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Whenever we bite down, we’re applying force with our jaw muscles. Functional appliances direct these forces to create healthier tooth and jaw alignment. They’re used to help correct bite problems and to encourage symmetrical jaw growth.

Functional appliances aren’t always necessary. Because every child’s teeth and bite are different, orthodontic treatment at our Redlands, CA office is carefully tailored to your child’s individual needs.

• For the child with minor tooth misalignment, traditional braces or aligners might be all that’s needed.
• For the child with a minor malocclusion, or bite problem, an orthodontist might use elastics (rubber bands) to bring teeth into healthy alignment.
• For the child who has a more serious malocclusion, involving both tooth and jaw alignment, an orthodontist might recommend a functional appliance.

A severe Class II malocclusion can be caused when the upper jaw or teeth are positioned too far forward, and/or the lower jaw is too small or positioned too far back. Common Class II malocclusions include:

• Open bite—the front teeth don’t touch when the back teeth bite down, or the back teeth don’t touch when the front teeth close.
• Overbite—some overbite is normal. A deep overbite occurs when the upper teeth significantly overlap the lower teeth.
• Overjet—the upper front teeth protrude further horizontally than they should.

Today’s functional appliances come in a variety of designs to treat Class II malocclusions. They can be fixed or removable. They can be used with or without braces. Some are designed to expand the upper palate to make sure there’s room for all the permanent teeth. What they all do is advance the position of the lower teeth and jaw to create a healthier, more comfortable bite.

Fixed devices are attached to the teeth and meant to be used full-time. These include the Forsus™ device, the Herbst® appliance, and the MARA appliance.

• Forsus Device

This appliance works with braces. A spring coil rod is most often attached to bands on the first molars on the upper jaw. It’s then connected to the arch wire on the lower jaw. Just like elastics—but more effective!—these spring coil rods provide gentle forward pressure that encourages the lower jaw and teeth forward.  

• Herbst Appliance

The Herbst appliance also applies forward pressure to the lower jaw using telescoping rods connecting the upper and lower teeth. The rods expand as the mouth opens, and telescope together as it closes, positioning the lower jaw further forward while the upper jaw is held back. The Herbst can be worn alone or with braces, and can also be used to expand the upper palate.

• MARA Appliance

The MARA (Mandibular Anterior Repositioning Appliance) uses an adjustable “elbow” piece connecting bands on upper and lower molars to guide the lower jaw and teeth forward when the jaw closes.

Removable appliances such as Bionator and Twin Block appliances can also improve Class II malocclusions. They are meant to be worn for a specific number of hours each day, and can be taken out for sports or other activities as needed. Because it’s essential to get all the necessary hours in, removable appliances require commitment!

• Bionators

A bionator is made of wire and acrylic, and it looks a lot like a retainer. The wire fits around the upper front teeth. It’s attached to a smooth piece of acrylic that sits behind the upper teeth and is shaped to guide the lower jaw forward when biting down. The bionator can also be adjusted to expand the upper palate.

• Twin Block Appliance

The twin block appliance uses two separate pieces made of wire and smooth acrylic. Both pieces are modeled to fit precisely over the upper and lower arches. The acrylic “blocks” fit over the biting surfaces of the teeth, working together like a 3D puzzle. When your child bites down, the upper blocks slide into place behind the lower blocks, pushing the lower jaw and teeth forward. The top plate can also be adjusted to expand the upper palate if needed.

Because these appliances are best used while a child’s bones are still growing and developing, dentists and orthodontists recommend an orthodontic evaluation by age seven. Early treatment with a functional appliance can help correct serious bite problems before or together with braces. In some cases, functional appliances may reduce the need for headgear or surgery.

Todays’ orthodontic technology has made functional appliances more comfortable and efficient than ever before. Talk to Dr. Byron Diehl to discover how an individualized treatment plan and a custom appliance can give your child a healthy bite and a lasting smile.

Your beaming smile makes a sunny day even brighter—and that sunny day can return the favor! How does the sun affect your dental health? Let’s shine some light on the subject.

You may have heard how important calcium is to your body. Over 99% of the calcium in our bodies is used to form teeth and bones, providing strength and structure to the hardest parts of the body. But that’s not the only task on the calcium to-do list. Calcium is also necessary for:

• muscles to work
• nerves to carry messages
• blood to deliver nutrients and oxygen
• the release of hormones

When we don’t get enough calcium in our diets, our bodies start to draw the calcium they need for these critical functions from our teeth and bones. Over time, a severe calcium deficiency can lead to teeth that are brittle, or more vulnerable to decay, or loose due to weakened bone density in the jaw.

Keeping up with your calcium is especially important when you’re wearing braces or aligners. Calcium helps protect you from tooth decay and gum disease, which could delay your treatment. And you want your jaw bones strong and healthy as the bone tissue reforms and then stabilizes around your teeth as they move to their new, ideal positions.

