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You may have noticed that we specialize in orthodontics and dentofacial orthopedics. And while most people we talk to have heard of orthodontics, many are confused by the dentofacial orthopedics part of the title. Today, Dr. Bradley Hoppens and Dr. Mary Beth Meier and our team thought we would explain the difference.

While orthodontics entails the management of tooth movement, dentofacial orthopedics involves the guidance of facial growth and facial development, which occurs for the most part during childhood, and is a reason why kids are often the best candidates for receiving dentofacial orthopedic therapy. Dr. Bradley Hoppens and Dr. Mary Beth Meier will examine and monitor your child’s growth to determine when starting treatment will be most effective. If your child begins orthodontic treatment before his or her adult teeth have erupted, it is known as Phase-One treatment. During this phase, Dr. Bradley Hoppens and Dr. Mary Beth Meier will use treatments designed to correct your child’s jaw growth and make sure that the jaw bone is properly aligned before beginning the next phase of treatment, which usually involves placing braces to straighten your child's teeth.

Dentofacial orthopedics is also used to treat adult patients at Hoppens & Meier Orthodontics, however, this process may involve surgery. With our younger patients, we know the jaw bones are still forming, making it easier for our team at Hoppens & Meier Orthodontics to control bone growth and tooth movement. Adults, however, are a different story; their bones are no longer growing, and their jaw bones have hardened, so it is more difficult to adjust the bite and move teeth into proper alignment. Dr. Bradley Hoppens and Dr. Mary Beth Meier may recommend surgery to adjust the jaw bone and establish the proper bite alignment before beginning treatment.

Because our team at Hoppens & Meier Orthodontics is skilled in both areas, we are able to diagnose any misalignments in the teeth and jaw as well as the facial structure, and can devise a treatment plan that integrates both orthodontic and dentofacial orthopedic treatments.

We hope that helps! To learn more about dentofacial orthopedics, and to find out if this type of treatment is right for you, please contact our McCook, North Platte, or Ogallala office and schedule an initial consultation for you or your child. It’s never too late to get a great smile, and we can’t wait to help you or your child get started.

One of the most common reasons for getting braces is because there’s just not enough room for all your teeth to fit next to each other evenly. The result is overlapping and crooked teeth. What’s the first step in creating the space you need? Well, that depends on just how much room you need to align your teeth and bite properly.

When there is going to be a serious need for space, there are orthodontic solutions that can help, including palatal expanders, surgical options, and extractions. But if you only need a tiny bit of room so that regular braces will fit properly, we have a tiny solution—orthodontic spacers!

Why do you need to make space before you get braces? Because Dr. Bradley Hoppens and Dr. Mary Beth Meier might need to make some room around crowded molars so your braces can be installed properly.

For example, you might need orthodontic bands to anchor your braces. An orthodontic band is a slim, custom-fitted ring of metal which fits snugly around a molar. It is durable, provides a place to attach bands and springs to help correct malocclusions (bite problems), and can securely surround a tooth that might be weak because of a large filling. Spacers can separate crowded teeth just enough to allow a band to be fitted around a molar.

Even if you don’t need bands, sometimes separators are necessary to provide enough space between the teeth for your braces to work effectively. The back teeth tend to move even closer together with braces, and, without adequate space, bite problems, risk of decay, and other difficulties can arise.

And while you might think that some serious equipment is in order to make room between those sturdy molars, the typical spacer, or separator, is actually extremely simple--usually a tiny, round elastic band, often made of rubber. Spacers can be placed between tight teeth in a matter of minutes. Each ring is stretched and positioned between your teeth with a special tool. As it returns to its original shape, the spacer’s width provides just enough pressure on the teeth it touches to make a bit of space between them. And a bit of space is usually all you’ll need.

What do spacers feel like? For some people, they can be uncomfortable. You might feel soreness, some pressure, or as though a piece of food is stuck between your teeth. Ask us for suggestions on making you more comfortable, whether it’s dining on ice cream and cold drinks, eating soft foods, or taking over-the-counter pain relief. Separators are only designed to be in place for a very short period (usually under two weeks), but if they are causing you pain, give us a call.

What do you need to do to help the process along? Actually, it’s more what you need not to do. Don’t use dental picks or floss on your separators, avoid chewing gum, and take chewy and sticky foods off the menu. And don’t be tempted to touch or play with your spacers!

Spacers can create space between the teeth so quickly and efficiently that they often fall out on their own after a few days. If your separators fall out, give our McCook, North Platte, or Ogallala office a call. It could mean that you are ready for your braces, and on the way to a lifetime of healthy, beautiful smiles. And it’s a journey that begins with a tiny, springy step.

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 McCook, North Platte, or Ogallala 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. Bradley Hoppens and Dr. Mary Beth Meier to discover how an individualized treatment plan and a custom appliance can give your child a healthy bite and a lasting smile.

It’s normal to be a little self-conscious when you first get your braces. Even though you really want to straighten any crooked teeth, or correct a bad bite, you might still be a bit hesitant about sharing your new orthodontic work with the world. What are some ways to get over those under-confident feelings?

• Keep It Clean

Make sure you brush after every meal to reduce the chance of food particles and plaque sticking to your enamel and brackets. Brushing and flossing is particularly important now, not only to prevent cavities, but because nobody wants to see food stuck in your braces—especially you! If you absolutely can’t brush, rinse with water right after eating.

And carry a small bag filled with all the essentials for gleaming braces: a travel toothbrush, floss, a small tube of toothpaste, an interproximal brush, and a handy mirror to make sure you’re good to go. When you know your teeth and braces are their cleanest, you can’t help but feel more confident.

• Express Yourself

Braces are no longer the one-style-fits-all appliances of the past. Traditional metal braces at our McCook, North Platte, or Ogallala office are more compact, and now come in different colors and shapes. Metal brackets are typical, but ceramic brackets are an option for an almost unnoticeable look. And don’t forget to accessorize!

You can choose from a rainbow of band colors to make a fashion statement that’s uniquely you. Show your spirit with school colors, celebrate the holidays with festive tones, or choose shades that do wonders for your coloring. Whether you go for bold contrast, mono-chromatic subtlety, or “just because I’m in the mood” quirky combinations, let your braces showcase your style. And remember—you can change that style with every adjustment!

• Smile with Confidence

Nothing looks better on you than a confident smile. If you’re a little unsure, practice! Some mirror or selfie time will get you used to seeing yourself in braces. Break them in with friends and family before you go public. Remember that any difficulties with talking or eating should only last a little while.

Above all, you’re still your unique and valued self. You can wear braces and be a good friend, a student, an athlete, a lovestruck Juliet on the theater balcony, a star at your after-school job. Don’t let wearing braces hold you back from the activities you love.  Act like your old self, and you’ll soon feel like your old self!

It’s normal to feel a little self-conscious when you first get your braces. But when you care for yourself and your braces, good things happen! If you’re having difficulty adjusting, talk to Dr. Bradley Hoppens and Dr. Mary Beth Meier. We want to help make sure your journey to a beautiful, healthy smile is as rewarding and as positive as it can be.