The Twin Block Orthodontic Appliance

What is the Twin Block Appliance?


twin block functional expander

Twin Block Appliance


The Twin Block appliance is a removable retainer-like device that straightens teeth by stimulating the jaws to slowly grow larger. More space in the mouth helps teeth fit better and be less crooked. The Twin Block stimulates the jaws and face to grow wider, taller and more forward. The result of therapy is more 3D space in the mouth and nasal passageways. Our Twin Block therapy helps our patients, not only have a better smile, but also to sleep, breathe and posture in a healthier way.

The Twin Block is only worn at night and is taken out during the day. It is not worn while eating. Oral hygiene is very easy since the appliance is removable. The treatment does not hurt because expansion pressure is very light compared to braces and conventional orthodontics. As long as the appliance is worn every night, designed properly and adjusted as advised, the treatment will go as planned.


What is our Twin Block Therapy About?


Drs Gary Adams and Viet Le welcome you to our practice. If you are looking for information about the Twin Block appliance therapy, you have found the right place. Many of our patients are children who have crowded teeth, tied tongues, and mouth breathing problems. Some also have posture and sleep disordered breathing issues. We integrate orthodontic expanders (such as Twin Block), chiropractic services, breathing exercises and myofunctional or tongue correction therapy. Our therapy helps our patients have a straighter smile, sleep better and live a pain-free and healthier life. We are located in Vienna Virginia near Tysons Corner and just outside of Washington DC.


Goals of Twin Block Appliance Treatment:


  • Improve facial growth and profile
  • Improve smile
  • Optimize tongue function
  • Establish healthy breathing patterns
  • Create a good bite
  • Balance upper and lower jaw relationships
  • Establish healthy posture


Why Do Teeth Grow-in Crooked?


Teeth become crooked because of poor tongue function, unhealthy mouth breathing patterns and a diet consisting of foods that are too soft. This is why kids mouths and faces do not grow large enough for all their teeth to fit and bite properly. If tongue and breathing problems are not corrected, your child will fall behind again in their development 1-2 years after appliance therapy. That is right, the teeth will get crowded and crooked all over again, if the root cause of developmental problems are not corrected. Kids continue to grow till at least the age of 19.


What Causes Under Growth Jaws and Faces?


Poor tongue movement is the root cause of underdevelopment of the face. Tongue pressure naturally expands the mouth and lower part of the face. Tongue ties cause diminished range of motion of the tongue. The tongue does not move out far enough and cannot reach the palate easily. Tied tongues often get pointy and curl down when extended out of the mouth. There is a sequential cause and effect relationship in the following order:


  1. Tongue Tie
  2. Poor Tongue Function
  3. Under Development of the Palate and Nasal Passageways
  4. Poor Nasal Breathing
  5. Mouth Breathing


How to Release Tongue Ties


Tongues can be untied with a soft tissue laser.  It is very quick, mostly painless and there is not bleeding. The dentist needs to verify the tongue is functioning correctly at the time of the procedure. Untying the tongue alone is not enough. The procedure is called a “functional tongue untie.”


What is Myofunctional Therapy


Myofunctional therapy is basically tongue physical therapy. Tongue exercises to achieve healthy movements. If tongue therapy and exercises are done with a functional untie procedure, tongue reattachment is less than 20%. Without myofunctional therapy, tongue reattachment is closer to 80%.


How to Stop Mouth Breathing Patterns


  1. Remove all Tongue Ties
  2. Myofunctional Therapy
  3. Orthodontic Expanders to correct jaw and facial under growth
  4. Breathing Exercises to restore proper nasal breathing patterns
  5. Posture Therapy with a chiropractor or qualified PT


Twin Block is a great Kids Expander


The Twin Block is very easy to tolerate because it only needs to be worn at night and it is removable. Unlike braces and other fixed expanders, the appliance does not get in the way of daily activities and is not worn during meal time. The appliance does not hurt when being adjusted.

The Twin Block is our favorite expansion appliance for children with deep bites and severe lower jaw under development. Twin Block appliance is great for when the lower jaw needs to grow more forward than the upper. And when the facial profile is back in the bottom part of the face. We call the reversed lower jaw position retrognathia. The Twin Block is often called a functional orthodontic treatment. “Functional” means to move the lower jaw position forward to improve the way teeth fit together. A more anterior jaw position also helps get the tongue further away from the throat/airway.


How the Twin Block Works


twin block device


Twin Block therapy uses top and bottom appliances that must be worn together. The appliances have a bite ramp that interlocks when biting to guide your jaws into s specific bite position. This will improve anterior growth of the mandible and the lower facial profile.


Expanders We use for Kids

  1. ALF appliance
  2. Schwarz Appliance
  3. Myobrace
  4. Crozat
  5. Healthy Start


What is An Expander Anyway?


We prefer the use of the term “growth appliances.”  They are small retainer-like devices that promote growth of the jaws. The goal is to grow the jaws into a more optimal size and shape. Growth appliances work by applying a light force in the direction the jaws need to grow. They are not mechanical devices and do not cause pain. The appliance mimics tongue pressure and encourages proper tongue position. Appliance therapy is synergistic with swallowing and tongue movement.


How Long is Twin Block Appliance Treatment?


Most kids only need to wear the appliances at night for 6-12 months during treatment. The appliances are usually not worn during the day or while eating. The patient is usually seen in the office every 5-7 weeks. During the office visits we will evaluate the growth, adjust the appliances and verify patient compliance. Treatment is usually performed between the ages of 5 and14 years of age.

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