We can get the calcium we need from a balanced diet. Dairy products are our most common source of calcium, and several servings of milk, cheese, or yogurt each day supply most of our needs. If dairy’s not on your menu, though, you can get calcium from other foods like broccoli, kale, collard greens, canned salmon, or sardines. Because calcium is so essential to our health, many foods are fortified with it, including fortified juices, bread, cereals—even tofu!

But there’s a snag here, and it’s a big one. We can’t really benefit from our careful consumption of calcium without the help of vitamin D. If calcium is the doorway to strong teeth and bones, vitamin D is the key which unlocks all of calcium’s benefits.

Without enough vitamin D, our bodies can’t absorb and make use of calcium. However, getting enough of this essential vitamin can be a problem. While we can get most of the vitamins we need from a balanced diet, there aren’t a lot of foods which are naturally rich in vitamin D.

So, how do we get this vital vitamin? The original option comes from nature.

• Sunlight

Vitamin D is called “the sunshine vitamin” because of the unique chemical reaction which creates it. When the ultraviolet B rays of the sun reach special cells in our skin, they convert cholesterol in these cells to a basic form of vitamin D. These vitamin molecules travel through the body, picking up hydrogen and oxygen molecules in the liver and kidneys to become active vitamin D.

Since sunlight exposure is easy, available, and free, it seems like a simple solution to getting the vitamin D we need.

But we’ve understandably moved away from the days of basking in the sun for hours at a time. Over-exposure to UV rays damages the skin, causing premature aging and, worse, a much greater risk of skin cancer. If you enjoy time in the sun, talk to your doctor about safe sun exposure, which can depend on the part of the country you live in, the time of year, and your individual skin type.

And, if you need to avoid sun exposure, there are other opportunities for getting the vitamin D you need.

• Diet

While there aren’t a lot of foods which are naturally rich in vitamin D, there are still a few options on the menu. Oily fish like salmon, tuna, and herring—and old-fashioned cod liver oil—are good sources of the vitamin. But most of us don’t live on a strict fish diet!

Instead, we can get the vitamin D we need from fortified foods. Vitamin D is commonly added to cow’s milk, soy milk, orange juice, and cereals to make sure the calcium in our diet is working effectively to keep our teeth and bones strong. Check out nutritional labels to discover whether your favorite grocery products contain vitamin D. And don’t forget to choose foods that are braces-friendly, as well!

• Supplements

For hundreds of years, people who lived in climates and cities without a lot of sunshine suffered from the effects of vitamin D deficiency. Diseases like rickets, where the teeth and bones don’t form properly, were common in children. Adults who couldn’t absorb enough calcium suffered from weak teeth and bones.

Today, depending on age, allergies to sun or food products, dietary choices, and health conditions, some people are still at risk for vitamin D deficiency. If you’ve been diagnosed with this deficiency, your doctor might recommend a vitamin D supplement. (It’s important to take any supplement as directed, because taking too much vitamin D can be harmful, too.)

So, which form of vitamin D is best? Fortified foods? Supplements? Or is it that radiant original source—the sun? No need to worry. With any form of vitamin D, you’re getting the key you need to unlock the benefits of the calcium in your diet—for healthy teeth and bones before, during, and after your treatment at our Redlands, CA orthodontic office. Your sunny smile will thank you!

Orthodontists do everything they can to save teeth, but sometimes, a tooth is so damaged by accident, injury, infection, or decay that extraction is the only option. Or perhaps your child’s wisdom teeth are starting to come in—and starting to cause problems. Or, when this is the healthiest alternative, an extraction might be necessary for orthodontic reasons.

While there are several possible reasons an extraction might be necessary, one thing is true for any extraction: you want to make sure that your child is as comfortable as possible and heals as quickly as possible after the procedure.

Aftercare and recovery time isn’t exactly the same for every extraction. Whether your child’s tooth is a baby tooth or a permanent one, whether it’s a single tooth or several, whether it’s erupted or impacted, whether a local anesthetic or sedation is recommended—these factors and more can make a difference in recovery time.

Dr. Byron Diehl will provide you with clear, specific instructions for helping your child to a speedy recovery after an extraction. We’d also like to offer you some general aftercare ideas to make sure your child is as comfortable as possible while recovering.

• Bleeding

Some bleeding is normal after an extraction. Follow your dentist or oral surgeon’s instructions carefully to minimize bleeding at the extraction site. Your child will probably need to keep a gauze pack in place for as long as directed to reduce bleeding and to help a clot form. If bleeding is heavier than expected or goes on longer than expected, call our Redlands, CA office.

• Swelling

Swelling is a normal response to extractions. Your dentist might suggest cold compresses to help reduce swelling immediately after the extraction. If you don’t have an ice pack, ask whether a bag of frozen peas or corn can substitute.

With any cold compress, it’s important to protect your child’s skin from injury. Follow your dentist’s suggestions for application and be sure not to exceed the time limits recommended. And don’t apply a compress directly to your child’s face—wrap a towel or cloth around the bag or pack to protect the skin.

• Careful Cleaning

The area around the extraction shouldn’t be disturbed or touched. The blood clot that forms after an extraction protects the area from irritation and infection caused by food particles and bacteria. If a clot is dislodged accidentally, it can lead to a condition called dry socket, which can be very painful.

