Functional Orthodontic Treatment

Table of Contents
  1. Functional Orthodontic Treatment

Functional orthodontic treatment represents a different approach than traditional orthodontic treatments used to correct problems in children’s teeth and jaw structures. This approach allows a holistic evaluation of the face and jaw structure, taking into account the child’s growth and development process, rather than focusing solely on the straightness of the teeth.

Functional orthodontic treatments are generally performed to correct the protruding upper jaw or retruded lower jaw in growing children.

Functional orthodontic treatments are applied to solve problems that we call ‘Class II orthodontic disorders’ in orthodontics. In this disorder, the upper jaw may be forward, the lower jaw may be backward, or a combination of the two (Figure 1).

In the photo on the left, we can see the difference between the upper and lower jaw due to retruded lower jaw. In the photo on the right, it is seen that the lower jaw comes forward with the twin block appliance. Twin Block Appliance. Functional orthodontic treatment.
Figure 1. Lower jaw positioned backwards. The removable functional appliance positions the lower jaw forwards, applying force backwards to the upper jaw and forwards to the lower jaw.

For more detailed information about functional orthodontic treatments, you can read the British Dental Journal article “The use of functional appliances in contemporary orthodontic practice“.

Basic Principles of Functional Orthodontics:

  • Growth Guidance: Functional orthodontic treatment aims to guide the natural growth and development of the jaw and facial structures. This ensures harmonious development of the jaw and facial structures and prevents the need for further treatment in the future.
  • Airway Improvement: Functional orthodontic treatments can improve the airway by promoting the development of the jaw and oral structures, which can lead to better breathing for the child and a reduced risk of sleep disorders such as sleep apnea.
  • Holistic Health Impact: The benefits of functional orthodontics go beyond oral health. Proper jaw alignment and improved airway function can improve sleep quality, nutrition, and even posture.

Functional and Growth Guidance Appliances

In functional orthodontic treatments, specially designed appliances are used for each child. These appliances support the child’s natural growth and correct imbalances in the oral and facial structures. At the same time, they provide an effective and comfortable treatment process without hindering the daily activities of children.

Functional orthodontic appliances, also called growth guidance appliances, are the cornerstone of our functional orthodontics practice. These appliances are designed to support and guide the natural development of children’s jaw and facial structures, ensuring that they grow correctly and harmoniously. Some of the benefits of growth guidance appliances include:

  • Individualized Treatment: Each appliance is customized to the child’s specific needs, growth patterns and developmental requirements.
  • Non-Surgical Approach: Growth guidance appliances work with the body’s natural growth processes and encourage proper development without invasive procedures.
  • Early Intervention: By addressing potential problems at a young age, these appliances can often reduce or eliminate the need for more complex orthodontic treatments in the future.

Functional orthodontic appliances play an important role in functional orthodontics by helping to prevent common problems such as crowding, misalignment and improper bite. By promoting optimal growth and development, growth guidance appliances help to create a solid foundation for lifelong oral health and well-being.

Functional appliances can be designed in two different ways: fixed (attached to the teeth) or removable. There are many different types and designs of these appliances and they are usually named after the scientist who first designed them, and their design also reflects the inventor’s treatment philosophy. Functional appliances that are attached to the teeth cannot be removed by the patient. The best example of these is the Herbst appliance. Removable functional appliances (Figure 2) can be weared and removed by the patient, and although they usually consist of two pieces attached to the upper and lower jaws, there are also single-piece types. The most commonly used type of removable functional appliances is the Twin Block appliance (Figure 2).

Intraoral front view of the Twin Block appliance, which is a type of removable functional appliance. Functional orthodontic treatment. Twin Block
Figure 2. Twin Block appliance, one of the removable functional appliance types.

