Retainers – keeping those teeth straight

So, you had your braces for all those months, wore your rubber bands, and even stayed away from all (well, almost all) the foods that were on the “don’t eat with braces” list. The day has finally arrived and your braces are off, what an amazing day. But…. what? They are telling you that you have to wear retainers (you actually knew this, you just filed if deep in the recesses of your brain) and you need to have impressions taken to make them. What a way to ruin an amazing day!

All kidding aside, retainers are as important to your orthodontic treatment as the braces (or clear aligners) themselves. They hold those perfectly straight teeth in their correct positions until the bone is solid enough to hold them. Here at Kruse Orthodontics we recommend our patients wear their retainers full time for at least the first year and then while sleeping after that.

We thought it would be interesting to show how those retainers are custom made for all our patients at Kruse Orthodontics in our on-site lab.

We start with the impressions. Plaster is poured into each impression and when set, the impression and plaster are separated. Now there is a model that looks exactly like your teeth.  The retainer will be made on this model.

In the next step, the retainer wire is bent to fit the teeth so they are held in the correct position.  Clasps are also bent and added to help hold the retainer in place when it is worn.

adding the acrylic to the retainer

The retainer wire is then held in place with wax as the acrylic (and sometimes glitter) is applied to the model.  This is all done by hand so these retainers are truly custom made for individuals and no two retainers are alike, even if they are made for the same person.  The model is then placed into a pressurized pot to cure the acrylic.

trimming the acrylic on the retainer

When the acrylic is cured, the model is removed from the pot and the retainer is taken off the model.  The retainer is now trimmed, polished and ready to go.

The finished retainer

If worn properly and cleaned daily, this retainer will last for years. Always remember, retainers need to be kept in a retainer case when not being worn because they can break or be lost.

Remember, you worked hard to achieve your beautiful smile.  Please work just as hard to maintain it by wearing your retainers as prescribed. Remember, those retainers need to be brought to every future appointment.

Malocclusion

The topic of conversation this time is malocclusion.  This is a term you will hear from Dr. Kruse when you visit our office as a new patient.  A malocclusion is a misalignment or incorrect relation between the teeth of the two dental arches when they approach each other as the jaws close. In common terms, when you bite together and your teeth don’t fit correctly.  The word literally means “bad bite”.

Your orthodontic treatment is based in part on the type of malocclusion you have.  This diagnosis is instrumental in determining the length of treatment, if extractions of teeth are necessary, whether rubber bands or Herbst/Forsus appliance will be necessary or even if you will be a candidate for orthognathic surgery.  It can even have an effect on the type of retainers you will be required to wear when your active orthodontic treatment is completed.

Types of Malocclusion

There are three types of malocclusion (as established by Dr. Edward Angle, the father of Orthodontics). To learn more about Dr. Angle visit https://en.wikipedia.org/wiki/Edward_Angle.  The specific type of malocclusion is determined by the way the upper first molar fits with the lower first molar on each side of the mouth.  A normal fit occurs when the upper teeth are slightly forward of the lower teeth and when biting, a small portion of the lower teeth are covered by the upper teeth (view A of diagram).

  • Class I malocclusion – upper and lower molars fit together properly but teeth can be crowded or spaced unevenly. Cross bites, rotations and constricted jaws (arches) can also occur with this type of malocclusion. (view B of diagram)
  • Class II malocclusion – the lower molars fit further back on the upper molars which results in the chin being drawn back (sometimes called a weak chin). The same issues as stated for a Class I malocclusion can occur here.  A Herbst or Forsus appliance is occasionally utilized to help correct this type of bite.  Sometimes, orthognathic surgery is required to correct a Class II bite.(view C of diagram)
  • Class III malocclusion – the lower molars fit too far forward of the upper molars and this results in a prominent jaw where the lower teeth fit in front of the upper teeth. Again, teeth can be crowded, spaced, rotated, in crossbite, or constricted arches with this bite.  In severe cases, this can require surgery to be completely corrected. (view D of diagram)

malocclusion

Please visit our “before and after” page to see some examples of these types and the results that were attained.

Keep in mind that your actual treatment plan is determined by this malocclusion along with other factors, such as:  crowding, crossbite, growth pattern, age, rotations, constricted jaws to name a few.  Also realize that family members can have completely different malocclusions which translate into different treatment plans and lengths.

If you have questions, call our office at 616-656-4155 for a complimentary exam.  If you are a current patient, just ask at your next visit.

 

 

 

 

Welcome to Straight Talk

Marty

Welcome to Straight Talk the blog page of Kruse Orthodontics. My name is Marty and some of you may know me as one of the assistants you see when you come to your appointment. The first topic of discussion is BRACES. After all, that is why we are all here. Most patients start orthodontic treatment with a vague understanding of braces. Hopefully, this post will give KruseOrtho patients a better understanding of braces and what the actual components are.

Brackets – these are the small metal (or ceramic) pieces that are attached to the teeth with orthodontic glue. This is the handle that allows tooth movement. At KruseOrtho, we use Damon brackets. You can get more information on this type of bracket by visiting www.damonbraces.com .
Bands – sometimes, small rings are placed around teeth instead of brackets on teeth. They also serve as a handle. Usually, bands are cemented because better anchorage is required for an appliance attachment or a bracket just will not stick to the tooth surface.
Arch wires – these are the wires that run through all the brackets of either the upper or lower set (arch) of teeth. The wires are actually what move the teeth.line them up. At KruseOrtho we use wires that apply light continuous forces so treatment is slow and steady and usually quite comfortable.
Ormolasts (colors)- these are small colored rubber bands that go around individual brackets to allow the patient to personalize their braces. Damon brackets do not require ormolasts and in fact, the clear Damon brackets do not allow for placement of ormolasts, so if you want colors make sure to request metal braces.
Elastics – these are the dreaded rubber bands. Elastics are used to make the top and bottom teeth fit together properly. Rubber bands stretch from the top to the bottom arch and the patient is given detailed instructions on how to wear them.
This is a brief description of braces. Future blogs will provide information about expanders, Herbst/Forsus appliances, TADS, retainers, and a host of other topics. If you have any suggestions for future topics, please send them to marty@kruseortho.com. Please visit the KruseOrtho blog page frequently.
Thanks, Marty