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By and large, the human body is a marvel of symmetry. But, of course, no one is perfect. You might have noticed one ear is a bit higher than the other. That you wear a shoe a half-size bigger on your left foot. That one shirtsleeve always looks longer.

Or that your smile looks off-center. This dental asymmetry could be caused by a condition known as “midline misalignment,” and, unlike that left foot, you can do something about it!

The dividing line between our center teeth, upper and lower, is called the midline. If we draw an imaginary line down the middle of a face, from the forehead to the nose to the midpoint of the chin, that line should go right between the front teeth. When it doesn’t, because the teeth have shifted past the midpoint, it’s often due to a condition called midline misalignment.

This kind of misalignment, also known as a deviated midline, can have several causes:

• Baby teeth that are lost too early

Baby teeth do more than promote healthy eating and speech development. They also reserve space for permanent teeth. If a primary tooth is lost too early, permanent teeth might “drift” to fill the empty space, causing the midline to move as well.

• Thumb sucking that goes on too long

As a child gets older, and certainly when by the time permanent teeth start to arrive, aggressive thumb sucking can lead to numerous orthodontic problems, including a deviated midline, as the teeth shift in response to that continuous pressure.

• Missing adult teeth

When you lose a tooth through decay or trauma, or when an adult tooth simply never develops, the remaining teeth can shift over to fill the open spot.

• Spacing issues

Crowded teeth, teeth with significant gaps between them, very large teeth, very small teeth—all of these issues can affect spacing and midline alignment.

• Crossbite

A crossbite is a kind of malocclusion, or bite problem. When you have a crossbite, the teeth don’t fit together properly, with upper teeth fitting inside lower teeth, instead of aligning on the outside where they belong. A deviated midline can indicate a posterior crossbite, where the top back teeth slant inwards or fit inside the bottom back teeth.

A tiny bit of midline shift one way or the other might be nothing to worry about, but if one front tooth is literally the center of attention, or if your teeth are noticeably out of alignment, it’s a good idea to talk to our Boynton Beach, FL orthodontic team.

Because there are several potential causes for midline misalignment, Drs. Lawrence Hier and Michelle Palmer will carefully analyze your individual situation to determine where the problem lies: with the teeth, the bite, or, rarely, the jaw itself.

Drs. Lawrence Hier and Michelle Palmer will also offer you your best dental treatment options. A shift of a few millimeters might be treated with clear aligners or traditional braces. A crossbite could require braces or aligners coupled with elastics (rubber bands) to bring your bite into alignment. A palatal expander can help correct a serious crossbite.

Why visit Hier & Palmer Orthodontics because of a little asymmetry? Because a deviated midline is more than a cosmetic concern. If you have a malocclusion to begin with, or if your misalignment leads to changes in chewing habits, which cause new bite problems, you might be facing jaw pain, chipped and cracked teeth, headaches, and all the other unpleasant consequences of malocclusion.

By and large, perfect symmetry in life is unattainable. But if you want a smile that is well-balanced and healthy, talk to us about all the treatments available to make sure your smile—and not a single tooth—is the center of attention.

It’s Valentine’s Day. Love and friendship are in the air, and candy is on the gift list. Are there tasty Valentine treats that are safe to eat even with your braces? We have some sweet news for you!

Safe Valentine candy, like the rest of your braces-friendly diet, won’t stick to your braces (potentially causing cavities) or damage them (potentially causing emergency visits to the orthodontist). In other words, foods that aren’t sticky, chewy, hard, or crunchy.

So, which candy treats are on the “Loves Me Not” list?

• Chewy Candies

Love heart-shaped gummies? Or spicy cinnamon jellies? Or Valentine-pink taffy? These sweet confections might be delicious, but, no matter how delicious, all that sugar sticking to your brackets and wires is not healthy for your teeth and it’s especially hard to brush off. And the chewy nature of these treats can break wires and pull brackets loose from your enamel.

• Hard Valentine Candies

Do U luv these? R they UR favorites? Whether or not they come in the shape of colorful hearts with clever stamped messages, as crunchy nuts surrounded by chocolate, or as gleaming red hearts on a lollipop stick, hard candies R not 4 U when you wear braces. Biting down on hard foods can damage wires and loosen brackets.

