Functional appliances

Functional appliances are removable or irremovable appliances used for correction of malocclusion.

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How do they work?

While correcting malocclusion functional appliances help patient to keep lower jaw in forced front position.

Types of functional appliances

There are many types of functional appliances. Most commonly used are Andresdeno and Twin Block appliances.

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When do functional appliances being used?

Usually functional appliances are being used during the period of the intensive growth, around 12 – 14 years. After the intensive growth period removable functional appliances are not useful (mostly because of lack of co-operation from the patient) and irremovable appliance is recommended to use. See Herbst appliance

Is treatment of teeth allowed when using functional appliance?

Yes, it is. If after the treatment it becomes difficult to put the appliance back on, contact your orthodontist immediately – new adjustments might be needed.

Is it painful?

It might feel uncomfortable for the first 3 to 5 days. If pain is intense pain reducing medications might be prescribed.

Later on teeth adopt to traction but if you decide to quit using the appliance because of the initial discomfort the adjustment will be the same as at the beginning.

How long do you have to wear the appliance?

It is recommended to keep it on for 12 to 14 a day (or more): 8 hours during sleep and 4 to 6 hours during day. If used for less time the appliance is ineffective and won’t provide good results. Average active wear of the appliance is 1,5 years.

Can you eat when wearing the appliance?

It is recommended to remove the appliance before meal.

Does the appliance impact the speech?

The appliance must be removed when talking because fixated appliance doesn‘t allow the lower jaw to move freely and prevents tongue from taking a correct position inside of the mouth.

How to take care of teeth while wearing the appliance?

The same way as you do normally – remove the appliance before brushing teeth.

Remember:

  • keep appliance in a special box and keep it away from pets;
  • remove the appliance before playing active games – you might get injured;
  • if the appliance doesn’t fit contact your orthodontist. Quitting to wear the appliance makes you lose the result that is already achieved;
  • bring your appliance to the next doctors’ visit – doctor will check it and will make an adjustments if needed.

Contact your orthodontist immediately if:

  • pain and discomfort lasts more than 5 days after the appliance was put on;
  • appliance doesn’t fixate or falls out during sleep time;
  • supporting hooks of the appliance got bended;
  • cheeks and lips are constantly scratched.

Herbst appliance

Herbst appliance is irremovable orthodontic device that corrects malocclusion.

The Herbst appliance is used with those patients who are diagnosed with the lower jaw in a backward position (i.e., small lower jaw).

 

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How does it work?

Functional appliance helps patient to keep the lower jaw shifted forward and changes the position of jaw and teeth.

When does Herbst appliance is used?

Treatment with the Herbst appliance is typically applied during the intensive growth period between ages 12 and 14, as well as with adult patients. The Herbst appliance is an alternative to orthognathic surgery, especially if a patient doesn’t want to change their facial appearance and only correct the occlusion.

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Is treatment of teeth allowed when using appliance?

Appliance doesn’t interfere with the treatment of teeth, it is being fixed on four teeth with standard metal crowns.

Is it painful?

It might feel uncomfortable for the first 3 – 5 days. If pain is intense medications might be prescribed. Crowns’ locks might scratch gums but small sores will heel on its own. It takes abut a week to get used to the appliance.

How long does the appliance need to be worn?

Active wear takes 8 to 12 months. After the appliance has been removed the decision about further orthodontic treatment is made.

How to eat while wearing the appliance?

It is recommended to avoid eating hard food, such as nuts, toasted bread etc. When opening your mouth very wide appliance might fall out. If it happens – try to put it back in yourself or contact your orthodontist. Appliances is activated by special rings – if ring gets lost contact your orthodontist immediately for repeated activation.

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Forsus appliance

It is a spring loaded appliance used for pushing upper teeth backwards and lower teeth forward to correct malocclusion.

Appliance is fixed on the bottom wire and upper molar teeth rings. Treatment with Forsus appliance is combined with treatment with braces. Forsus effect on teeth position is very significant because the appliance is being fixed onto braces. In some cases, lower front teeth lean forward and it becomes difficult to correct side occlusion into correct one.

How does it work?

Functional appliance helps patient to keep the lower jaw shifted forward and changes the position of jaw and teeth.

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In what cases Forsus appliance is used?

Treatment with the Forsus appliance is typically applied during the intensive growth period between ages 12 and 14, as well as with adult patients. Appliance is perfect for treating simple and intermediate class II malocclusion problems. In rare cases, when more serious malocclusion problems are diagnosed, Herbst appliance is chosen as a priority.

Is treatment of teeth allowed when using appliance?

In order to start treatment, appliance needs to be loosened up and orthodontic wires that connect braces need to be removed.

Is it painful?

It might feel uncomfortable for the first 3 to 5 days. If pain is intense medications might be prescribed. Locks from crowns might scratch gums but small sores will heel on its own. It takes abut a week to get used to the appliance.

How long does the appliance need to be worn?

Active wear takes 6 to 8 months. After the appliance has been removed the decision about further orthodontic treatment is made.

How to eat while wearing Forsus?

It is recommended to avoid eating hard food, such as nuts, toasted bread etc. When opening your mouth very wide appliance might fall out. If it happens – try to put it back in yourself or contact your orthodontist. Appliance is activated by special rings – if ring gets lost contact your orthodontist immediately for repeated activation.

External stretcher

The appliance is used to create an extra space for permanent teeth in the upper jaw by pulling molar teeth back and to correct simple malocclusion problems.

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How long does the appliance need to be worn?

It is recommended to keep it on for 12 to 14 a day (or more): 8 hours during sleep and the rest of the time during day. If used for less time the appliance is ineffective and won’t provide good results. Active wear of the appliance is 6 to 12 months.

Is it painful?

It might feel uncomfortable for the first 3 to 5 days. If pain is intense pain reducing medications might be prescribed. Later on teeth adapt to traction but if you decide to quit using the appliance because of the initial discomfort the adjustment will be the same as at the beginning.

Can you eat when wearing the appliance?

It is recommended to remove the appliance before meal.

How to take care of teeth while wearing the appliance?

The same way as you do normally – remove the appliance before brushing teeth.

Remember:

  • when removing the appliance detach stretcher module first then carefully pull metal band out of ring locks. Removing appliance not carefully it can brake and even injure;
  • remove the appliance before playing active games – you might get injured;
  • bring your appliance to the next doctors’ visit – doctor will check it and will correct or change the stretching if needed;
  • if appliance falls out during sleep – contact your orthodontist immediately.

Contact your orthodontist immediately if:

  • pain and discomfort last more than 5 days after the appliance was put on;
  • appliance falls out;
  • appliance band got bent;
  • rings from molar teeth brake or get loose;
  • cheeks and lips get scratched constantly.