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Orthodontic treatment is a type of dental care that focuses on correcting misaligned teeth and jaws. One common problem that orthodontists often encounter is class 2 malocclusion, which refers to a condition in which the upper teeth protrude significantly beyond the lower teeth. This can result in an excessive overjet, or the horizontal distance between the upper and lower front teeth, and an excessive overbite, or the vertical overlap of the upper front teeth over the lower front teeth.

Patients with class 2 malocclusion often also have mandibular retrognathia, which is a condition in which the lower jaw is underdeveloped or recessed compared to the upper jaw. This can result in a variety of problems, including difficulty biting and chewing, speech impairments, airway disturbances, and facial asymmetry.

Orthodontists have several treatment options available to address class 2 malocclusion, excessive overjets, and overbites in patients with mandibular retrognathia. These options may include:

1. Braces: Traditional metal braces are a common treatment option for patients with class 2 malocclusion. The braces apply gentle pressure to the teeth to gradually move them into their correct positions. Braces are generally paired with orthodontic elastics which help to align your bite into an ideal position. Elastics are placed onto the brackets themselves by the patient themselves. Elastic rubber bands help align your bite and are very important for the bite-fixing phase of orthodontic treatment, which is usually the longest and most difficult part of the whole process.
2. Herbst Appliance: A Herbst appliance is an orthodontic device that helps align the upper and lower jaws, correcting bite discrepancies such as an excessive overjet and/or overbite. If your child is suffering from an excessive overjet or overbite, this functional appliance works 24 hours a day to influence jaw growth and improve the position of a recessed lower jaw.
3. Headgear: Headgear is a type of orthodontic appliance that is worn on the head and attached to the braces. It helps to correct overbites by applying pressure to the upper jaw to encourage it to grow forward.
4. Invisalign Mandibular Advancement: Invisalign treatment with mandibular advancement is meant for tweens and teens presenting with retrognathic Class II malocclusions in permanent dentition or stable late mixed dentition. The special feature of enhanced precision wings for Invisalign treatment with mandibular advancement are integrated into the Invisalign aligners.
5. Removable appliances: Removable appliances, such as aligners or clear plastic retainers, can be worn to gently move the teeth into their correct positions. These appliances are often used in conjunction with braces to achieve optimal results.
6. Surgery: In severe cases of mandibular retrognathia, surgery may be necessary to correct the position of the lower jaw. This type of procedure is typically reserved for patients who have not responded to other treatment options or have severe jaw deformities.

Regardless of the treatment option chosen, it is important for patients to follow their orthodontist's instructions and attend all scheduled appointments in order to achieve the best possible results. With proper treatment, patients with class 2 malocclusion, overjets, overbites, and mandibular retrognathia can achieve a more functional and aesthetically pleasing smile.

NOTE: The author, Dr. Graydon Carr, is a board-certified orthodontist who is in the private practice of orthodontics in Chico, California with his partner Dr. B. Scott Hood. Dr. Graydon Carr was trained at the University of the Pacific, Arthur A. Dugoni School of Dentistry in San Francisco, California, and the University of Nevada at Las Vegas School of Orthodontics and Dentofacial Orthopedics. Dr. Graydon Carr & Dr. B. Scott Hood’s are experts in two-phase treatment, extraction and non-extraction therapy, functional orthodontics, clear aligners (Invisalign), and multiple bracket systems. This blog is for informational purposes only and is designed to help consumers understand currently accepted orthodontic concepts. It is not a venue for debating alternative treatment theories. Dr. B. Scott Hood & Dr. Graydon Carr are licensed to diagnose and treat patients in the state of California. They cannot diagnose cases described in comments nor can they select treatment plans for readers. The opinions expressed here are protected by copyright laws and can only be used with written permission from the author.

