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Congratulations! You’ve done the hard work necessary to create your beautiful smile! You’ve carefully completed all the steps needed to reach the end of your orthodontic journey. Well, nearly all the steps. We can’t forget that last step which will ensure that all your hard work is rewarded.

When you first began orthodontic treatment, Dr. Nathan R. Yetter decided on the best plan for straightening your teeth and perfecting your bite, whether you wore traditional braces, lingual braces, aligners, or other orthodontic appliances. And now that you’re finishing treatment, there’s one more option to consider—your retainer.

Why do I need a retainer?

While you’ve spent time in treatment, more has changed than just the position of your teeth. The periodontal ligament, the connective tissue that connects the teeth to the jawbone, is stretched as the teeth shift. The bone in your jaw changes, too, reforming and rebuilding around the roots of your teeth as they move to their ideal locations.

These changes happen because your braces or aligners apply gentle, constant pressure to move your teeth. When you’ve finished wearing these appliances, the pressure stops. Ligaments will try to return to their original shape, which can shift teeth back toward their old positions. And the rebuilding bone isn’t dense enough yet to stop teeth from shifting due to the normal, everyday pressures of eating, chewing, and smiling.

A retainer prevents your teeth from moving back, or “relapsing,” by giving your bones and ligaments time to stabilize and rebuild. The process takes months, so keeping your teeth in place as bones rebuild and grow denser is crucial. This is especially important for patients with more serious misalignments. Dr. Nathan R. Yetter will let you know which kind of retainer will be best for you and just how long you’ll need to wear your retainer.

Are there different kinds of retainers?

There are! Retainers can be removable or fixed, visible or nearly invisible, metal, plastic, or metal and plastic. Three of the most popular retainer options include:

• Hawley Retainers—the traditional removable retainer, which uses a molded acrylic plate with wires attached to keep your teeth properly aligned and to hold your retainer in place.
• Clear Plastic Retainers—a removable retainer made of custom vacuum-formed plastic, which fits over the teeth like a clear aligner.
• Fixed Retainers—a small single wire bonded to the back of specific teeth, which holds them in place and prevents any movement.

Dr. Nathan R. Yetter will let you know whether a removable or fixed retainer is best for making sure your teeth don’t start to relapse, and fill you in on the benefits and care of each type of retainer.

How long do I need to wear a retainer?

There’s no standard answer to this question. Just like your retainer is custom-built to fit your individual teeth, the amount of time you’ll spend in that retainer depends on your individual needs. Retainers might be worn fulltime for months or years, be worn only at night after several months of daily wear, or be worn long-term to make sure your orthodontic work lasts.

Because you’ve done the hard work already, and your beautiful, healthy smile is the result. Talk to a member of our Mesa team about which retainer option will be best for making sure that this smile lasts a lifetime.

Orthodontic treatment involves a lot more than just straightening your teeth. For a healthy smile, your bite must be healthy as well! This means that the upper and lower jaws need to fit together properly and comfortably.

If your bite is out of alignment because of jaw misalignment, orthodontic treatment can help correct the shape and position of your jaws with devices called functional appliances. These appliances are most often used for young patients whose bones are still growing, and are designed to treat malocclusions, or bite problems.

Common malocclusions such as overbites and overjets can occur when the upper teeth protrude further than they should, or the lower jaw is positioned too far back, or both. The Twin Block appliance can be used in such cases to help move your lower jaw and teeth into alignment with your upper jaw.

Why “Twin”? Because the Twin Block appliance is two separate pieces, each made of wire and smooth acrylic. Both pieces are crafted to fit precisely over your upper and lower arches and can be adjusted as your treatment progresses. The top plate can also be adjusted, if necessary, to widen the upper palate.

Why “Block”? Acrylic blocks cover the biting surfaces of several of your upper and lower teeth. These blocks fit together like a 3D puzzle. When you bite down, the upper blocks interlock with the lower blocks, pushing the lower blocks forward just a bit before you can bite down completely. Over time, bit by bit (and bite by bite), the Twin Block appliance advances your lower jaw and teeth to create a balanced, comfortable bite.

