Early diagnosis and treatment by Drs. Moshiri can help tooth eruption, guide facial growth, and therefore prevent more serious problems from occurring. Also, addressing problems early reduces the need, extent, and potentially the cost of later orthodontic treatment.
The following are indications that an orthodontic problem may be present:
- Unusual facial problem
- Thumb and finger sucking
- Overlapped and crowded teeth
- Underbite
- Protrusion of upper front teeth
- Mouth breathing and snoring
These are just a few of the early indications that orthodontic problems may exist. Please follow the following links to review information and videos for correction of some common problems:
Crowding and Overlapped Teeth
Expanders
Removable Expanders
Click here to view our introduction to Expanders video.
Removable Expanders demonstration video.
The removable expander is a functional appliance used to expand the upper dental arch by stimulating bone growth in the midpalatal suture. It is a full coverage (covers the teeth and palate) acrylic appliance with an expansion screw inserted in the middle to facilitate opening of the appliance. The screw is opened, as instructed by Dr. Moshiri, until the palate has been widened to an adequate amount. The appliance is then worn, without activation, for a period of roughly four months as a retainer to facilitate proper healing and retention of the new bone width.
Download our Removable Expander handout for more information.
Fixed Expanders
A fixed expander is a functional appliance used to widen the upper dental arch by stimulating growth of the midpalatal suture. It is attached to the teeth via solder joints to bands, along with attachments to an expansion screw inserted in the middle to facilitate opening of the appliance. The screw is opened, as instructed by Dr. Moshiri, until the palate has been widened to an adequate amount. The appliance is then worn, without activation, for a period of several months as a retainer to facilitate proper healing and retention of the new width.
Download our Fixed Expander handout for more information.
Transpalatal Bar
The Transpalatal Bar (TPA) is a fixed appliance that is attached to bands on the upper molar teeth. The bar that sits across the roof of the palate fits into a soldered clip located on the bands. When making scheduled orthodontic visits, Dr. Moshiri is able to remove the TPA from the bands to make necessary adjustments.
The TPA is used to move the molar teeth when wires cannot provide sufficient force to accomplish the required movement. Once adjusted in the office, the TPA may cause pressure to the teeth being moved, but will subside soon after the adjustment.
Home Care
- Please brush and clean your TPA assembly at least three times a day, two minutes at a time, with water, a toothbrush and toothpaste. Pay special attention to the upper molar bands and gum line.
- Proxy brush is to be used twice per day to clean the appliance and around where it is attached to the bands on the inside of the roof of the mouth.
- Floss daily.
- Do not eat anything hard, sticky, or chewy.
- Use wax as needed.
Download our Transpalatal Bar handout for more information.
Click here to view our Transpalatal Arch demonstration video.
Lip Bumper
The lip bumper is a removable appliance, used in developing children, to create and hold space for erupting crowed teeth. The appliance is used in the attempt to avoid the extraction of adult teeth at a later age. The lip bumper works by both using and eliminating some of the natural forces of the soft tissues within the mouth. Pressure from the lower lip pushes against the front acrylic shield pushes back on the lower molars gently, creating space for erupting teeth in front.
By keeping pressure away from the lower teeth at the same time, the tongue pressure gradually moves the front teeth forward to “unravel” crowding. The appliance is usually worn 12 to 18 months, although this will vary according to the severity of crowding and each child’s rate of growth.
Appliance Wear
- The lip bumper should be worn 24 hours a day, except for brushing and flossing.
- Brush at least 3 times a day, two minutes at a time, paying special attention to the lower bands, and around the gum line.
- Use your proxy brush specifically in the front area when brushing. Do not eat anything hard, sticky, or chewy.
- Use wax as needed
Download our Lip Bumper handout for more information.
Click here to view our Lip Bumper demonstration video.
Class II Problems
Class II refers to an anteroposterior (AP) jaw discrepancy due to overdevelopment of the top jaw or protrusion of the upper teeth, from a small lower jaw, or combination of the aforementioned. This gives the patients the apparent look of having a weak lower jaw and chin. Listed in this section are examples of some treatment modalities we use to treat class II malformations:
Functional Appliances
Twin Block
The Twin Block is a removable functional appliance comprised of upper and lower retainers which work in concert to correct a class II malocclusion (lower jaw behind upper jaw). Often, the upper appliance also has an expansion component that requires activation as many class II patients also have narrow maxillas. At scheduled appointments, Dr. Moshiri may add acrylic to the lower retainer to further “push” the lower jaw forward as patients adjust to their corrected positions.
For more information on the Twin Block appliance, read our informative Twin Block handout.
Click here to view our Twin Block introductory video.
Click here to view our Twin Block demonstration video.
MARA Appliance
The MARA is a functional appliance which creates positional changes of the lower jaw, positioning it forward over the period of a year while at the same time expanding the upper jaw to “fit” to new position of the lower jaw. This change in position favors correction of a class II skeletal malocclusion, or “weak” lower jaw. In many adolescents, this appliance is able to improve their profile significantly; however, for few patients, full correction may involve orthognathic jaw surgery later in life.
For more information on the MARA appliance, read our informative MARA handout.
Click here to view our MARA appliance introductory video.
Click here to view our MARA demonstration video.
Distalizers
Pendex Appliance
The Pendex appliance is a fixed appliance that rests along the roof of the mouth and is attached to bands on the upper molars. It is used for a class II malocclusion where space has been lost in the upper arch by teeth moving forward too early into spaces created by baby teeth lost prematurely. The appliance is used to expand the upper arch, while moving to molars back to create space for erupting or crowded teeth. Once the proper amount of expansion and distalization (backward moving of the molars) is achieved, the appliance is removed and then a retention appliance is placed.
For more on the Pendex Appliance, download our Pendex handout.
View our Pendex Appliance video.
Carrière Distalizer
The Carrière distalizing appliance is a fixed appliance (non-removable) that is used for dental correction of anteroposterior problems in the dentition. This appliance is used in class II dental malocclusions (upper teeth ahead of the lower teeth), prior to braces treatment, in order to help alleviate the horizontal discrepancy of the upper and lower dental relationships.
For more on the Carrière Distalizer, download our Carrière handout.
Class II Dental Correctors
The Forsus appliance is a fixed appliance that is used for dental correction of anteroposterior problems in the dentition. The Forsus is used in class II dentitions (lower teeth behind the upper) when elastic force alone is not enough to fix the discrepancy, or when a patient has not been compliant with their elastic wear. Download our Forsus Appliace handout for more information.
Wearing the appliance
The Forsus is placed in the orthodontic office by Dr. Moshiri. The appliance is not removable, and is generally in place for several months. As with rubber band wear, teeth may be sore for a few days following activation of the Forsus, but discomfort will subside soon afterwards. Clean the appliance with water, toothpaste, toothbrush, and your proxy brush. Brush at least three times a day, two minutes at a time, paying special attention to the upper bands that hold the appliance in and around the gum line.
Common Problems
The rod may come out of the spring if you open your mouth too wide, as may happen with yawning. If you open your mouth very wide again, you can replace the rod back into the sleeve and fix the appliance. If you feel the bands on your upper molars are loose, if you are unable to fix a loose Forsus, or if you have any questions, please call us at (314) 4-BRACES.
Click here to view our Forsus video.
Click here to view our Forsus demonstration video.