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Orthognathic surgery is surgery to correct a wide variety of abnormalities of our patients' jaw and teeth. The surgery is often done in conjunction with orthodontic treatment. While the patient’s appearance may be significantly improved as a result, the primary purpose of the surgery is to correct functional problems including but not limited to:

• Unbalanced facial appearance
• Protruding jaw
• Open bite (upper and lower teeth don’t overlap properly
• Excessive wearing down of the teeth
• Difficulty with chewing or biting
• Chronic mouth breathing
• Sleeping problems such as sleep apnea
• TMJ pain (jaw joint pain)
• Restoring facial injuries

Knowing when to start the orthodontic treatment in preparation for orthognathic surgery can also be tricky if our team at Hoppens & Meier Orthodontics is treating a teenager. It is important to know when to get started. If orthodontic treatment is initiated too soon and the teenager is still growing, the patient will either need to hold in braces until his or her growth is complete and they are ready for surgery or the braces will have to be removed and then placed again when growth is complete. Neither of these options is attractive since it requires longer time in treatment, which is something all our patients want to avoid. Our team at Hoppens & Meier Orthodontics strives to get all patients finished with treatment as quickly as possible because it is healthier for the teeth and gums and gives them a beautiful smile to enjoy for a lifetime.

If you are considering orthognathic surgery or you have been told that you need jaw surgery, give us a call to schedule your initial consultation today. Dr. Bradley Hoppens and Dr. Mary Beth Meier and our team at Hoppens & Meier Orthodontics will explain our treatment plan in a way you will understand and we will keep you informed every step of the way.

August 22 is National Tooth Fairy Day! If the Tooth Fairy is a treasured part of your child’s life, you’re just in time to celebrate! But what to do when the Tooth Fairy doesn’t arrive on schedule—when baby teeth stay longer than expected or are lost too soon? 

A baby’s 20 baby teeth tend to come in within a fairly predictable time frame. The bottom central incisors in the very front of your baby’s mouth typically make their appearance first, when your baby is around six to ten months old. Over the next few years, the remaining incisors, canines, and first molars arrive. Last on the scene are the second molars, which usually show up between the ages of 23-33 months. 

Just as baby teeth follow a pattern coming in, they tend to follow the same pattern falling out. The front teeth begin to wiggle and loosen around age six or seven, while the last of the baby teeth, the canines and second molars, are often lost between the ages of ten and 12. 

Baby teeth fall out as the adult teeth below them push up as they erupt. The top of the new tooth puts pressure on the root of the baby tooth, gradually dissolving it. As the root grows smaller and can’t anchor the tooth, the tooth begins to wiggle and eventually becomes loose enough to fall out. This leaves the adult tooth perfectly placed to grow into its proper position.

Sometimes, though, teeth linger far past their fall-out date. Sometimes, because of decay or trauma, they are lost much too early. In either case, Dr. Bradley Hoppens and Dr. Mary Beth Meier can provide treatment to protect little smiles now and to ensure that there’s space for the permanent teeth to erupt and align correctly.

Teeth Which Overstay Their Welcome

If that baby tooth never gets wiggly, the team at Hoppens & Meier Orthodontics can help! When baby teeth stubbornly hang on, adult teeth can erupt behind them, creating a double row of teeth commonly known as “shark teeth.” These permanent teeth can become crowded or misaligned as they try to fit in any space available. Or a baby tooth can block an adult tooth from erupting at all. When that baby tooth just isn’t budging, an extraction will create space for the permanent tooth to erupt.

Extracting a baby tooth is generally a straightforward procedure because primary teeth have very small roots. Your child’s dental team at Hoppens & Meier Orthodontics are experts in helping you prepare your child for the procedure in a gentle, reassuring, and age-appropriate way. 

Often, a local anesthetic is all that’s necessary for a simple extraction, but if you feel sedation would better fit your child’s needs, discuss sedation options with your dentist. After the extraction, you’ll be given clear information on how to deal with pain and swelling, which foods and drinks are best while the extraction site heals, and how to protect the area.

Teeth Which Exit Too Early

In the case of decay or trauma, your child’s dentist will do everything possible to save the tooth. When decay is so extensive that there’s not enough structure left to hold a filling or crown, or when there’s an infection in or around the tooth, or when an accident or injury has caused serious damage, extraction might be the healthiest option. Depending on your child’s age, further treatment might be needed afterward to protect future smiles. 

Besides their roles in eating and speaking, baby teeth save space for permanent teeth. If remaining baby teeth shift, taking up part of the empty space left behind by the lost tooth, the adult teeth below won’t have the space they need to align properly as they arrive. Permanent teeth could come in at an awkward angle or erupt in the wrong spot. 

To prevent these problems, your dentist might recommend that your child visit an orthodontist for a space maintainer. Space maintainers are small, custom-designed appliances which keep the remaining baby teeth in place. This prevents neighboring teeth from shifting to fill the empty spot and ensures that there’s enough room for the adult tooth to arrive right on schedule and right where it belongs. 