For the quickest and best results, you should wear your Twin Block appliance as directed. It’s made to be worn comfortably while you sleep, eat, and otherwise go about your day. (It’s a good idea to check with our Mesa orthodontic team to see about removing it when you’re active, especially for swimming and contact sports.) When it’s time to brush, the Twin Block appliance is removable. This means that you can clean your teeth and your appliance easily.

And, while it’s made to work hard for you, it’s not indestructible. Don’t expose your appliance to heat or hot water, as the plastic may warp. Use the cleaning methods we recommend. Finally, when your appliance is out of your mouth, keep it in its case! You don’t want your appliance to end up carefully wrapped in a napkin in the nearby recycling bin. Or, even worse, in your dog’s mouth instead of yours.

The Twin Block appliance might fit together like a puzzle, but there’s nothing puzzling about how to achieve your best and fastest results. Your success really depends on you. Follow Dr. Nathan R. Yetter and our team’s advice, wear your appliance as directed, and you’ll be on your way to a healthy, comfortable bite and an attractive, confident smile!

It’s useful to know some of the common problems that can arise when you get braces. Even if you take great care of your braces and teeth, you might not be able to avoid certain issues or side effects that accompany braces. But don’t worry: These are all common problems that can be taken care of by following some simple advice.

If you just had your braces put on, you may notice some general soreness in your mouth. Your teeth are starting to adjust to having to shift, so they may ache, and your jaw might feel tender at first. This will subside once your mouth becomes used to the new appliance in residence.

You may experience soreness on your tongue or mouth, which may be a sign of a canker sore. Canker sores are common when braces rub against your mouth. You can use ointments to relieve pain and numb the area that’s been irritated. Canker sores are commonly caused by broken wires or loose bands on your braces.

Common Issues

• Loose brackets: Apply a small amount of orthodontic wax to the bracket. You might also apply a little between the braces and the soft tissue of your mouth.
• Loose bands: These must be secured in place by Dr. Nathan R. Yetter. Try to save the band for repair.
• Protruding or broken wires: Use the eraser end of a pencil to push the wire carefully to a less painful spot. If you are unable to move it, apply orthodontic wax to the tip. If a mouth sore develops, clean your mouth with warm salt water or antiseptic rinse.
• Loose spacers: These will need to be repositioned by Dr. Nathan R. Yetter and possibly replaced.

Avoiding Issues

You should avoid certain foods that could cause major damage to your braces. No matter what you eat, make the effort to cut your food into small pieces that can be chewed easily. This will prevent chunks of it from getting lodged between brackets.

Avoiding hard and chewy foods is also wise. Some foods can break your hardware: for example, popcorn, nuts, apples, gum, taffy, and hard candies. Avoiding any foods that easily got stuck in your teeth when you didn’t have braces is a good rule to follow.

The appliances in your mouth are bound to attract food particles and make it easier for plaque to build up. By making sure you brush and floss carefully every day, you can prevent stains and cavities from developing over time. Dr. Nathan R. Yetter and our team recommend brushing and making sure that food isn’t lodged between your braces after every meal.

Having braces can be very exciting, but it can also be challenging at first. Watching for these common issues during your first few weeks can prevent problems down the road. If you experience a lot of pain from your braces, contact our Mesa office and we can try to resolve any issues.

Braces can sometimes be a pain, but they’re well worth it once your new smile gets revealed!

When does an underbite need surgery? The short answer is: when Dr. Nathan R. Yetter and our team recommend surgery as the best way to give you a healthy, functional bite. But let’s take a longer look, and see just why your doctors might come to that conclusion.

• First, what exactly is an underbite?