The Effect of Functional Orthodontics on Child Health

Functional orthodontic treatment is an investment not only in your child’s smile, but also in their overall health and future well-being. Functional orthodontics can make a profound impact on a child’s life by addressing structural and developmental aspects of the jaw and face. Holistic health benefits include:

  • Improved Breathing and Sleep: Proper jaw alignment and open airways facilitate breathing, which is essential for restful sleep and overall health. Children with corrected orthodontic problems often experience significantly improved sleep quality.
  • Improved Nutrition: Aligned teeth and jaws can significantly improve a child’s ability to chew and digest food properly, leading to better nutrition and overall health.
  • Speech Development: Functional orthodontics can aid in the proper development of speech by ensuring correct alignment of oral structures, thereby facilitating clearer and more effective communication skills.
  • Long-Term Dental Health: By directing teeth into their optimal positions at an early age, functional orthodontics sets the stage for a healthier oral environment, reducing the risk of cavities, gum disease and other dental problems later in life.

Functional orthodontics combines growth guidance appliances with an approach to facial, oral and dental development to ensure that each child’s path to optimal oral health is as smooth and effective as possible. The benefits of this approach extend far beyond the aesthetics of straight teeth, touching every aspect of a child’s growth and development.

Changes in Face

Functional orthodontic treatment creates positive changes on the face, although not always very noticeable. If the treatment is successful, they change the face shape positively from the profile by positioning the lower jaw forward. You can see an example of a successful removable functional treatment in the photo below.

In the left photo, it is seen that the lower jaw is far behind the line lowered from the subnasale. In the profile photo on the right, it is seen that the lower jaw has come forward thanks to the removable functional appliance.
Figure 3. Forward growth of the lower jaw as a result of treatment with a functional appliance.

Success in Functional Treatments

Functional treatments are often successful. Although rare, failure is encountered. There are three main reasons for failure. First, if the appliance is not used for the duration of the day that your doctor tells you, the treatment will fail. The second reason is genetic. Some individuals do not respond well to functional appliance treatment, this is often related to genetic factors. Unfortunately, it is impossible to determine in advance which patient will respond positively and which patient will respond negatively to this treatment. The third reason is timing. The period when functional appliances are most effective is the period when puberty is the developmental spurt. This period is between the ages of 10-13 in girls and 12-14 in boys. The age ranges I have specified are estimates and the doctor determines the time to start treatment. Sometimes it is necessary to look at bone age to determine when to start treatment. In special cases, functional treatments can be performed at an early age.

To summarize:

Fonksiyonel ortodontik tedaviler genellikle başarılı sonuçlar verir, ancak nadiren de olsa başarısızlıklarla karşılaşılabilir. Başarısızlığın temel nedenleri şunlar olabilir:

  • Failure to Use the Appliance Regularly
  • Genetic Factors
  • Timing of Treatment

Başarısızlık Durumlarında Neler Yapılabilir?

In cases where treatment is unsuccessful, other methods for resolving a Class II orthodontic problem may be considered. Examples of other options include:

  • Continuing treatment by extracting teeth
  • using headgear
  • jaw surgery.

Your doctor will decide if you are suitable for these alternative treatment options. If jaw surgery seems to be the only option, treatment can be postponed until the age of 17-18, with some exceptions.

Treatment Duration

The most important factor affecting the duration of treatment is the size of the existing problem. Usually treatment ends in 9-12 months. After the treatment is over, your doctor may want you to use the appliance at night for a while longer. Thus, the first phase of the treatment, the functional treatment phase, is over. Now, the second phase of the treatment, the fixed orthodontic treatment phase, can be moved on. You can read our Orthodontic Treatments article for more information about fixed orthodontic treatments.

Functional Orthodontics: An Investment in Children’s Future

Functional orthodontics is a holistic approach that helps improve not only children’s teeth, but also their overall health and well-being for the future. With growth guidance appliances and personalized treatment plans, functional orthodontics allows children’s jaw and facial structures to develop naturally and healthily. This helps them have a better quality of life and increase their self-confidence.

Parents considering functional orthodontic treatment can enjoy the comfort of leaving their child’s dental and jaw development in the hands of experienced professionals focused on holistic health outcomes. With a comprehensive approach to functional dentistry and state-of-the-art orthodontic solutions tailored to each child’s individual needs, our clinic helps children achieve optimal oral health.

Remember, early diagnosis and treatment are critical to the success of functional orthodontics. If you have concerns about your child’s teeth and jaw development, don’t hesitate to talk to an orthodontist to find out if functional orthodontics is a good option for them.

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