This means no brushing near the extraction site, and no heavy rinsing or spitting for as long as directed. If your child is younger, you might need to help with brushing over the days following to make sure those sturdy bristles don’t get close to the extraction site before it’s healed.

• Soothing Foods

Have a supply of your child’s favorite comfort foods handy while healing, such as cream soups, mashed potatoes, scrambled eggs, gelatin, yogurt, and smoothies. Hot and cold foods can be irritating, so stick to cool or lukewarm foods for the first few days. Encourage your child to drink lots of liquids, but nothing carbonated. And do wait until any numbness wears off before giving your child chewable foods to avoid biting tongue or cheeks.

Remove spicy favorites from the menu, which can be irritating, as well as chewy, crunchy, or jagged foods like crackers, since tiny, sharp bits of food can make their way inside the site. Remind your child to chew on the side of the mouth opposite from the extraction site. And, since suction is an all-too-easy way to dislodge the clot over the extraction site, no straws!

• Schedule Recovery Time

Make sure your child rests and takes it easy after the procedure. Exercise, lifting, even bending over can dislodge a protective clot, so re-schedule any physically demanding sports and activities until your child is given the dental all clear.

• Medication

If your child has been given a prescription for pain medication or antibiotics, follow the instructions as directed. Dr. Byron Diehl might recommend age-appropriate over the counter pain relievers to have on hand. For severe or continuing pain, call your orthodontist or oral surgeon right away.

• Coordinate Dental Schedules

Orthodontic extractions, if needed, will be scheduled into your child’s orthodontic treatment plan. Treatment can begin or resume when the extraction site has healed.

If an emergency extraction is necessary, call our Redlands, CA office so we can be aware of the situation and can coordinate with your child’s dentist or oral surgeon to keep treatment on track as much as possible.

An extraction can be worrying for both patient and parent, so talk to your orthodontist for the best ways to make this experience a positive one for your child before, during, and after treatment.

You’re biting into something delicious, and, Ouch! You bite into something you didn’t mean to—the inside of your tender cheek.

Painful moments like this happen every now and again. But if you find that more frequent cheek biting means that you’re extra-cautious when eating or speaking, if you wake up with sore cheeks in the morning, or if you catch yourself gnawing on your cheeks during the day, it’s time to see Dr. Byron Diehl.

Causes of Cheek Biting

Many of us experience the occasional cheek chomp when we’re eating or talking. No fun! Besides the pain, a bite can cause broken skin, inflammation, a canker sore, or a cyst. Luckily, the discomfort from these accidental bites generally resolves after a few days.  

Sometimes, though, biting becomes a more frequent annoyance. Regular bites can be caused by several conditions. One of the most common?

• Orthodontic Misalignment

If you notice that you seem to be biting your cheek a lot when eating or speaking, it could be an orthodontic problem. When your teeth or jaws don’t align properly, if your mouth is small in proportion to your teeth, or if your teeth have shifted over time, your cheeks can feel the consequences! Dr. Byron Diehl can help you discover if a misaligned bite is the source of your biting problems.

But it’s not just orthodontic problems which can cause painful cheek bites. Other causes can include:

• Bruxism

Bruxism is a medical term for tooth grinding. If you clench or grind your teeth as you sleep, it’s hard on your teeth and on your jaws. And for some people, that nightly gnashing causes cheek biting as well.

• Wisdom Teeth

Most of us don’t have the room to welcome four new—and large—teeth. As the wisdom teeth come in, they can cause bites, especially if they erupt leaning outward toward your cheeks. They can also push your other teeth out of place.

Treatment Options

Why visit our Redlands, CA orthodontic office? A one-time bite can be extremely uncomfortable, and might lead to inflammation or a sore spot inside your mouth. Usually, these reactions fade in a short while.

But what about continuous biting? Regular biting injuries can lead to bigger problems. Tissue can get thicker or erode. Scar tissue can build up inside the mouth. Ulcers and other sores can become larger and more painful.

If you’ve been biting your cheeks more often, your orthodontist can diagnose the cause and offer you treatment options depending on the reason for this frequent biting:

• Orthodontic Treatment

Orthodontic treatment can improve tooth and bite alignment—and can eliminate those painful cheek bites if misalignment is what’s causing them. Today’s orthodontics offers more options than ever before, for both adults and kids.

• Traditional braces are more effective—and more subtle—than ever, with brackets which are smaller or come in clear and ceramic styles.
• Clear aligners are a convenient, almost invisible way to treat misalignment with a series of trays which gradually improve alignment with each new set.
• Lingual braces are attached to the back of the teeth, so there are no visible brackets and wires.
• Functional appliances can improve and correct bite issues which braces or aligners alone can’t treat as effectively.

Whatever the reason for painful cheek biting, you deserve to eat and speak and enjoy your day without constant “Ouch!” moments affecting your comfort and health. If these moments are happening all too often, visit our Redlands, CA office for the answers to your biting problems.