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Dr. Henry Browning and our team have the experience and training to evaluate the present state of your teeth and bite, and to design a treatment plan to give you the healthy, attractive smile you picture for your future. And when you choose Invisalign^® for your treatment, you’ll be able to get an advance view of exactly what that future will look like!

How is this possible? Because when you choose Invisalign, you’re getting the benefit of some of the most advanced technology in orthodontics.

The process begins with a computerized scan of your teeth and mouth. Special scanner software creates a 3D image to capture your smile as it is now. But that’s not all. Using our customized treatment plan, Invisalign software can provide not only a model of your smile today, but an evolving model of what your smile can be. Seeing your present smile transform step-by-step into your future smile is a great motivator to follow that treatment plan!

For each step of your treatment, Dr. Henry Browning will provide a new set of aligners created to move your teeth and bite toward this goal. Why don’t you need a mold made of your teeth every time you get a new aligner? Because, with Invisalign, we design your aligners to fit your future tooth alignment.

Aligners are not fabricated to snugly fit around your teeth as they are, but as they will be after several days of wear. Each set is molded with small improvements to your alignment, and provides gentle, consistent pressure to move your teeth to that next step.

This “future fit” is why you may experience a bit of discomfort with a new set of aligners. Over the days that you wear them, the fit will become more and more comfortable. This won’t be because your aligners have changed. It will happen because your teeth have gradually moved where your aligners direct them.

Once your teeth and bite have reached this new step in your treatment, it will be time for the next set of aligners in the series, and so on. Dr. Henry Browning will let you know just how long you need to wear each set, and you can even track your progress with every appointment.

So, are we predicting the future? Not really. When you use Invisalign, we are planning and creating your future smile. Dr. Henry Browning will use the Invisalign system to customize your treatment for your very specific needs, step by step, and aligner by aligner, until you attain the smile you previewed before you even started treatment.

But one thing we can predict: If you follow our recommendations, keep your appointments at our Wilmington office, and wear your aligners as directed, there’s going to be a beautiful, healthy smile in your future.

It's the big day and your braces are finally coming off! Does that mean you are completely done? Not so fast! After you complete your treatment here at Browning Orthodontics, Dr. Henry Browning and our team will recommend you wear a retainer, which must be worn routinely after treatment in order to hold your teeth in their proper, new position while your gums, ligaments and bones adapt. Most patients are required to wear their retainer every night at first, with many also being directed to wear them during the day. It's important to know there are different kinds of retainers, and today we thought we would explain the differences between them.

Hawley Retainers

The Hawley retainer is one of the most common types of retainers. It is a removable retainer made of a combination of a metal wire that typically surrounds the six anterior teeth and is designed to keep your teeth in place. This retainer is made from impressions of your teeth so that it fits snugly and comfortably in the roof of your mouth, while the wire and acrylic framing keeps your teeth in an ideal position. The acrylic can also be personalized with a large number of colors or patterns.

Essix (Clear) Retainers

The Essix retainer is a transparent removable retainer that fits over the entire arch of your teeth. This clear or transparent retainer fits over the entire arch of teeth and is produced from a mold. Similar to Invisalign’s clear aligner trays, Essix retainers have no metal or wires. They can also be used to produce minor tooth movements and can be helpful in prevention of tooth wear due to tooth grinding at night.

Bonded Retainers

Bonded lingual retainers are cemented directly to the inside surface of your lower canines. Dr. Henry Browning and our team at Browning Orthodontics encourage our patients with bonded lingual retainers to be careful with their bite as the bonding material may break due to incorrect biting and cause your teeth to shift. As with removable retainers, it is important to keep your bonded retainers clean. When brushing, make sure to carefully clean the inside of your lower teeth, as well as the wire itself.

The retention phase of treatment begins when the patient’s braces are removed. Retainers are worn full time, typically for the first nine months, except while eating. Retainers should also be removed before brushing your teeth.