In a perfect bite, the upper and lower jaws align, well, perfectly. Upper teeth overlap lower teeth very slightly, upper and lower teeth meet comfortably, and jawbones and joints function smoothly. When the alignment is off, it causes a malocclusion, or “bad bite.”

When we talk about an underbite, or Class 3 malocclusion, it means that the lower jaw protrudes further than the upper jaw. This protrusion causes the bottom teeth and jaw to overlap the upper teeth and jaw.

• What causes an underbite?

Sometimes an underbite is caused by childhood behaviors while the teeth and jaw are developing, including tongue thrusting or prolonged thumb-sucking and pacifier use. (Working to stop these behaviors before they affect tooth and jaw formation is one of the many good reasons children should have regular visits with their dentists and pediatricians.)

Most underbites are genetic, however, and tend to run in families. It’s estimated that from five to ten percent of the population has some form of underbite. The lower jawbone (mandible) might be overdeveloped, the upper jawbone (maxilla) might be underdeveloped, both bones could be affected, or, sometimes, tooth size and placement might cause an underbite. These irregularities in jaw shape and size and/or tooth crowding are not something that can be prevented, and require professional treatment.

• Why? What’s the problem with an underbite?

Even a minor underbite can cause difficulties with biting and chewing. A more severe underbite can lead to speech problems, decay and loss of enamel where the teeth overlap, mouth breathing and sleep apnea, persistent jaw and temporomandibular joint pain, and self-confidence issues.

• Can’t my dentist treat my underbite?

Most probably not. A very mild underbite can be camouflaged cosmetically with veneers, but this does not address the cause of the underbite, and will not work for moderate or severe underbites.

• Can my orthodontist treat my underbite?

Dr. Nathan R. Yetter will create an underbite treatment plan after a detailed study of each patient’s individual dental and skeletal structure. Treatment options will vary depending on the cause of the underbite, its severity, and even the patient’s age.

Early intervention is especially important for children who show signs of an underbite. That’s why we recommend that children visit our Mesa office by the age of seven.

If an underbite is caused by tooth misalignment or crowding, braces can reposition the lower teeth. Sometimes extractions are necessary to make room for proper alignment.

If the cause is due to jaw structure, children’s bones are still forming, so treatment can actually help correct bone development. Palatal expanders, headgear, and other appliances are various methods of encouraging and guiding bone development.

But braces and appliances aren’t effective for every patient with an underbite, and especially in patients (usually those in their late teens and older) when the jawbones are already fully formed. In this case, we might suggest coordinating treatment with an oral and maxillofacial surgeon.

• What does an oral and maxillofacial surgeon do?

An oral surgeon has the training, experience, and skill to help correct an underbite by surgically reshaping and repositioning the jawbone. This corrective jaw surgery is called orthognathic surgery.

• What will happen during orthognathic surgery?

Your treatment will be tailored to your specific needs. Two of the common surgical procedures for treating an underbite involve repositioning the upper jaw to lengthen it and/or reshaping the lower jaw to shorten it.

Bone is sometimes removed or added, small bone plates or screws are sometimes used to stabilize the bone after surgery—your surgeon will let you know exactly which procedures will give you a healthy, functional bite. The surgery itself is most often performed under general anesthesia and requires a brief stay in the hospital.

• How will my orthodontist and oral surgeon coordinate my treatment?

Correcting a Class 3 malocclusion can take time. Your oral surgeon will work together with Dr. Nathan R. Yetter to analyze the interrelationship of teeth, bones, and joints to determine dental and skeletal problems, and will develop the best treatment plan possible to create a healthy alignment.

• So, when does an underbite need surgery?

Sometimes, a minor underbite can be corrected with braces and appliances alone. A serious underbite, however, will often require the specialized skills of both Dr. Nathan R. Yetter and an oral surgeon.

And, while it’s not the primary purpose of surgery, corrective jaw surgery and orthodontics can also make you happier with your appearance and boost your self-confidence. Achieving a lifetime of beautiful, comfortable, and healthy smiles—that’s the answer to your question.