer Hacks

January 11th, 2023

Even with the best of care, accidents can happen, and your retainer, unfortunately, is not immune. Of course, you need to visit our Hanover, NH office ASAP if your retainer is damaged, but, in the meantime, there are some strategies you can use to help your teeth—and your retainer—stay as healthy as possible while you wait.

For Removable Retainers

  • When you notice any damage to your removable retainer—remove it.

Don’t wear a damaged retainer, especially overnight. You don’t want to damage it further, and you do want to avoid the possibility of choking if a retainer breaks while you’re sleeping. Dr. Donald Neely and our orthodontic team are experts when it comes to deciding if your retainer is wearable, so always consult an expert before putting a suspect retainer back in your mouth.

  • Damaged Hawley retainer?

If you have a Hawley retainer—the traditional wire retainer—here’s some good news: a Hawley retainer can often be repaired if it’s not damaged too badly. Don’t try to fix your retainer yourself, and bring it into our office as soon as possible to see if it’s fixable.

  • Damaged clear retainer?

If you have a clear retainer, let’s start with the bad news: A clear retainer is not a repairable retainer. Cracks, breaks, warping—these injuries mean that a new retainer is in your future.

The good news is that materials for plastic retainers are available that are more durable than ever. This might be a good option for you to check out, especially if you suffer from bruxism, or tooth grinding, which can be very hard on clear retainers.

  • When you’ve just finished treatment with clear aligners . . .

It’s worth asking if your last tray can sub for your retainer until you have it repaired or replaced.

  • Ask us about over-the-counter mouthguards.

While you wait for a retainer repair/replacement, your teeth are at risk of shifting out of alignment. A customizable OTC mouthguard might reduce the chance of shifting, although it’s definitely not a long-term solution! We can let you know if this temporary fix is worth it.

For Fixed Retainers

If the wire retainer bonded to your teeth becomes loose, or if you notice your teeth shifting, you might need a repair or a replacement. This is a job for us. In the meantime,

  • When you have a broken wire . . .

If a broken wire is causing discomfort, check to see if you should flatten it or cover the wire tip with dental wax to protect soft tissues. Warm water rinses can ease irritation.

  • When your wire is broken or loose . . .

Stay away from chewy, sticky, and crunchy foods. You should be doing this anyway with a fixed retainer to keep it from becoming detached—and if it’s already loose, no need to make it more so!

  • Ask us about over-the-counter mouthguards.

Check to see if an OTC, customizable mouthguard is a good idea to keep your teeth from shifting if you can’t visit Hanover Orthodontics right away.

We started off by saying that accidents can happen even with the best of care. So you can imagine what can happen without the best of care. Keep your retainer in its case, keep it away from heat, don’t eat foods that can harm your retainer—all the precautions that make accidents unlikely to happen.

But if something awful befalls your retainer, call our Hanover, NH office right away. Why aren’t we suggesting ways to fix your broken retainer with the supplies you have in your home toolbox? Because the best life hack of all for someone with a damaged retainer is to leave the fixing to a dental professional.

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