Night Guards

What You Should Know Before Buying

Night guards are widely recommended whether it’s for grinding, clenching, TMJ, etc. However the wrong one can actually cause damage when it should be preventing it!

                         Before Treatment                                                               After Treatment

Why should expansion start as soon as it’s needed?

Expansion is done when a patient has breathing issues or narrow arches or both. Narrow arches can be treated and resolved at any age with general orthodontics, however breathing issues become much harder to treat with age. When a patient has breathing issues it is most likely related to a narrow airway. The airway size is determined by the width the of the roof of your mouth (upper palate) which is a bone with a suture down the middle. This suture/seam in the bone begins to fuse and harden during puberty making it a much more difficult process to treat breathing disorders in older patients. Expanding early means a retainer must be worn in order to maintain the space created. The retainer must be worn for 4-6 months until the teeth on each side of the two upper front teeth grow in. This means the patient will be wearing a retainer at night for longer than if we had waited to start expansion but it’s important that the breathing issues are addressed now. The patient will also have a wide “grown up, adult” smile that they will grow into as their permanent teeth erupt. Breathing issues can have a big effect a child’s development and overall quality of life so it’s important to help them breath better as early as

Before Expansion                                                                                            After Expansion

MARPE

What is it? What makes it different from a traditional expander?

As an orthodontic office that focuses on airway health, we are always looking for the most updated methods to better serve our patients. One of these advancements that has been proven effective in many journal articles is MARPE, or Mini-implant Assisted Rapid Palatal Expansion.

What is MARPE?

MARPE is a type of palatal expander that uses mini-implants, or mini anchors, to expand the upper jaw. The mini-implants are placed in the roof of the mouth using local anesthesia, a procedure that we do in our office. They are connected to a palatal expander that is used to widen the upper jaw by turning it at home. The process of expansion occurs at the suture, which is the “joint” where the right and left bones of the upper jaw meet.

How is MARPE different from traditional RPE?

Traditional RPE also widens the upper jaw by turning at home, but it is done using an expander that is connected to the teeth. RPE is most ideal for young children (5-9 years old). It can be used predictably anytime before puberty, however the amount of expansion at the suture can be limited in the older children.

MARPE, on the other hand, is connected directly to the roof of the mouth with four mini-implants. This allows for greater bone expansion at the suture, which can be beneficial for patients with airway concerns such as sleep apnea / sleep disordered breathing and difficulty nasal breathing / mouth breathing.

Marin Ortho orthodontic patients (including Dr. Gorton’s son Kai) were among the first worldwide to be treated with Invisalign for early expansion. We have found this technique to be effective, also more patient-friendly and hygienic than traditional expanders.

The demand for esthetic, comfortable orthodontic treatment appears to be on the rise across all age groups. Not surprisingly, parents’ perceptions of the types of appliances that are acceptable for their children
closely mirror their standards of esthetics for themselves. According to a survey by Rosvall and colleagues, clear aligners and lingual appliances are generally preferred, followed in order by ceramic appliances, ceramic selfligating appliances, and self-ligating stainless steel (including hybrid).

The same study found that esthetic appliances were acceptable to more than 90% of adults, while traditional stainless steel and metal self-ligating brackets were acceptable to only 55% and 58%, respectively.

Click the link below to see the full published article:

Phase 1 Invisalign Expansion

Dr Jasmine Gorton was asked to join Dr Drew Ferris in sharing Invisalign cases with the west coast Schulman Group members. Her slides showed our treatment plans + results for young children with sleep apnea symptoms (age 7) with a combination of a Palatal Expander and Invisalign and young children (age 7) without apnea treated with Invisalign Only Expansion. She also presented a unique approach to non-invasive Invisalign treatment of adults with strong lower jaws who would traditionally be treated with jaw surgery and braces.