• Boxes of Assorted Chocolates

The beauty of a heart-shaped box filled with chocolates is its variety. The problem with a heart-shaped box filled with chocolates is its variety. Any pieces with nuts, toffee, or caramel should be left in their little paper cups. Sticky, chewy, and crunchy foods are some of the worst offenders when it comes to damaging your braces. If your candy doesn’t come with descriptions, break open the piece before you indulge to see just what you’re biting into.

Is this list a bit depressing? Take heart! There are several Valentine’s options that are safe for your braces.

• Soft Chocolates

Any kind of soft chocolate should leave your braces intact—and if you choose dark chocolate, you’ll be enjoying less sugar and more minerals and antioxidants.

• Chocolate-Covered Peanut Butter Candies

These treats are also soft enough to be harmless to your brackets and wires. And if they’re molded into hearts? Bonus!

• Boxes of Assorted Candies

The problem with a heart-shaped box filled with chocolates is its variety. The beauty of a heart-shaped box filled with chocolates is its variety. Nestled among all the sticky, chewy, and crunchy chocolates are the safer soft cream centers. Choose the braces-friendly options and share the rest.

Whether you’re buying a candy gift for someone in braces, or you’re the lucky giftee, choose candies that will make Valentine’s Day memorable for all the right reasons! Don’t be afraid to think out of the (heart-shaped) box—pink milkshakes or smoothies, sweetly decorated cupcakes, and creamy pastel ice creams and frozen yogurts are soft, smooth, and safe holiday treats.

Of course, after indulging in any Valentine treat, be sure to clean your teeth and braces carefully. Cavities are never fun, and especially not when you’re in braces. Brush and floss after eating, and make sure your brackets and wires are clear of any sticky, sugary souvenirs. If you do have a problem with damaged wires or brackets, be sure to call our Boynton Beach, FL office right away to keep your treatment plan on track. Valentine’s Day comes once a year, but your beautiful, healthy smile? You want it to last 4ever!

Maybe you’ve known people with braces and aligners—maybe you’ve worn them yourself!—so if braces or aligners are in your teen’s future, you have some idea what to expect and when to expect it.

But quite often, orthodontic issues require more treatment than braces alone can provide. When misalignment affects not only the teeth but the jaw as well, treatment can be more effective when it begins earlier and makes use of a different kind of appliance—the “functional appliance.”

During the years your child’s bones are still rapidly growing and forming, around the ages of eight to 14, functional appliances can help guide tooth movement and encourage jaw growth and development. One of the most widely used of these devices is the Herbst® appliance.

What does the Herbst appliance do?

There are several types of malocclusions, or “bad bites” treated by Drs. Lawrence Hier and Michelle Palmer. A common condition called a Class II malocclusion occurs when the upper jaw and teeth project too far forward over the lower jaw and teeth. Signs of a Class II malocclusion might include an overjet (protruding upper teeth), and/or a small or recessive lower jaw.

While correcting this malocclusion often enhances facial symmetry, which can be very important for a child’s confidence, correcting a Class II malocclusion also promotes jaw and dental health. Misaligned teeth are more difficult to clean, which can lead to decay and gum disease. Bite problems can cause persistent jaw pain and damage to the teeth. And, with an overjet, a child’s upper teeth are more at risk for injury.

The Herbst appliance was developed to treat this kind of malocclusion. It moves the lower jaw and teeth forward to create a balanced, healthy smile.

How does the Herbst appliance work?

The Herbst appliance is fixed in place with stainless steel bands or crowns that are secured to four teeth in the rear of the mouth, often the first molars on each side of the upper and lower jaws. The band or crown on each lower tooth is equipped with a small bar that extends toward the front of the mouth.

An arm on each side links the bands or crowns on the upper teeth to the front of the bar assemblies on the lower teeth. Each arm consists of a rod that fits smoothly into a tube. The telescoping action of the rod and tube allows the mouth to open and close normally. When the mouth is closed, the arms on both sides telescope shut, forming compact cylinders that hold the jaw forward.

While a child’s bones are still growing, the lower jaw’s new forward position can stimulate further bone growth and remodeling to maintain the jaw in that forward position. The Herbst appliance also has a restraining effect on the forward movement of the upper jaw. The result is a steady, noticeable improvement in the relationship between the upper teeth and jaw and the lower teeth and jaw.

Is the Herbst appliance hard to take care of?

The Herbst appliance is fairly low maintenance, but, like any orthodontic gear, it should be treated with care.

