Thumb sucking, pacifier use, lip biting, and tongue thrusting are all oral habits that may have negative side effects on the teeth and development of the jaws over the long term. For instance, thumb sucking will apply pressure that often causes constriction of the upper jaw and the upper front teeth to be protruded too far forward.
Due to the negative effects of oral habits, the goal is to eliminate oral habits as early as possible. For a motivated child, the first recommendation is a reminder and reward system. For digit sucking, a reminder would be a band-aid on the particular finger or a thin golf glove. Rewards should be given after one day, one week and one month without the habit, with bigger rewards at each level.
If the reminder/reward system is not effective, Dr. Lissauer may recommend a habit appliance. Habit appliances are custom-made based on the habit and are typically cemented to increase effectiveness. For example, a habit appliance for thumb sucking would interfere with the sensation of the thumb being placed against the roof of the mouth.
In an ideal bite relationship, the upper back teeth are wider out towards the cheek than the lower back teeth. A Posterior Crossbite exists when a patient has the opposite bite relationship, meaning the upper teeth are inside the lower back teeth. In the situation of a posterior crossbite, the underlying issue is not just that the upper teeth are too constricted towards each other but also that the upper jaw is too narrow. The upper jaw needs to be expanded to the appropriate width, typically using a palatal expander at a young age.
A palatal expander is a custom-made, cemented appliance that uses an expansion key to widen the upper jaw. The goal is to achieve the perfect amount of expansion, not too little and not too much, so periodic appointments are scheduled with Dr. Lissauer to check the progress. After the Posterior Crossbite is corrected, the expander is removed folllowing a stabilizing period of 4-5 months.
Certain situations, like caries or trauma, may cause a child to loose a baby tooth earlier than desired. After the premature loss of a baby tooth, children are often apt to have issues with crowding and a lack of space for the adult teeth to erupt into the mouth. Also, when a baby tooth is lost early, the adjacent teeth tend to drift in unfavorable directions with the newfound space available. To maintain all available space and reduce the risk of teeth drifting, a space maintainer is often recommended. Space maintainers are custom-made and designed based on the particular situation for each individual.
Most children cannot wait to choose colors for their braces. |Children often plan their selections in advance and love to coordinate with their school colors, favorite team, seasons and holidays. Don’t worry, we have extra orange and black in October and pink and red in February!
Do these colors serve a function? Yes. Simply put, metal braces are adhered to each tooth. Then an orthodontic wire is placed to align the teeth. The orthodontic wire engages each brace with a small circular colored rubber band. Patients are able to choose a new color each visit.
Virtually invisible, clear braces are ideal for patients that are looking for a more esthetic option during orthodontic treatment. Clear braces look fantastic and are a popular choice among our adult and teenager patients.
Parents often ask if they are equally as effective and efficient as metal braces. Fortunately, the answer is certainly yes! Dr. Lissauer strongly believes clear braces are an amazing option for patients that want beautiful straight teeth in a timely manner but don’t want the appearance of metal braces.
Dr. Lissauer loves Invisalign! Invisalign is a series of custom-made, clear aligners that gradually move your teeth to create the perfect smile. The removable aligners are smooth, comfortable, and virtually invisible. Your friends won’t even notice you are straightening your teeth.
Dr. Lissauer works with Invisalign to design the aligners just for you and move the teeth in the exact way he prescribes. You will change the aligners each week and watch your smile transform. Invisalign is truly an amazing option to perfect your bite and create a gorgeous smile without braces.
Invisalign Teen is the perfect option for teenagers that need orthodontics but would prefer to avoid braces. Invisalign Teen uses a series of clear, esthetic aligners that are changed weekly to gradually create the perfect smile.
Dr. Lissauer works directly with Invisalign to dictate the precise movement of the teeth for each individual to establish the perfect bite relationship with custom-made aligners. From his extensive experience with Invisalign Teen, he loves how smooth the process is for the patient and the beautiful results. The best part is your friends will not even notice the aligners.
Dr. Lissauer develops an individualized plan of treatment for each orthodontic patient based on the person’s specific diagnosis. Different bite relationships obviously require different orthodontic treatment. One bite relation that is fairly common is an excessive overjet, where the upper front teeth are considerably further protruded relative to the lower front teeth. Decreasing this discrepancy is accomplished by moving the upper front teeth back, the lower front teeth forward or a combination of the two.
In the situation where a patient has an excessive overjet and should be treated by moving the upper front teeth back and the lower front teeth slightly forward, Carriere Correctors are often the best solution. When this is the case, a patient starts orthodontic treatment with full lower braces and Carriere Correctors on the upper side teeth. A simple rubber band is worn from the Carriere Corrector down to the lower molar. The rubber band will apply adequate pressure in the perfect vector to bring the upper teeth back and the lower teeth slightly forward. The rubber bands will quickly correct the excessive overjet, as the upper front teeth will come back to meet the lower front teeth in an ideal bite relationship. At this time, the Carriere Correctoes will be removed and the upper braces will be placed to finalize treatment and create the perfect smile.
You finished braces or Invisalign, and your smile is now absolutely beautiful! You obviously want to keep that perfect bite and smile for the rest of your life. Retainers are the key! When finished with active orthodontics, Dr. Lissauer will make you perfect fitting removable retainers.
There are two main options for removable retainers: an invisible Essix retainer (that looks like a clear Invisalign aligner) or a traditional Hawley retainer made with acrylic and a thin metal bar. Dr. Lissauer typically recommends invisible retainers but will discuss the advantages and disadvantages of each type to determine which is best for you or your child.
For the first two months, we recommend retainers to be worn all of the time, except eating, swimming, brushing/flossing, and playing sports with a mouthguard. After these two months, we recommend the retainers to be worn from after dinner until the next morning.