212 Linden Drive, Suite 150
Winchester, VA 22601
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Orthodontics with a Difference: Functional Orthodontics

Closeup of mouth with traditional ceramic braces on teeth

At Winchester Dental, our orthodontics philosophy addresses both the cosmetic repositioning of teeth and the correction of negative habits that may have contributed to the orthodontic condition. Genetics may be one cause of crooked, crowded teeth, but finger or thumb sucking, mouth breathing, reverse swallowing, and tongue thrust are all poor myofunctional (muscle function) habits that can derail growth and result in dental misalignment. Traditional orthodontic braces will straighten teeth, but do not address poor myofunctional habits. Without correction of the underlying myofunctional problems causing the disorder, the risk increases for straightened teeth to shift over time and again become misaligned.

In such situations, it is functional orthodontics that makes the difference. Age 4 or 5 is an ideal time to begin treating children showing signs of developing malocclusion (a “bad bite”). If necessary, we also refer patients to chiropractors, oral myofunctional therapists, and osteopaths for help in correcting such issues.

What is the difference between traditional orthodontics and functional orthodontics?

Where traditional orthodontics is focused only on straightening teeth, functional orthodontics is a twofold, whole-patient approach whose initial focus is orthopedic. This focus includes improving a patient’s airway and bite (occlusion). Achieving straight teeth through traditional orthodontics is the secondary focus of functional orthodontics. Before any traditional orthodontic treatment begins, functional orthodontics addresses these orthopedic aspects of the patient’s overall health:

  • the skeletal bones that make up the head and face
  • the upper and lower jaw bones and the temporomandibular joint (TMJ)
  • the relationship of the of the TMJ to the neck and back
  • the patient’s airway

After these developing orthopedic aspects have been addressed, then any necessary traditional orthodontic treatment to straighten a patient’s teeth can begin.

What is the goal of functional orthodontics?

Functional orthodontics seeks to help children develop to their full genetic potential by optimizing the four areas listed above through various orthodontic treatment methods. Palate expansion, which increases the size of jaws and airways, occurs through the use of oral appliances and traditional braces, thus creating sufficient room for the teeth to come into place. For children, functional orthodontics promotes proper (forward) facial development. This minimizes the need for extractions of permanent teeth as part of the course of treatment.

How should functional orthodontics proceed?

Because it works best in conjunction with a patient’s growth and development, functional orthodontics is best begun when children are young—around age 4 or 5. Treatment usually occurs in two phases:

  • Phase 1: Patients are fitted with oral appliances to develop the upper and lower jaw bones (maxilla and mandible). Treatment timeframes generally last from 9 to 18 months but sometimes last longer.
  • Phase 2: After the jaws have developed and all the permanent teeth have appeared, patients wear traditional braces to straighten their teeth, if needed. Treatment time typically lasts another 9 to 18 months, but may last several years in some cases.

The benefits of functional orthodontics include more than straight teeth. This treatment method provides children more ability to develop to their maximum genetic potential, and also helps correct sleep breathing disorders. As the palate expands, the nasal and sinus passages expand, allowing patients to breathe more easily through their noses. Proper brain and body development depend on oxygenation in the body, and palate expansion promotes this.

Exactly how does Phase 1 work?

During Phase 1, patients wear functional appliances to develop their upper and lower jaw bones, and to expand their palates where necessary. These appliances work best when there is a combination of primary and secondary teeth in the mouth. A functional appliance that is designed to guide teeth into the right position and to help patients break poor muscle function habits can actually reverse deteriorating orthodontic conditions, improve the shape of a patient’s face, realign the teeth, and develop the proper arch form.

Varying functional appliances are available during Phase 1, including palatal expanders and Myobrace appliances. Our team evaluates each case, selects an appliance, and customizes a treatment plan according to patients’ individual needs.

What about Phase 2? Are traditional braces always needed?

After treatment with functional orthodontic methods, the next logical step for many patients will indeed be treatment with traditional braces. When this step is necessary, we can certainly provide it.

How does Phase 2 work?

Braces may be removable; or patients can choose from ceramic, metal, or plastic brackets that we bond to their teeth. These latest materials typically move teeth faster with more comfort. Wires are less noticeable than they once were, and through gentle, constant force applied in the right direction, the teeth move into the proper position. Different types of traditional braces are shown below.

How long does Phase 2 usually last?

Treatment time varies, and in some cases will last up to three years, depending on factors the patient’s age, treatment method, and the severity of the case. The more diligent patients are in following instructions, the more efficient treatment can be. Treatment begun early for children can also lead to quicker treatment timeframes.

What do the different types of traditional braces look like?

Traditional Metal Braces

Traditional-braces-metalMetal braces are most common, and these days they are more comfortable than ever before. These braces are made from high-grade stainless steel, and use metal brackets and archwires to straighten teeth. Patients who require elastics (rubber bands) with their metal braces can usually choose from an array of colors.


Self-ligating Braces

Traditional-braces-self-ligatingSelf-ligating braces are also made of metal. However, self-ligating braces do not require the use of elastics, resulting in fewer appointments and less friction on the teeth. For these braces, traditional metal, ceramic, or clear brackets may be used. Self-ligating braces are similar in size to metal braces. To help the archwire guide teeth into place, they use a specialized clip instead of elastics. This helps reduce the amount of pressure being placed on the teeth, and with no elastics to replace, the braces require fewer adjustments.


Clear (Ceramic) Braces

Traditional-braces-ceramicMade of clear materials, ceramic braces are not as visible as metal braces. Ceramic braces are commonly used on older teenagers and adult patients who have cosmetic concerns. While they are not as noticeable as metal braces, they do require that patients give careful attention to their oral hygiene. Ceramic braces are also larger and more brittle than metal braces. For these reasons, we generally place ceramic braces on upper front teeth rather than on lower teeth.


Clear Aligners

Traditional-braces-clear-alignersClear aligners are a series of comfortable, invisible acrylic trays that straighten teeth like braces do. The aligners are removable, so patients can eat and drink as they wish while in treatment. The removable aligners also make flossing and brushing much easier than they would be with braces bonded in place. And with clear aligners, there is no metal to cause mouth abrasions during treatment.


Before beginning any orthodontic care, we will discuss all available options and provide an estimate for how long the full course of treatment may take. Please contact our office to schedule an appointment, and to learn more about orthodontics and all the treatments we provide.