• It’s important to watch your child’s diet, because sticky, crunchy, and chewy foods can damage the appliance. Save the caramels for a post-treatment celebration!
• Carefully cleaning around the appliance is necessary, because a buildup of bacteria and plaque leads to consequences like bad breath, gum disease, and tooth decay. A water flosser can make reaching and cleaning tight spots easier if a brush alone isn’t effective.
• If the Herbst appliance is damaged, some minor fixes might be doable at home with instructions from your treatment team. But if a band or crown comes loose, or if there’s a problem you’re unfamiliar with, call our Boynton Beach, FL office right away.
• To help avoid the need for minor (or major) fixes, playing with the appliance with fingers or tongue, nibbling on pens and pencils, chewing on ice, or any other risky habits should be strictly off limits.

When it comes to your child’s health, you always have high expectations. Drs. Lawrence Hier and Michelle Palmer and our team have all the answers you’ll need about what to expect from this phase of your child’s orthodontic treatment, and just why the Herbst appliance is the very best option to create a future of attractive, healthy smiles.

Bite problems are so common that most of us know someone who’s worn braces. So perhaps you’re already familiar with the terms “overbite” and “underbite”—but if you’ve been diagnosed with an “overjet,” that just might be an orthodontic diagnosis that is new to you. If so, here are a few questions and answers to help promote overjet understanding.

Just what is an “overjet”?

An overjet is a type of malocclusion, which means that there’s a problem with your bite, the way your jaws and teeth fit together when you bite down. In a healthy bite, the front top teeth project slightly beyond, and slightly overlap, the bottom teeth. The key word here is “slightly.”

An overjet is a Class II malocclusion, which means that the upper front teeth project further beyond the lower teeth than they should. Overjets and overbites are both Class II malocclusions, and the words are often used interchangeably, but there’s a notable difference between the two conditions.

An overbite occurs when the top teeth overlap the bottom teeth too far vertically, and you can’t see as much of the lower teeth as you should when you bite down.

An overjet is considered more horizontal in nature, where the top teeth project at an outward angle toward the lips instead of pointing straight down toward the bottom teeth. This condition is sometimes called protruding or buck teeth.

What causes an overjet?

The reason for your overjet might be dental (caused by tooth alignment), or skeletal (caused by bone development), or a combination of both.

Overjets can run in families. They can also be caused by the size and position of your jaws and the shape and position of your teeth, all of which affect your bite alignment. But early oral habits, such as prolonged and vigorous thumb-sucking or pacifier use, can also contribute to overjet development.

How do we treat an overjet?

There are many types of treatment available. Drs. Lawrence Hier and Michelle Palmer will recommend a treatment plan based on the cause and severity of your overjet. Because some treatments are effective while bones are still growing, age plays a part as well.

• Braces and Aligners

If you have a mild overjet, and minor dental issues are the main cause of the malocclusion, braces or clear aligners can effective.

• Functional Appliances

If the overjet is caused by a problem with upper and lower jaw development, devices called functional appliances can be used to help guide the growth of the jawbones while a child’s bones are still forming.

For young patients, there are several appliances which can help correct an overjet. Some, such as the Twin Block and the Forsus Spring appliances, work inside the mouth, while others, like headgear, are worn externally. Your orthodontist will recommend the most effective appliance for your needs.

• Surgical treatment

In some cases, where the malocclusion is skeletal in nature as well as dental, surgical treatment might be necessary to reshape the jawbone itself.

If we recommend surgery, oral and maxillofacial surgeons are experts in surgical procedures designed to create a healthy and symmetrical jaw alignment. Drs. Lawrence Hier and Michelle Palmer will work with your surgeon to design a treatment plan, which will usually include braces or other appliances following surgery.

Why treat your overjet?

A serious, moderate, or even mild overjet can lead to many dental and medical problems, including:

• Concerns about facial and dental appearance
• Front teeth which are more at risk for injury
• Difficulty closing the lips
• Problems speaking or chewing
• Headaches, facial, and temporomandibular (jaw) joint pain

When you work with our Boynton Beach, FL team to correct your overjet, you’re not just correcting a problem. You’re also creating something—a healthy, comfortable bite, and an attractive, confident smile. We can talk about general answers to your overjet questions, but when it comes to understanding your very individual smile, Drs. Lawrence Hier and Michelle Palmer will have all the answers you need to make that healthy bite and that confident smile a reality!