Our Blog

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. Trevor Bonilla. 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 Coppell, TX 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. Trevor Bonilla 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.

You might have been one of the lucky few born with perfectly straight teeth and a healthy bite. You might have spent months in orthodontic treatment as a teenager to achieve perfectly straight teeth and a healthy bite. But now that you’re growing older, you might be unhappily surprised to discover that your smile isn’t aging as gracefully as you are.  What’s changed?

That’s a trick question, because our bodies never stop changing, growing, and adapting. And these constant adjustments include the changes taking place in your teeth and mouth. You might begin to notice subtle differences in your smile when you’re in your thirties or forties. After young adulthood, several factors come into play which can cause shifting teeth and a misaligned bite:

• Teeth naturally shift.

Shifting can be a result of the normal changes time brings. The periodontal ligaments which attach our teeth firmly to the jawbone lose some of their strength; the jawbones which hold our teeth in place lose some of their density and begin to narrow. Our teeth also have a natural tendency to move toward the front of the mouth, a phenomenon called “mesial drift.”

Add all of these elements together, and your once straight teeth start to crowd together and even overlap—especially the front bottom teeth.

• Stressful habits stress your teeth.

If you habitually grind or clench your teeth, you’re putting pressure on them. Just like the gentle pressure of braces and aligners can shift teeth into alignment, the more uncontrolled force of grinding can push teeth out of alignment.  

• Losing a tooth affects surrounding teeth.

Nature abhors a vacuum, and so does your smile. If you lose a tooth, your other teeth will automatically start to drift into the space left open by the missing tooth.

• A neglected retainer is gathering dust in a drawer somewhere.

You might have spent time as a teenager in orthodontic treatment, with a beautiful smile to show for all your hard work. And, back in the day, your orthodontist no doubt let you know that you needed to keep wearing your retainer at night once your treatment was completed.

If that’s one healthy habit you abandoned as you got older, don’t be surprised if your teeth start to migrate back to their old, less-than-perfect positions.

Between normal biological changes and the wear and tear of daily life, you might find one day that your smile isn’t that same beaming smile you’re used to seeing in the mirror. And it’s not just an aesthetic concern.

Crooked teeth are harder to clean, and built-up plaque means more decay and gum disease. Shifting teeth can cause malocclusions, or bite problems, which can bring you jaw pain, headaches, and chipped or cracked teeth.

If your smile has changed over time, it’s time to give Dr. Trevor Bonilla a call. There are many discreet options which can return your smile to you, including:

• Clear aligners—comfortable, removable, and often unnoticeable.
• Traditional braces—brackets are smaller than ever, and you can choose ceramic brackets which are color-matched to blend in with your enamel.
• Lingual braces—these braces are attached to the inside of the teeth, for complete invisibility.

And what if you’ve never been as confident in your smile as you wanted to be? There’s good news here as well—it’s never too late to see an orthodontist. Make an appointment at our Coppell, TX office to discover how you can make sure your smile looks just as young as you feel!

Colorful elastic ligatures (the official name for those tiny bands around your brackets) are often replaced when you come in to have your braces adjusted. Which is great! Now you have the opportunity to go with your team colors, or your school colors, or tones that work with your skin and eyes, or shades that represent your favorite holiday season. Today’s bands come in a wide variety of colors, so you never need to worry about becoming bored with your choices.

But are there certain hues that can be a bit more challenging to work with. Let’s look at some of those trickier tones.

• Lunch Look-Alikes

If you don’t want kind friends constantly informing you that you have something stuck in your teeth, you might want to leave certain colors off your list. Dark greens and browns can sometimes give the appearance of food trapped in your braces. Have a look at the shades available, and see what is least likely to send you running for a mirror and a toothbrush.

• Smile Dimmers

A blazing white band might seem like a good match to your blazing white teeth, but for many people, really light colors can make teeth look more yellow. And often bands in shades of yellow can bring out any yellow in your enamel. If you’re looking for a brighter smile, try some darker, richer tones for a gleaming contrast.

