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As you near the end of your orthodontic treatment, you’re probably already imagining the day when your brackets and wires finally come off. Or the moment you’ve finished with your last set of aligners. That day might come just a bit sooner if Dr. Anthony Bisconti and our team recommend a positioner.

While not as well-known as other orthodontic treatments, a positioner is an appliance that can shorten your time in traditional braces and aligners by weeks or even months. Curious? Read on!

• What Exactly Is a Positioner?

A positioner resembles a clear mouthguard. Its arched shape is designed to fit snugly over your teeth. It’s sometimes called a finishing appliance, because it’s designed to make those last small adjustments to your alignment and bite. If you’re a good candidate for a positioner, it can replace your braces or aligners for your last several weeks or months of treatment.

• How Are Positioners Made?

This appliance is custom fabricated to fit your very specific orthodontic needs. Commonly, a mold is made of your teeth. A model of your teeth is made from this mold. Precision instruments are used to move the model teeth into your ideal alignment.

Once this model of your future finished smile is complete, it is used to create the positioner. When the thermoplastic material is molded to the model, it creates an appliance with an indentation for each individual tooth in its desired final location.

Available in a variety of materials, a positioner is most often designed as a clear single piece, covering both your upper and lower teeth. This makes sure that your teeth are not only aligned properly, but that your upper and lower teeth are working together for a healthy bite. Openings in the positioner provide airways which allow you to breathe easily.

• How Do Positioners Work?

Because your teeth haven’t settled firmly into place yet (this will happen as you wear your retainer), they’re still able to move. That’s why your positioner is shaped to fit your teeth in their future ideal placement, not where they are at present.

Positioners require your active participation. Your teeth move to the ideal spots molded into the positioner through “exercise”—biting down on your appliance for 15-20 seconds before relaxing your bite, usually every 10-15 minutes during your daily wear. The gentle force provided by your jaw muscles helps guide your teeth into position more quickly. Dr. Anthony Bisconti will give you instructions on just how to—and how often to—do these exercises.

• How Long Are They Worn?

Positioners are commonly worn at least four hours a day to start with and all night long, or Dr. Anthony Bisconti might recommend 24 hour a day wear for the first week. As you progress, you’ll wear them for shorter periods during the day, gradually tapering off until your treatment is complete.

Depending on the amount of correction that’s still needed, positioner use ranges from several weeks to several months. One thing that will ensure that your time in a positioner is as short as it can be is your willingness to follow our instructions. The speed and effectiveness of your final tooth movements is largely up to you!

• Caring for a Positioner

Gentle treatment is best. Clean your positioner before and after wearing it using a toothbrush and mild toothpaste. Never boil it or expose it to heat. We will give you instructions for how to clean it more thoroughly, if needed.

Like retainers, clear aligners, and mouthguards, a positioner needs to be protected when it’s not in your mouth. Your positioner will come with a case, so be sure to use it!

Positioners aren’t recommended for every orthodontic patient. But if you feel this might be an option worth pursuing, talk to us when you visit our Youngstown, OH office. A positioner could be an effective, time-saving step on your path to a lifetime of healthy smiles.

Now that you’ve graduated from your braces or aligners, you might think you’re finished with orthodontic cleaning tips. Not quite yet! Your retainer needs love, too—not just because it can look or smell “less than appealing” without your help, but because it’s good for your dental health.

Removable Retainers

If you have a Hawley retainer or a clear retainer, cleaning it whenever you remove it is a great idea. Unappetizing white patches mean plaque or mineral deposits from your saliva have dried and hardened on your retainer’s surface. And if you notice an unpleasant taste or odor, it probably means that germs and bacteria have made themselves at home and are growing in and on your appliance.

You don’t want old plaque or new bacteria in your mouth! Here are some ways to keep your retainer clean and fresh:

• After wearing it, you can clean your retainer with a toothbrush, but don’t brush too vigorously. You might scratch it. Use a soft or even extra-soft brush to clean out all the nooks and crannies, and then rinse.
• Use cleaning products which have been recommended by Dr. Anthony Bisconti if your retainer needs a deeper clean. Denture cleaners, retainer cleaners, and even toothpastes can be too abrasive or cause discoloration, so use the products made for your specific retainer.
• Let your retainer dry before storing it in a dry place after cleaning. Shutting a damp retainer into a closed case provides bacteria with the damp, dark environment they thrive in. (PS—clean your case regularly, too!)
• One of the benefits of a clear retainer is that it’s almost invisible. And you can help keep it that way by removing it whenever you eat or drink. Your retainer can become stained from colored foods or liquids.

Fixed Retainers

A permanent retainer is a small piece of wire that is custom-fit and bonded to the inside of selected teeth to keep them from shifting. Because food particles and plaque can accumulate around a fixed retainer, brushing after meals and at least twice a day is recommended. Bacteria and plaque cause bad breath, cavities, and tartar buildup, and removing tartar might require removing your retainer.

While a fixed retainer can be tricky to clean, there are techniques and products that make cleaning easier and more effective:

• An orthodontic toothbrush with a smaller head might reach behind your teeth more comfortably.
• Don’t forget to floss! Using a floss threader will help you get that wriggly floss behind the retainer and between your teeth.
• Try a water flosser. These handy devices direct a stream of water right into hard-to-reach places for more thorough cleaning.

If you’re having trouble keeping your retainer clean, our Youngstown, OH orthodontic team can teach you all you need to know about tools and techniques to keep your retainer—and your teeth and gums—healthy. An attractive smile is a great thing. A healthy, attractive smile is even better!

