Miscellaneous

When it comes to keeping your mouth healthy and your smile bright, dentists may be the first health care professionals you think of. But for certain orthodontic problems, we may recommend a team approach that involves consulting a professional in another field. For example, when a persistent habit like tongue thrusting is causing trouble with your child's bite, it may be time to pay a visit to an orofacial myologist. If you haven't heard of this specialist, you're not alone. Let's take a closer look at how the muscles in your mouth work together, how problems in this area may develop, and how they can be fixed.

Your oral cavity is surrounded by many muscles, including those that control facial expression, speech, mastication (chewing), and swallowing. One of the largest is the tongue, which has a prominent role in speaking and swallowing. In a normal, relaxed posture, the tip of the tongue touches the upper palate (roof of the mouth), the top and bottom teeth aren't in contact, and breathing is done through the nose. But in some people, this posture doesn't occur naturally. Instead, the tongue may rest on the "floor" of the mouth, allowing too much open space above; or it may be positioned too far forward, even protruding between the front teeth (tongue thrusting). Either of these postures can spell trouble for the bite.

How Orofacial Myofunctional Therapy Works

The goal of OMT is to re-train the facial muscles (including the tongue) to habitually assume the proper resting posture. A health care professional called an orofacial myologist may employ various approaches to achieve this goal, including exercises for the oral muscles combined with motivational techniques that use positive reinforcement. Some exercises are designed to accustom the tongue to resting on the proper spot on the palate; others promote good muscle tone and lip strength. An orofacial myologist may also help train your child to use the adult swallowing pattern, and encourage him or her to replace harmful habits with healthier behavior patterns.

Rather than being a one-size-fits-all treatment, orofacial myofunctional therapy is tailored to each individual's needs. Following a thorough evaluation, OMT uses age-appropriate techniques (and rewards) to bring about positive changes in behavior. As therapy progresses, exercises learned in the office are often practiced at home in front of a mirror. Simple tools, such as tongue depressors, dental elastics, or even healthy snack foods, are sometimes used to help young patients develop good oral behaviors. While every situation is different, OMT typically brings improvement in a period of weeks, and is generally completed in 15-17 sessions.

Orofacial myofunctional therapy is an established treatment method that can be beneficial in a number of situations. If you have questions about OMT or would like more information or a referral, please contact our office.

Temporary Anchorage Devices (TADS) are small, screw-like dental implants made of a titanium alloy. As the name implies, they're temporary — they usually remain in place during some months of treatment, and then they are removed. Their function is to provide a stable anchorage — that is, a fixed point around which other things (namely, teeth) can be moved. But why is anchorage so important?

Moving teeth in the jaw has been compared to moving a stick through the sand. With the application of force, sand moves aside in front of the stick, and fills up the space behind. The "sand" in this case consists of bone cells and cells of the periodontal ligament, which attaches the tooth to the bone. These tissues slowly move aside and reform as force is applied to them by orthodontic appliances, such as wires and elastics.

But to do its work, that force needs a fixed point to push against. For example, imagine trying to move the stick while you're floating free in the water: Not so easy! But with two feet firmly planted in the sand, you can do it. When possible, orthodontists use the back teeth as an anchor — but sometimes, cumbersome headgear may be required to provide the necessary anchorage. In many cases, using TADS can change that.

Getting and Maintaining TADS

Like dental implants (which have been in use since the 1970s) TADS are small, screw-like devices that are placed into the bone of the jaw. Unlike implants, however, they don't always need to become integrated with the bone itself: They can be fixed in place by mechanical forces alone. Plus, they're much easier to put in and remove when treatment is complete. How easy?

Placing and removing TADS is a minimally-invasive, pain-free procedure. After the area being treated is numbed (with an injection or other numbing treatment), a patient feels only gentle pressure as the device is inserted. The whole process can take just minutes to complete. Afterwards, an over-the-counter pain reliever can be taken if needed — but many patients need no pain reliever at all. And taking TADS out is even easier. So if you're worried that it may be a painful procedure: Relax! It's far less stressful than you may think.

While they're in place, TADS require minimal maintenance. Generally, they should be brushed twice daily with a soft toothbrush dipped in an antimicrobial solution. We will give you specific instructions regarding maintenance when your TADS are placed.

Not every orthodontic patient needs TADS — but for those who do, it's a treatment option that offers some clear benefits.