It’s comforting to have charts which let us know when little teeth will typically come in and when they will typically fall out. But unexpected events might mean teeth overstay their welcome or depart too soon. When the Tooth Fairy can’t keep to her schedule, schedule an appointment at Hoppens & Meier Orthodontics in McCook, North Platte, or Ogallala as soon as possible to make sure your child is on track for a future of healthy smiles.

Congratulations! You’ve done the hard work necessary to create your beautiful smile! You’ve carefully completed all the steps needed to reach the end of your orthodontic journey. Well, nearly all the steps. We can’t forget that last step which will ensure that all your hard work is rewarded.

When you first began orthodontic treatment, Dr. Bradley Hoppens and Dr. Mary Beth Meier decided on the best plan for straightening your teeth and perfecting your bite, whether you wore traditional braces, lingual braces, aligners, or other orthodontic appliances. And now that you’re finishing treatment, there’s one more option to consider—your retainer.

Why do I need a retainer?

While you’ve spent time in treatment, more has changed than just the position of your teeth. The periodontal ligament, the connective tissue that connects the teeth to the jawbone, is stretched as the teeth shift. The bone in your jaw changes, too, reforming and rebuilding around the roots of your teeth as they move to their ideal locations.

These changes happen because your braces or aligners apply gentle, constant pressure to move your teeth. When you’ve finished wearing these appliances, the pressure stops. Ligaments will try to return to their original shape, which can shift teeth back toward their old positions. And the rebuilding bone isn’t dense enough yet to stop teeth from shifting due to the normal, everyday pressures of eating, chewing, and smiling.

A retainer prevents your teeth from moving back, or “relapsing,” by giving your bones and ligaments time to stabilize and rebuild. The process takes months, so keeping your teeth in place as bones rebuild and grow denser is crucial. This is especially important for patients with more serious misalignments. Dr. Bradley Hoppens and Dr. Mary Beth Meier will let you know which kind of retainer will be best for you and just how long you’ll need to wear your retainer.

Are there different kinds of retainers?

There are! Retainers can be removable or fixed, visible or nearly invisible, metal, plastic, or metal and plastic. Three of the most popular retainer options include:

• Hawley Retainers—the traditional removable retainer, which uses a molded acrylic plate with wires attached to keep your teeth properly aligned and to hold your retainer in place.
• Clear Plastic Retainers—a removable retainer made of custom vacuum-formed plastic, which fits over the teeth like a clear aligner.
• Fixed Retainers—a small single wire bonded to the back of specific teeth, which holds them in place and prevents any movement.

Dr. Bradley Hoppens and Dr. Mary Beth Meier will let you know whether a removable or fixed retainer is best for making sure your teeth don’t start to relapse, and fill you in on the benefits and care of each type of retainer.

How long do I need to wear a retainer?

There’s no standard answer to this question. Just like your retainer is custom-built to fit your individual teeth, the amount of time you’ll spend in that retainer depends on your individual needs. Retainers might be worn fulltime for months or years, be worn only at night after several months of daily wear, or be worn long-term to make sure your orthodontic work lasts.

Because you’ve done the hard work already, and your beautiful, healthy smile is the result. Talk to a member of our McCook, North Platte, or Ogallala team about which retainer option will be best for making sure that this smile lasts a lifetime.

So, you just got your braces on, and you're wondering why you should continue visiting your general dentist since you’re seeing Dr. Bradley Hoppens and Dr. Mary Beth Meier every other month. Patients always ask us if they should continue to see their dentist while in orthodontic treatment. In short, the answer is yes.

Today, we thought we would share a few reasons why it’s crucial to keep up with your regular visits with your dentist in addition to coming in for your regular adjustments at Hoppens & Meier Orthodontics.

One of the best reasons to visit your dentist while you undergo orthodontic treatment is to remove plaque and tartar. Having braces provides additional nooks and crannies in which food particles and bacteria can hide. Eventually, plaque and tartar can form around your brackets, bands or other appliances which can lead to cavities. Having your teeth professionally cleaned can help ensure most, if not all, plaque and tartar is removed. Even if you are undergoing clear aligner treatment, dental checkups and cleanings are equally as important.

The next reason to visit a dentist is to help protect your teeth from decalcification, or the loss of calcium in your teeth. A potentially serious condition in which white spots on your tooth surfaces, decalcification is irreversible and if left untreated, can lead to cavities. Decalcification is preventable; patients who cut down on sugary sweets and acidic foods, practice good oral hygiene, and visit their dentist regularly can help prevent decalcification.

The final reason we recommend visiting your dentist while you have braces is this: cavities can prolong your treatment. If you are interested in completing your orthodontic treatment on time and without any delays, visiting your dentist every six months or as recommended can go a long way toward making that a realistic goal. Your dentist can provide fluoride treatments or other treatments that strengthen your teeth and protect them from cavities.

Making sure to visit your dentist will help ensure your teeth look their best once your braces come off. If you do not have a general dentist and would like a recommendation on finding one in the McCook, North Platte, or Ogallala area, please give us a call or let us know at your next adjustment appointment!