Dr. Anthony Bisconti and our team have the experience and training to evaluate the present state of your teeth and bite, and to design a treatment plan to give you the healthy, attractive smile you picture for your future. And when you choose Invisalign^® for your treatment, you’ll be able to get an advance view of exactly what that future will look like!

How is this possible? Because when you choose Invisalign, you’re getting the benefit of some of the most advanced technology in orthodontics.

The process begins with a computerized scan of your teeth and mouth. Special scanner software creates a 3D image to capture your smile as it is now. But that’s not all. Using our customized treatment plan, Invisalign software can provide not only a model of your smile today, but an evolving model of what your smile can be. Seeing your present smile transform step-by-step into your future smile is a great motivator to follow that treatment plan!

For each step of your treatment, Dr. Anthony Bisconti will provide a new set of aligners created to move your teeth and bite toward this goal. Why don’t you need a mold made of your teeth every time you get a new aligner? Because, with Invisalign, we design your aligners to fit your future tooth alignment.

Aligners are not fabricated to snugly fit around your teeth as they are, but as they will be after several days of wear. Each set is molded with small improvements to your alignment, and provides gentle, consistent pressure to move your teeth to that next step.

This “future fit” is why you may experience a bit of discomfort with a new set of aligners. Over the days that you wear them, the fit will become more and more comfortable. This won’t be because your aligners have changed. It will happen because your teeth have gradually moved where your aligners direct them.

Once your teeth and bite have reached this new step in your treatment, it will be time for the next set of aligners in the series, and so on. Dr. Anthony Bisconti will let you know just how long you need to wear each set, and you can even track your progress with every appointment.

So, are we predicting the future? Not really. When you use Invisalign, we are planning and creating your future smile. Dr. Anthony Bisconti will use the Invisalign system to customize your treatment for your very specific needs, step by step, and aligner by aligner, until you attain the smile you previewed before you even started treatment.

But one thing we can predict: If you follow our recommendations, keep your appointments at our Youngstown, OH office, and wear your aligners as directed, there’s going to be a beautiful, healthy smile in your future.

Maybe you’ve known people with braces and aligners—maybe you’ve worn them yourself!—so if braces or aligners are in your teen’s future, you have some idea what to expect and when to expect it.

But quite often, orthodontic issues require more treatment than braces alone can provide. When misalignment affects not only the teeth but the jaw as well, treatment can be more effective when it begins earlier and makes use of a different kind of appliance—the “functional appliance.”

During the years your child’s bones are still rapidly growing and forming, around the ages of eight to 14, functional appliances can help guide tooth movement and encourage jaw growth and development. One of the most widely used of these devices is the Herbst® appliance.

What does the Herbst appliance do?

There are several types of malocclusions, or “bad bites” treated by Dr. Anthony Bisconti. A common condition called a Class II malocclusion occurs when the upper jaw and teeth project too far forward over the lower jaw and teeth. Signs of a Class II malocclusion might include an overjet (protruding upper teeth), and/or a small or recessive lower jaw.

While correcting this malocclusion often enhances facial symmetry, which can be very important for a child’s confidence, correcting a Class II malocclusion also promotes jaw and dental health. Misaligned teeth are more difficult to clean, which can lead to decay and gum disease. Bite problems can cause persistent jaw pain and damage to the teeth. And, with an overjet, a child’s upper teeth are more at risk for injury.

The Herbst appliance was developed to treat this kind of malocclusion. It moves the lower jaw and teeth forward to create a balanced, healthy smile.

How does the Herbst appliance work?

The Herbst appliance is fixed in place with stainless steel bands or crowns that are secured to four teeth in the rear of the mouth, often the first molars on each side of the upper and lower jaws. The band or crown on each lower tooth is equipped with a small bar that extends toward the front of the mouth.

An arm on each side links the bands or crowns on the upper teeth to the front of the bar assemblies on the lower teeth. Each arm consists of a rod that fits smoothly into a tube. The telescoping action of the rod and tube allows the mouth to open and close normally. When the mouth is closed, the arms on both sides telescope shut, forming compact cylinders that hold the jaw forward.

While a child’s bones are still growing, the lower jaw’s new forward position can stimulate further bone growth and remodeling to maintain the jaw in that forward position. The Herbst appliance also has a restraining effect on the forward movement of the upper jaw. The result is a steady, noticeable improvement in the relationship between the upper teeth and jaw and the lower teeth and jaw.

Is the Herbst appliance hard to take care of?

The Herbst appliance is fairly low maintenance, but, like any orthodontic gear, it should be treated with care.

• It’s important to watch your child’s diet, because sticky, crunchy, and chewy foods can damage the appliance. Save the caramels for a post-treatment celebration!
• Carefully cleaning around the appliance is necessary, because a buildup of bacteria and plaque leads to consequences like bad breath, gum disease, and tooth decay. A water flosser can make reaching and cleaning tight spots easier if a brush alone isn’t effective.
• If the Herbst appliance is damaged, some minor fixes might be doable at home with instructions from your treatment team. But if a band or crown comes loose, or if there’s a problem you’re unfamiliar with, call our Youngstown, OH office right away.
• To help avoid the need for minor (or major) fixes, playing with the appliance with fingers or tongue, nibbling on pens and pencils, chewing on ice, or any other risky habits should be strictly off limits.

When it comes to your child’s health, you always have high expectations. Dr. Anthony Bisconti and our team have all the answers you’ll need about what to expect from this phase of your child’s orthodontic treatment, and just why the Herbst appliance is the very best option to create a future of attractive, healthy smiles.