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When the time comes for Dr. Nicola Crichigno to remove your braces, it is very exciting. Unfortunately, it can be somewhat confusing, too, because you are faced with choosing between two kinds of retainers. Should you go with permanent, removable, or a combination of the two? It is always wise to follow Crichigno Orthodontics recommendations, but knowing more about the two types of retainer beforehand can be helpful.

Removable Retainers

Removable retainers offer the advantage of easy use: you will generally put a removable retainer in at night and take it out in the morning. Regardless of your retainer schedule, you'll be able to enjoy some time with no retainer. However, a removable retainer can easily be forgotten at times, and this means you won't be taking full advantage of teeth retention.

Another potential advantage of a removable retainer is that you can take it out and brush and floss your teeth with ease, which is more of a challenge with a permanent retainer. Although removable retainers can be very effective, they don't tend to be as effective as permanent retainers, especially if they are not used as directed.

Permanent Retainers

Permanent retainers are the clear choice for patients who want to “get it and forget it.” Once your permanent retainer is placed in your mouth, you won’t need to worry about daily retainer schedules, since it is permanently affixed to your teeth.

Because teeth begin to shift naturally as we age, a permanent retainer typically offers better long-term results for teeth straightening than a removable one. You can't forget to put it in — it's already there! Temporary retainers get lost or are forgotten on trips, and often fail to get used as often as they should be.

One drawback to permanent retainers is flossing. Some patients find it more difficult to floss with a permanent retainer, but we can show you effective ways to floss fairly quickly with your permanent retainer.

Some orthodontists may recommend a combination of the two; for example, a removable retainer for the top teeth and a permanent one for the lower ones because the lower teeth are smaller and tend to shift more.

Ultimately, the most important thing to remember is that wearing your retainer as directed is extremely important. As long as you follow our orthodontist’s advice, you will get the best results from your retainer, regardless of its type. If you’re still not sure whether the choice you’ve made is truly right for you, get in touch with us at our Stoney Creek location right away!

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. Nicola Crichigno. 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 Stoney Creek 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. Nicola Crichigno 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.

All over the Internet you'll find videos and articles showing how you can close the gap between teeth or space them out. There is a plethora of DIY orthodontic techniques out there — you can even mail order your own impressions to get clear aligners, without even seeing a dentist or orthodontist. Following the instructions laid out in these videos and articles (by people who have zero training in orthodontics) is about the worst decision you can make for your overall oral health.

Performing DIY or at-home orthodontia can lead to or cause:

• Loss of teeth
• Infection
• Cavities or infections that are missed or undiagnosed
• Gum damage

Dr. Christina Carter, president of the Northeastern Society of Orthodontists, says that DIY orthodontics can have terrible consequences. She spoke to TODAY about closing gaps between teeth using rubber bands or elastics:

"The teeth are connected to the gums and the blood supply and there is a risk of infection, of tearing the gums which might not heal properly, and a risk of damaging the attachment between the tooth and gums so the tooth no longer gets the support it needs." She also noted, "A simple rubber band can actually slide up the tooth and cut all the attachments to it and you can actually lose a tooth."

One of the worst parts about DIY orthodontics is that you never consult with a trained orthodontist, so you're really operating on a dangerous lack of information. It's best not to risk damage to your teeth or infection. Let Dr. Nicola Crichigno know what you want to accomplish with your teeth and we will help you find the safest and most cost-effective way to achieve it.

Dr. Nicola Crichigno want you to be informed and practical about your oral health. Should you have any questions about orthodontic treatment options, please do not hesitate to give us a call at our convenient Stoney Creek office.

You’re in the band and you’re getting braces. Now what? If you are a member of the string or percussion sections, you can go back to rehearsal. You’re good to go. When your talents have seated you in the reed or brass sections, though, a little adjustment might be necessary to keep your instrument and your braces working in harmony.

If you play a wind instrument, you know the term embouchure—the way you position and use your lips, tongue, facial muscles, and teeth to produce the sound you want. Depending on the instrument you play, you might be completely unaffected when you get your braces, or you might need to develop a more comfortable embouchure to accommodate them.

Wires and Woodwinds?

If you play a wind instrument such as the flute or piccolo, you might find that your normal lip positioning or blowing angle is affected by your braces, but usually the adjustment time is fairly short. Reed instruments such as the saxophone, clarinet, oboe, and bassoon are considered some of the easiest to adjust to when you have braces, but even though the single and double reed mouthpieces don’t require as much pressure as brass instruments, there can still be an adjustment period. One thing you should look out for is more condensation in your mouthpiece or instrument—be sure to keep your instrument clean to keep your sound pure.

Brackets and Brass?

Brass instruments require mouthpiece pressure. This leaves your lips pressed between the mouthpiece and your braces. For this reason, many brass players have a more challenging adjustment when wearing braces. Smaller mouthpieces (trumpet, French horn) usually require more pressure than larger ones (tuba, trombone). It’s important to learn how to use technique to avoid cuts, irritation, and other injuries caused by the pressure of your braces against your lips. Learning to play with less pressure on the lips and more air control and breath support will help you to recover your tone and range of notes while protecting your lips and mouth.

How Can We Help?

Let Dr. Nicola Crichigno know if you play, or plan to play, a wind instrument. We might be able to offer some suggestions. For regular metal and ceramic braces, some musicians find extra wax is helpful in preventing lip and cheek injuries. There are brace guards available that can be applied over the braces to protect your lips and mouth if wax doesn’t do the trick.

There are also alternatives to regular bracket-and-wire braces, depending on your orthodontic needs, cost factors, and length of treatment. Invisalign® devices fit smoothly over your teeth and can even be removed when it is time to practice or play, as long as you get the necessary hours of wear in per day. In some cases, lingual braces, where the brackets and wires are placed behind the teeth, might be the best choice for you.

Finally, don’t forget to talk to your music instructor. Don’t be dismayed if you find the quality of your playing has been affected. Your teacher might have valuable suggestions for adjusting your embouchure, playing with less pressure on the lips, and developing better air and breath support. You might need to shorten your practice time at first, and there might be another period of adjustment after your braces come off.

Above all, take care of yourself! If something is poking your lip or cheek, call our Stoney Creek office immediately before it causes injury. It might be difficult at first, but finding an embouchure that works for your comfort and technique is worth it. And remember, these temporary fine-tunings will lead to a wonderful coda: skilled musicianship and a beautiful, healthy smile. Bravo!