Orthodontic treatment, also known as braces or aligners, is a common dental treatment used to correct misaligned teeth and improve the overall function and appearance of the smile. However, there is a common misconception that orthodontic treatment can cause temporomandibular joint (TMJ) issues or temporomandibular joint dysfunction (TMD).

It is important to understand that TMJ issues and TMD are multifactorial in origin, meaning they can be caused by a variety of factors, including genetics, trauma, occlusal disturbances (issues), stress, and most importantly – individual adaptability. There are many conditions that can cause pain in the area of the TMJ that are not related to the teeth at all. Some are serious like degenerative arthritis and certain cancers. Others are related to functional habits like clenching and grinding.

While cross bites and open bites may be linked to joint problems, not all imperfect bites result in TMD. Many orthodontic patients have imperfect bites, and yet very few report TMJ issues or TMD. And in other instances, many patients who report severe TMJ pain often have ideal bites. This simple observation supports the scientific studies that have separated the fields of TMJ and orthodontics. There is no scientific evidence to support the claim that orthodontic treatment causes TMJ issues or TMD.

Except for two exceptions, malocclusion (imperfect bite) in general cannot be linked to a higher prevalence of joint problems. The two exceptions are a posterior cross bite that causes the jaw to shift to one side upon closure, and an anterior open bite where all the biting force is on the back teeth only and the front teeth do not touch at all.

Some people may be more susceptible to developing TMJ issues or TMD due to certain risk factors, such as a history of jaw injury or a family history of the condition. However, these risk factors do not include orthodontic treatment.

In fact, orthodontic treatment can actually help alleviate TMJ issues and TMD by correcting misaligned teeth and improving the overall function of the jaw. Properly aligned teeth can help distribute the force of biting and chewing evenly across the jaw, reducing strain on the TMJ.

It is important to address any concerns about TMJ issues or TMD with a qualified healthcare professional, such as a dentist or an orthodontist. They can provide a proper diagnosis and recommend appropriate treatment options.

NOTE: The author, Dr. Graydon Carr, is a board-certified orthodontist who is in the private practice of orthodontics in Chico, California with his partner Dr. B. Scott Hood. Dr. Graydon Carr was trained at the University of the Pacific, Arthur A. Dugoni School of Dentistry in San Francisco, California, and the University of Nevada at Las Vegas School of Orthodontics and Dentofacial Orthopedics. Dr. Graydon Carr & Dr. B. Scott Hood’s are experts in two-phase treatment, extraction and non-extraction therapy, functional orthodontics, clear aligners (Invisalign), and multiple bracket systems. This blog is for informational purposes only and is designed to help consumers understand currently accepted orthodontic concepts. It is not a venue for debating alternative treatment theories. Dr. B. Scott Hood & Dr. Graydon Carr are licensed to diagnose and treat patients in the state of California. They cannot diagnose cases described in comments nor can they select treatment plans for readers. The opinions expressed here are protected by copyright laws and can only be used with written permission from the author.

Orthodontic emergencies can be stressful and painful, especially when you are at home or traveling and don't have access to your usual orthodontic care. However, there are steps you can take to minimize the discomfort and damage to your teeth and braces. Here is what you can do in an orthodontic emergency at home and while traveling:

1. Loose or broken braces: If one of your braces comes loose or breaks, try to put it back in place or cover the sharp edges with wax or orthodontic adhesive. If the brace is completely detached, keep it in a safe place and bring it with you to your next appointment. In the meantime, use wax or adhesive to keep the loose wire from poking or scratching your cheek or tongue.
2. Loose or missing bands: If a band comes loose or falls off, try to put it back in place using wax or adhesive. If the band is missing or cannot be reattached, contact your orthodontist as soon as possible to have it replaced.
3. Wire irritation: If a wire is poking out of your braces and causing irritation, try using the back of a spoon or a pencil eraser to gently push the wire back into place. If this doesn't work, cover the wire with wax or a small piece of gauze until you can see your orthodontist.
4. Lost or broken retainers: If you lose or break your retainer, contact your orthodontist as soon as possible to have it replaced. In the meantime, try to avoid eating hard or sticky foods that could damage your teeth.
5. Toothache or jaw pain: If you have a toothache or jaw pain, rinse your mouth with warm salt water and take over-the-counter pain medication as needed. Avoid biting down on hard or chewy foods and contact your orthodontist for further treatment.
6. Broken rubber bands: Every once in a while, the tiny elastic bands or little wire ties that hold your brackets and wires together, known as elastomeric ligatures or "o-ties", can rip, tear, or break off. If it’s a rubber band, sterilize your tweezers and use them to gently try to put the wire back in place. If the o-tie becomes completely disloged or broken, let us know so we can add a new one. If it’s a wire ligature and it’s just sticking out, use a cotton swab or a pencil eraser to push it back to where it belongs. If it’s really loose, take it out with tweezers.
7. Sensitive Teeth: When you first get your braces put on and after your visit with an orthodontist and the wire is changed or tightened, or whenever you pop in a new set of Invisalign or Invisalign Teen aligners, your teeth can be a little sensitive for a few days. This is normal and not a concern. If possible, try to schedule your orthodontic appoints so they’re not right before you leave for vacation since, of course, you don’t want sore teeth while you’re enjoying your time on vacation. Regardless, stick to soft foods and cold drinks for the first day or two if necessary. You can also try swishing with salt water or taking an over-the-counter pain reliever.
8. Lost Separator: There aren’t really any DIY remedies for a lost separator and it just happens sometimes. Contact our office and we’ll let you know if you should come in to have it replaced before your next scheduled appointment. Generally speaking, if your next visit is within 1-2 days it shouldn't be too much of an issue. However, its better to be safe than sorry and call us as soon as possible.
9. Lost Invisalign Aligner: Always carry your case with you and put your aligners in it when you take them out. If you accidentally lose the current aligner and you still have aligners remaining in your set scheduled to be worn later, its generally okay to jump to the next aligner. Try in the next aligner and if it appears that it fits well with no spaces in between the teeth and the plastic, then continue wearing until your next visit. If you’re traveling, you’ll also want to call us so we can determine the best course of action. If you don't have any next set of aligners, then try to go back to your previous set of aligners until you can be seen in the office for evaluation. Regardless, whenever you lose an aligner you should call our office to best determine how to proceed.

While traveling, it is a good idea to pack a small emergency kit with supplies such as wax, adhesive, and a small pair of scissors or pliers in case you need to make any temporary repairs to your braces. It is also a good idea to have the contact information for your orthodontist and a nearby emergency dental clinic in case of a more serious problem.

Remember to always follow your orthodontist's instructions for caring for your braces and teeth, and don't hesitate to contact them if you have any questions or concerns. By taking care of your braces and seeking proper treatment when needed, you can minimize the risk of orthodontic emergencies and keep your teeth and braces in good condition.

NOTE: The author, Dr. Graydon Carr, is a board-certified orthodontist who is in the private practice of orthodontics in Chico, California with his partner Dr. B. Scott Hood. Dr. Graydon Carr was trained at the University of the Pacific, Arthur A. Dugoni School of Dentistry in San Francisco, California, and the University of Nevada at Las Vegas School of Orthodontics and Dentofacial Orthopedics. Dr. Graydon Carr & Dr. B. Scott Hood’s are experts in two-phase treatment, extraction and non-extraction therapy, functional orthodontics, clear aligners (Invisalign), and multiple bracket systems. This blog is for informational purposes only and is designed to help consumers understand currently accepted orthodontic concepts. It is not a venue for debating alternative treatment theories. Dr. B. Scott Hood & Dr. Graydon Carr are licensed to diagnose and treat patients in the state of California. They cannot diagnose cases described in comments nor can they select treatment plans for readers. The opinions expressed here are protected by copyright laws and can only be used with written permission from the author.