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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 Vancouver, BC 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. Daniel Ma to discover how an individualized treatment plan and a custom appliance can give your child a healthy bite and a lasting smile.

It's a moment many of our patients have experienced. One second you're chewing on a piece of gum, then suddenly you forget to keep chewing and swallow the entire rubbery gob whole! It's at this point you remember your mother warning you as a child that if you swallow gum it will stake a claim and take up residency in your belly for seven years. Dr. Daniel Ma and our team at our office hate to take all the fun out of the mystery, but the truth is that chewing gum, when swallowed, will enter your stomach and move through your digestive system just like any other piece of food. So, if you ever accidentally swallow a piece of gum, there is no need to worry!

That being said, it's important to know that gum does not have any dietary benefits, so while it’s not exactly harmful to swallow, you still want to avoid swallowing it. If you are an avid gum-chewer, we encourage you to chew sugarless gum, especially if you are wearing braces, because gum with sugar can lead to cavities. Sugarless gum still has the same amount of flavor, but has fewer cavity-causing ingredients. In fact, many brands contain an additive called xylitol, a natural sweetener known to fight cavity-causing bacteria. Xylitol is also known to increase salivary flow as it rinses away plaque and acid.

The fact is, when the bacterium in your mouth breaks down sugar, what’s left behind is acid. This acid eats away at the enamel coating of your teeth, causing holes that we call cavities. Cavities can lead to other long-term mouth problems if they are not treated in time, so it is best to try and avoid overexposing your teeth to too many harmful substances!

If you have any questions about chewing gum, please contact our office. Happy (sugar-free) gum chewing!

Since the introduction of the power toothbrush in the 1960s, this tool has undergone many technological advances, from design and bristle motions to rotation oscillation and sonic vibration.

What is rotation oscillation? That’s when the head of the toothbrush alternately rotates in one direction and then the other. Power toothbrushes can deliver up to 50,000 strokes per minute, which is much more effective than the average 300 strokes per minute with a manual toothbrush.

A smaller brush head is available for hard-to-reach areas, which is a good alternative for small mouths. The brush heads are replaceable and should be changed every three to six months. Each family member should have his or her own brush head while sharing the base motor. What a great deal! Check the handle size. A large handle is better for members of the household with arthritis, children, or family with other physical disabilities.

A rechargeable toothbrush is ideal. It should deliver enough power on a full charge for one week of brushing.

We recommend you brush for a minimum of two minutes. Some electric toothbrushes include a signal you can hear, such as a beep every 30 seconds, to indicate it's time to switch to a different area of the mouth. Others sound an alert after the full two minutes has elapsed.

Will an electric toothbrush harm the teeth or gums? Studies indicate that people tend to apply more damaging pressure to their teeth and gums during manual brushing than when they use an electric toothbrush. If you experience tooth sensitivity, choose a model with pressure sensors that stop the toothbrush any time you press too hard.

Who would benefit from an electric toothbrush? Everyone! Consumers with a physical disability may have specific needs that power toothbrushes can address. Children also tend to maintain better oral health hygiene when they use an automatic toothbrush. Plus, many of them find it fun to brush!

Automatic toothbrushes really do remove debris better than the old-fashioned way. You may have heard the term “biofilm.” Better known as plaque when it occurs in the mouth, biofilm is the debris and bacteria that cause infections to your teeth. It regenerates quickly, so healthy habits are the best defense for a healthier you! With a healthier mouth, you face a lower risk of gum disease and other conditions like heart disease: mouth health has been linked to heart health.

When you're ready to make your decisions, be a wise comparison shopper. Consult with Dr. Daniel Ma at our office to decide what is best for you!

Xylitol is a naturally occurring sweetener found in tree bark, plants, fruits, and vegetables. The human body also produces it in small amounts. It looks and tastes like sugar, so as part of a health regimen, most people require no willpower to use it.

Xylitol is safe (approved by the World Health Organization) because only a small amount is needed for health benefits. With a glycemic index of seven, it is safe for diabetics. It has less than three calories per gram and 40% fewer calories than other carbohydrates. If eaten in extremely large amounts too quickly, it has a laxative effect in humans.

Tooth decay happens when bacteria in your mouth consume the sugars you eat. When you eat food that contains ordinary sugar, it gives energy to the bacteria on your teeth, allowing them to multiply and start making acids that destroy the enamel on the teeth.

Since xylitol is a natural sweetener derived from the fibrous parts of plants, it does not break down like sugar, so it helps maintain a neutral pH level in the mouth. Xylitol also prevents bacteria from sticking to the teeth because they are unable to digest it. That is how it protects the teeth from cavities.

With xylitol, the acid attack is diminished. With less bacteria and acid, your teeth stay healthier. The frequency of xylitol ingestion is important: aim for five grams a day, or one gram every three hours.

Studies of xylitol use as either a sugar substitute or a small dietary addition have demonstrated a dramatic reduction in new cavities. It has also stopped and even reversed some existing cavities. This effect is long lasting and possibly permanent. Low cavity rates persist even years after the trials have been completed.

Xylitol needs to be one of the first ingredients in a product to be effective. It is convenient and easy to use. You can find it in health food stores and specialty grocery stores. Xylitol can be delivered to your teeth in chewing gum, tablets, or even candy and mints.

It also comes in toothpaste, mouth rinse, baby oral wipes, gel and pacifiers, nasal wash, dry mouth spray, a granulated form for cooking, granulated packets to add to drinks, and commercially prepared foods. It can replace sugar on a one-to-one ratio.

Sweet rewards in xylitol are good for the body and the teeth! If you have specific questions please feel free to contact our office. We look forward to seeing you soon!