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As you near the end of your orthodontic treatment, you’re probably already imagining the day when your brackets and wires finally come off. Or the moment you’ve finished with your last set of aligners. That day might come just a bit sooner if Dr. Don Connolly and Dr. Stanley Sokolow and our team recommend a positioner.

While not as well-known as other orthodontic treatments, a positioner is an appliance that can shorten your time in traditional braces and aligners by weeks or even months. Curious? Read on!

• What Exactly Is a Positioner?

A positioner resembles a clear mouthguard. Its arched shape is designed to fit snugly over your teeth. It’s sometimes called a finishing appliance, because it’s designed to make those last small adjustments to your alignment and bite. If you’re a good candidate for a positioner, it can replace your braces or aligners for your last several weeks or months of treatment.

• How Are Positioners Made?

This appliance is custom fabricated to fit your very specific orthodontic needs. Commonly, a mold is made of your teeth. A model of your teeth is made from this mold. Precision instruments are used to move the model teeth into your ideal alignment.

Once this model of your future finished smile is complete, it is used to create the positioner. When the thermoplastic material is molded to the model, it creates an appliance with an indentation for each individual tooth in its desired final location.

Available in a variety of materials, a positioner is most often designed as a clear single piece, covering both your upper and lower teeth. This makes sure that your teeth are not only aligned properly, but that your upper and lower teeth are working together for a healthy bite. Openings in the positioner provide airways which allow you to breathe easily.

• How Do Positioners Work?

Because your teeth haven’t settled firmly into place yet (this will happen as you wear your retainer), they’re still able to move. That’s why your positioner is shaped to fit your teeth in their future ideal placement, not where they are at present.

Positioners require your active participation. Your teeth move to the ideal spots molded into the positioner through “exercise”—biting down on your appliance for 15-20 seconds before relaxing your bite, usually every 10-15 minutes during your daily wear. The gentle force provided by your jaw muscles helps guide your teeth into position more quickly. Dr. Don Connolly and Dr. Stanley Sokolow will give you instructions on just how to—and how often to—do these exercises.

• How Long Are They Worn?

Positioners are commonly worn at least four hours a day to start with and all night long, or Dr. Don Connolly and Dr. Stanley Sokolow might recommend 24 hour a day wear for the first week. As you progress, you’ll wear them for shorter periods during the day, gradually tapering off until your treatment is complete.

Depending on the amount of correction that’s still needed, positioner use ranges from several weeks to several months. One thing that will ensure that your time in a positioner is as short as it can be is your willingness to follow our instructions. The speed and effectiveness of your final tooth movements is largely up to you!

• Caring for a Positioner

Gentle treatment is best. Clean your positioner before and after wearing it using a toothbrush and mild toothpaste. Never boil it or expose it to heat. We will give you instructions for how to clean it more thoroughly, if needed.

Like retainers, clear aligners, and mouthguards, a positioner needs to be protected when it’s not in your mouth. Your positioner will come with a case, so be sure to use it!

Positioners aren’t recommended for every orthodontic patient. But if you feel this might be an option worth pursuing, talk to us when you visit our Santa Cruz, Aptos, or Watsonville, CA office. A positioner could be an effective, time-saving step on your path to a lifetime of healthy smiles.

You’ve worked hard for your attractive, healthy smile, and now you’re making sure it stays attractive and healthy by wearing your retainer. Since wearing a retainer is usually a matter of years, not months, it’s natural to wonder just how long you can count on that retainer to help you maintain your smile.

That answer depends on the type of retainer you get at our Santa Cruz, Aptos, or Watsonville, CA office. A Hawley retainer, a clear retainer, and a fixed wire retainer have different lifespans. Because they each have their own advantages, Dr. Don Connolly and Dr. Stanley Sokolow will recommend the retainer that’s right for protecting your individual smile.

So let’s look at the average lifespan for different retainers, and, equally important, some of the common mishaps that can shorten that working life.

The Hawley Retainer

This is the retainer most people picture when they think “retainer.” Made of wire securely attached to an acrylic base, the Hawley retainer keeps the teeth in place, and can even be adjusted, if needed, to improve alignment. They generally last anywhere from three to ten years.

How can you make sure your Hawley retainer keeps working for you as long as possible?

• Keep it in its case. While some damages to these retainers can be repaired, why take a chance? And it’s much harder to lose a retainer if it’s in its case as opposed to, say, a cafeteria napkin.
• Keep it away from your pet. Dogs, especially, are tempted by the taste and smell of saliva, but there are safer, less expensive chew toys out there.
• Keep wearing it. Without your retainer, your teeth can shift. Over time, not only will your retainer fail to fit anymore, but you might need to return for further orthodontic treatment. If you notice your retainer is starting to feel uncomfortable, give your orthodontist a call.