If you have any questions about the retainers we offer or to learn more about post-orthodontic treatment, please feel free to contact us at our convenient Wilmington office and we will be happy to answer any of your questions!

When does an underbite need surgery? The short answer is: when Dr. Henry Browning 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. Henry Browning 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 Wilmington 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. Henry Browning 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. Henry Browning 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.

Winter and its snowball fights are behind us, true, but there might be another kind of snowball heading your way. When you neglect the small steps involved in your everyday orthodontic routines, little problems can start to snowball into bigger ones, affecting your dental health and delaying your orthodontic progress.

Here are three areas where letting the small steps in your routine slide can have consequences:

Dental Hygiene

It can be harder to get your teeth their cleanest while you’re wearing braces. After all, there are wires to get behind and brackets to brush around, and you still need to get that floss in between your teeth. But neglecting your dental hygiene can have big consequences:

• Demineralization

The bacteria in plaque create acids that strip the minerals from tooth enamel. This process is called demineralization. Wherever plaque is allowed to build up, you’ll start to see white spots in the enamel. This discoloration is a sign that minerals are missing, and is often found around brackets, where it’s harder to brush. White spots can be treated cosmetically, but better to avoid them as much as possible, because eventually they can become . . .

• Cavities

As demineralization continues, the enamel becomes weaker and weaker, until a hole forms in the tooth—a cavity. Besides damaging your tooth, a cavity can put you behind your orthodontic schedule if you need parts of your braces removed for treatment.

• Gum Disease

When plaque builds up around the gums, gum tissue becomes inflamed and irritated—this is gingivitis, or early-stage gum disease. Symptoms often include puffy gums, redness, bleeding, and bad breath. Mild gum disease becomes more serious over time, so treat gingivitis early—or, even better, prevent gum disease with careful brushing and flossing.

Looking After Your Appliances

• Follow Care Instructions

Orthodontic appliances need love, too! Any instructions you get for their care are for a good reason. Brackets can become loose when you bite down on chewy foods. Wires can break when you eat hard candy. Aligners can warp if you leave them on a hot dashboard. If you follow instructions carefully, you won’t need to postpone your progress while you wait for repairs.

• Use Your Protective Case

If you wear aligners, or a removable appliance, or a retainer, don’t forget to protect these items when you’re not wearing them. This means placing them in their cases, not wrapped in a napkin on your lunch tray, or in the bottom of your gym bag, or anywhere your dog can reach them!

• Be Proactive If Accidents Happen

Unfortunately, accidents do happen, and loose brackets, broken wires, lost ligatures, and cracked or warped aligners can interrupt orthodontic progress and cause you pain and discomfort. Give our Wilmington orthodontic office a call to see if minor damage to an appliance can be handled at home, or whether you should be seen before your next regular appointment for repairs.

Following Your Orthodontic Plan

There’s more to following your orthodontic schedule than arriving on time for appointments. Depending on your treatment, you might be responsible for keeping track of the time you spend wearing:

• Elastics

Elastic bands can be used to help align your upper and lower jaws. If you don’t wear your bands as directed, you won’t make progress as quickly as you could. And remember to replace your elastics as often as recommended, because after hours of s-t-r-e-t-c-h-i-n-g they lose their effectiveness.

• Aligners

Most aligners are worn for around 22 hours each day. If you don’t follow your orthodontist’s instructions and wear your aligners for the recommend hours each day, your teeth won’t be in the proper alignment when your next set of trays is ready to begin work.

• Retainers

If you have a retainer and don’t wear it, your teeth will start to shift position. Skip wearing your retainer long enough, and you might need a return to your braces or aligners to repair any new misalignment.

Don’t ignore what seem like little dental and orthodontic responsibilities. Keep up with daily cleaning and brushing, take care of your appliances, and follow your orthodontic plan, and you’ll finish your treatment with a beautiful and healthy smile—right on schedule.