• You’re So Over the Rainbow

If you are someone who loves a monochromatic look, perhaps any colors will be, well, just too colorful. In that case, there are ligatures for you! Silver or grey braces will blend with your metal brackets, and clear or tooth-colored bands will be less obvious with metal or ceramic brackets. Light colored bands can be more prone to staining, so keep that in mind if you’re going for invisibility or a close bracket match.

Now with all that being said, you be you! If you like a color, give it a go. It might be the perfect accessory for your smile and your personality. And, if it doesn’t work . . . no big deal! You can explore another part of the color palette on your very next adjustment to our Coppell, TX office.

When we think orthodontics, we commonly think teeth. Naturally! Straight teeth and a beaming smile are everyone’s orthodontic goal. But orthodontics is a field which specializes in more than misaligned teeth. While your beautifully aligned teeth are the visible outcome of your orthodontic work, a properly aligned bite is the foundation for your healthy smile.

A malocclusion occurs when the teeth and jaws aren’t properly aligned—they don’t fit together the way they should when the mouth is closed. A malocclusion, or bad bite, affects many people to some degree, but not always in exactly the same way. Some of the different types of malocclusion include:

• Crossbite

A crossbite occurs when upper teeth fit inside lower teeth. An anterior crossbite refers to the front teeth, with one or more upper front teeth, or incisors, fitting behind lower front teeth. A posterior crossbite affects the back teeth, with upper teeth fitting inside the lower teeth on one or both sides of the jaw.

• Crowding

When the jaw is small and/or the teeth are large, lack of space can result in crowded, twisted, or crooked teeth.

• Open bite

An anterior open bite means that the front teeth don’t close when biting down, leaving an open space between the upper and lower teeth. A posterior open bite occurs when the back teeth don’t make contact when the front teeth close.

• Overbite

Our upper front teeth naturally overlap the lower ones a small bit when the teeth are closed. An overbite occurs when the upper teeth significantly overlap the lower teeth.

• Overjet

When the upper front teeth protrude too far forward over the bottom teeth, it’s called an overjet, or, sometimes, buck teeth. Where an overbite causes a vertical overlap, an overjet takes into account the horizontal relationship of the teeth.

• Spacing

A jaw that is large, teeth that are small, missing teeth—these conditions can lead to gaps between the teeth.

• Underbite

An underbite results when the lower teeth and jaw extend further forward than the upper teeth and jaw, causing the bottom teeth to overlap the top teeth.

If you have a malocclusion, what comes next? This depends.

Some malocclusions are so minor that no treatment is necessary. Some are the result of misaligned teeth. Some occur because the upper and lower jaws are growing at different rates. Some are a combination of teeth and jaw misalignments. Some are caused by genetics, while others are caused by injuries or habits like prolonged thumb sucking or tongue thrusting.

Because malocclusions are so varied, your treatment plan will be designed for your specific needs. Braces, aligners, appliances like the Herbst® appliance or the palatal expander, surgery for severe malocclusions—there is a larger variety of treatment options than ever before to help you achieve a healthy bite.

When teeth and jaws don’t fit together as they should, the consequences can be damaged teeth and enamel, problems with the temporomandibular joint, headaches and facial pain, and difficulty chewing, eating, and speaking.

The good news is that early intervention for children can help correct teeth and jaw problems before they become more serious, leading to easier orthodontic care in the teen years, and helping to avoid the possibility of surgery or extractions. This is why Dr. Trevor Bonilla and our team recommend an orthodontic assessment at our Coppell, TX office for children around the age of seven.

If you’re an adult with concerns about your teeth or bite, there’s good news for you, too. Dr. Trevor Bonilla can devise a treatment plan to improve your bite and your smile no matter what your age.

Of course, despite our title, there’s really no such thing as a “common malocclusion” when we’re talking about your dental health. Each person—and each smile—is unique. Dr. Trevor Bonilla will diagnose your malocclusion and create a personalized plan carefully tailored to your exact needs, for an uncommonly attractive, confident, and healthy smile.