The Clear Retainer

Clear retainers look like clear aligners, and, like clear aligners, are almost invisible. Made of vacuum-formed plastic, they’re designed for a close, comfortable fit, often around the entire arch of your teeth. Also like clear aligners, these retainers aren’t made to last forever. If they become loose, warped, or cracked, they should be replaced. With care, they can last from six months to several years. How to protect them?

• Protect your retainer from damage. Keep it in its case when you’re not wearing it. You’ll avoid losing it, and you’ll avoid damaging it.
• Protect it from teeth. And we don’t just mean pets, although they find clear retainers yummy, too. If you grind your teeth, your retainer can suffer. Clear retainers are not the same thing as night guards, so talk to your orthodontist for recommendations.
• Protect it from heat. Hot surfaces like ovens or heaters, hot dashboards, washers and dryers, even very hot drinks can be a problem. (You should only be drinking water while you wear your clear retainer, so that particular issue shouldn’t arise!)

The Fixed Retainer

A fixed retainer is a small piece of wire that is custom-fit and bonded to the back of specific teeth to prevent any movement from occurring. Because it’s bonded to the inside of the teeth, a fixed retainer is completely invisible when you speak or smile. It can last five years, ten years, and in some cases, even longer. Even though you won’t be exposing this retainer to external dangers like hungry pups or the wash-and-rinse cycle, there are still some situations to watch for:

• Watch your diet. The same sticky, crunchy, or hard foods that can damage brackets and wires can also loosen a fixed retainer.
• Watch your dental hygiene. While cleaning around a bonded retainer can be a bit challenging, not cleaning around it can result in plaque and tartar buildup—and your retainer might have to be removed to clean your teeth.
• Watch for changes. If your teeth start to shift, it could mean your retainer has detached from one or more teeth. Ask your dentist to check the retainer’s bond whenever you have a checkup.

So, how long will that retainer last? Depending on the kind of retainer you have, if you don’t keep it in its case, or if you don’t watch your diet, or if you expose it to heat, the answer is—not nearly long enough. Dr. Don Connolly and Dr. Stanley Sokolow will give you the very best tips to keep your retainer clean, safe, and working for as long as possible. Now, it’s up to you!

When we think orthodontics, we commonly think teeth. Naturally! Straight teeth and a beaming smile are everyone’s orthodontic goal. But orthodontics is a field which specializes in more than misaligned teeth. While your beautifully aligned teeth are the visible outcome of your orthodontic work, a properly aligned bite is the foundation for your healthy smile.

A malocclusion occurs when the teeth and jaws aren’t properly aligned—they don’t fit together the way they should when the mouth is closed. A malocclusion, or bad bite, affects many people to some degree, but not always in exactly the same way. Some of the different types of malocclusion include:

• Crossbite

A crossbite occurs when upper teeth fit inside lower teeth. An anterior crossbite refers to the front teeth, with one or more upper front teeth, or incisors, fitting behind lower front teeth. A posterior crossbite affects the back teeth, with upper teeth fitting inside the lower teeth on one or both sides of the jaw.

• Crowding

When the jaw is small and/or the teeth are large, lack of space can result in crowded, twisted, or crooked teeth.

• Open bite

An anterior open bite means that the front teeth don’t close when biting down, leaving an open space between the upper and lower teeth. A posterior open bite occurs when the back teeth don’t make contact when the front teeth close.

• Overbite

Our upper front teeth naturally overlap the lower ones a small bit when the teeth are closed. An overbite occurs when the upper teeth significantly overlap the lower teeth.

• Overjet

When the upper front teeth protrude too far forward over the bottom teeth, it’s called an overjet, or, sometimes, buck teeth. Where an overbite causes a vertical overlap, an overjet takes into account the horizontal relationship of the teeth.

• Spacing

A jaw that is large, teeth that are small, missing teeth—these conditions can lead to gaps between the teeth.

• Underbite

An underbite results when the lower teeth and jaw extend further forward than the upper teeth and jaw, causing the bottom teeth to overlap the top teeth.

If you have a malocclusion, what comes next? This depends.

Some malocclusions are so minor that no treatment is necessary. Some are the result of misaligned teeth. Some occur because the upper and lower jaws are growing at different rates. Some are a combination of teeth and jaw misalignments. Some are caused by genetics, while others are caused by injuries or habits like prolonged thumb sucking or tongue thrusting.

Because malocclusions are so varied, your treatment plan will be designed for your specific needs. Braces, aligners, appliances like the Herbst® appliance or the palatal expander, surgery for severe malocclusions—there is a larger variety of treatment options than ever before to help you achieve a healthy bite.

When teeth and jaws don’t fit together as they should, the consequences can be damaged teeth and enamel, problems with the temporomandibular joint, headaches and facial pain, and difficulty chewing, eating, and speaking.

The good news is that early intervention for children can help correct teeth and jaw problems before they become more serious, leading to easier orthodontic care in the teen years, and helping to avoid the possibility of surgery or extractions. This is why Dr. Don Connolly and Dr. Stanley Sokolow and our team recommend an orthodontic assessment at our Santa Cruz, Aptos, or Watsonville, CA office for children around the age of seven.

If you’re an adult with concerns about your teeth or bite, there’s good news for you, too. Dr. Don Connolly and Dr. Stanley Sokolow can devise a treatment plan to improve your bite and your smile no matter what your age.

Of course, despite our title, there’s really no such thing as a “common malocclusion” when we’re talking about your dental health. Each person—and each smile—is unique. Dr. Don Connolly and Dr. Stanley Sokolow will diagnose your malocclusion and create a personalized plan carefully tailored to your exact needs, for an uncommonly attractive, confident, and healthy smile.

Some experiences are great, and we look forward to enjoying them again and again. Others have wonderful outcomes, but you feel no need for a sequel. If you’re wondering whether you need to revisit orthodontic treatment, you’re probably in this second group.

After all, you put in your time as a teenager. All those days in bands and braces, all the adjustments, all that cleaning with little tiny tools in little tiny places. That was a lot of work, and you reaped the rewards of your conscientious orthodontic habits with beautifully aligned teeth and a healthy, comfortable bite.

But now you’ve started to notice that your teeth aren’t quite as beautifully aligned, or your bite’s not quite as comfortable. So, what’s happened? Let’s look at some possibilities, and whether a return to the orthodontist’s office is in order.

• You’ve Lost a Tooth

If you’ve lost a tooth because of injury or decay, that gap is an open invitation for surrounding teeth to move in to fill the void. Whenever you lose a tooth, consider an implant. Implants function, look, and maintain healthy spacing just like natural teeth.

One thing implants can’t do? Move like our own teeth will during orthodontic treatment. Your natural teeth can move because they are held in place within the bone by flexible periodontal ligaments. Implants, on the other hand, are anchored directly to the bone for stability.

If you’re considering new or further orthodontic work and want to replace a lost tooth with an implant, it’s a good idea to talk to Dr. Don Connolly and Dr. Stanley Sokolow to discover the best timing and scheduling for your procedures.

• You’ve Gained a Tooth

Problems with your alignment can also arise if you add a tooth or teeth. If you’re in your late teens or early twenties, wisdom teeth could be in your near future. And a new tooth can throw off the spacing and alignment of your existing teeth.

Talk to Dr. Don Connolly and Dr. Stanley Sokolow about your options if your wisdom teeth are about to make an appearance, and if it looks like your tooth and bite alignment might be affected.

• You’re Getting Older

Our teeth naturally tend to shift as we age. Teeth move forward, causing crowded or crooked front teeth—especially on the lower jaw. There’s even a medical term for this phenomenon: mesial drift. While we don’t know exactly why this drifting occurs, we can treat it.

Adults make up a large—and growing—segment of orthodontic patients. If your teeth have lost their ideal alignment over time, a visit to our Santa Cruz, Aptos, or Watsonville, CA office is a great way to bring your youthful smile back. And you’ll probably find your treatment much shorter and more comfortable than it was decades earlier!

• You Haven’t Been Wearing Your Retainer

Remember that word “conscientious” in the second paragraph? You need to wear your retainer conscientiously, for as often and for as long as recommended by Dr. Don Connolly and Dr. Stanley Sokolow.

If you’ve been ignoring a damaged retainer, or you keep forgetting to look for your lost retainer, or you have a perfect, undamaged retainer sitting unworn on your dresser, your teeth can start to shift out of their hard-won alignment within a short time.

Does this mean it’s back to months of bands and adjustments and appointments? Maybe not! See us as soon as you notice any changes in your teeth or bite. When caught early, shifting teeth can be treated much more easily.

What can we do to help you regain your best smile? A lot!

• Treatment Planning

When you need to accommodate implants, wisdom teeth, or other dental work which could affect your tooth alignment, Dr. Don Connolly and Dr. Stanley Sokolow can work with your dentist to make sure your alignment isn’t disturbed in the process. They can also map out a treatment schedule which coordinates your other procedures with any orthodontic treatment.

• Retainer Evaluation/Adjustment

Your retainer is probably a passive retainer, meaning it keeps your teeth in place instead of moving them. If you notice your alignment shifting, or if your retainer is uncomfortable when you try to put it on after a lapse in nightly wear, ask us about a replacement.

• Active Retainers

An active retainer helps move teeth into alignment rather than simply keeping them in place. A new active retainer might be just what you need to correct a slight shift.

• Aligners or Braces

If you have some serious shifting going on, we might recommend a second round of treatment with clear aligners or braces. But there’s good news here, as well! Treatment to correct an orthodontic relapse usually takes less time than it did originally, and treatment options are more comfortable and less noticeable than ever before.

Talk to Dr. Don Connolly and Dr. Stanley Sokolow about an orthodontic sequel if you have any concerns about changes in your bite or alignment. You might need only a simple retainer adjustment or a short time in clear aligners or traditional braces to make your smile its best and healthiest once again. And this time, remember to wear your retainer to make sure there’s no need for Orthodontics—Part III!