Palatal Expander
Attached to the upper molars through bonding or by cemented bands, the Rapid Palatal Expander is an orthodontic device used to create a wider space in the upper jaw. It is typically used when the upper jaw is too narrow for the lower jaw or when the upper teeth are crowded or blocked out of the dental arch.
When patients are still growing, their connective tissue between the left and right halves of their upper jaw is very responsive to expansion. By simply activating the expander through turning a screw in the center of the palatal expander, with a special key we provide, gradual outward pressure is placed on the left and right halves of the upper jaw. This pressure causes an increased amount of bone to grow between the right and left halves of the jaw, ultimately resulting in an increased width.
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Herbst
One of the most common problems orthodontists treat is the discrepancy that occurs when the upper teeth protrude beyond the lower. Ordinarily, when we see a patient with the upper teeth protruding, we tend to think that the upper jaw and teeth are too far forward; but, more often than not, this condition is due to a small lower jaw that is further back than it should be. With these patients, we would like to encourage the lower jaw to catch up in growth, and braces like the Herbst appliance help this happen.
Even though the Herbst appliance prevents the lower jaw from moving backward, opening and closing movement still occur easily, and patients do not have any problems learning to chew their food with their lower jaw in this new position.
As with all kinds of braces, patients with Herbst appliances need to be careful about what they eat. For instance, cold foods such as ice slushes, Popsicles and ice will freeze the cement and make the brace loosen. Sticky foods such as caramels, bubble gum and candy suckers will pull the brace away from the teeth. Hard foods like crisp vegetables and hard candies will bend and loosen the Herbst appliance, too. So stay away from these foods during your orthodontic treatment.
Your Herbst appliance will be checked and adjusted at your appointments. If, sometimes between appointments, you develop some sore areas on the inside of your cheeks, please do not try to adjust the appliance yourself. Call for an appointment so that the necessary adjustments can be made.
Wearing a Herbst Appliance
At first, your mouth will feel unusually full and speaking will be awkward. But if you practice reading aloud, your ordinary speech will return quickly. You may also notice more saliva than normal, but this will decrease as you become accustomed to the appliance.
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Distal Jet
The Distal Jet Appliance is a non-removable lingual appliance that is used to move upper teeth backward faster and more predictably than headgear. The Distal Jet distalizes molars and corrects teeth that have rotated. This appliance corrects class II problems.
The Distal Jet Appliance uses a solid track wire and two sets of locking screws on each side. The appliance is self-limiting by design because it has a distal stop attached to the tracking wire. The Distal Jet can be converted to a Nance Appliance by tightening the distal and anterior locks against the track wire and adding a Nance holding arch.
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Quad Helix
The Quad Helix is a fixed orthodontic appliance used for upper arch expansion. Bands are cemented to your back molars to keep the appliance in place while four helix springs help widen the arch. This appliance is ideal for patients with crowding in the upper arch or to correct a posterior crossbite.
It is important to maintain a good oral hygiene regimen while wearing the Quad Helix. Patients should brush around and under the appliance and also floss and rinse thoroughly to remove any food particles.
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Headgear
Headgear is often used to correct an excessive overbite. This is done by placing pressure against the upper teeth and jaw, which would hold the teeth in position or help move them into better positions. The severity of the problem determines the length of time headgear needs to be worn. The key to success with your headgear appliance is consistency. Headgear must be worn a certain number of hours per day, and if not, it must be made up the following day.
Headgear should never be worn while playing sports and should also be removed while eating or brushing your teeth.
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Facemask
In some cases where an underbite is present, we may recommend using a facemask (reverse headgear) as part of the treatment plan. This appliance is designed to fix the discrepancy between your upper and lower jaws by moving the upper jaw forward to correct the malocclusion.
For the results to be successful, patient compliance is of the utmost importance. It may take several days to become accustomed to the appliance. With practice, it will become easier to place and remove the facemask. We will determine the length of time you should wear your facemask, but it is generally 10-14 hours per day, which can include wearing while you sleep. You should not wear your facemask while participating in sporting activities.
Sometimes your chin may get irritated from the facemask. If this happens, you should always keep the area clean and often change the insert in the chin cup. If the skin becomes very dry, the use of moisturizing cream twice a day can be helpful. If your jaw joints are extremely sore or you cannot open and close your mouth without difficulty, stop wearing the appliance and contact us for further instructions as we may need to fit you with a different appliance. Also, if your facemask breaks or is bent, call us so we can fit you in with a repair appointment so your treatment will not be delayed.
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Lower Lingual Arch
A Lower Lingual Arch acts as a space maintainer to keep the molars from drifting forward, and prevent them from blocking the space where permanent teeth will eventually erupt. This appliance is commonly used in cases of premature loss of baby tooth or when the lower teeth of a growing child are slightly crowded and no permanent teeth are extracted to correct the problem.
You should expect soreness the first day or two, and it may hurt to chew. We recommend a soft diet initially. You may take Advil or Tylenol to relieve the pain. Avoid sticky or hard foods, and please monitor how many foods you eat that are high in sugar.
Brushing and flossing daily is very important. Be sure to clean around the bands that are connected to the molars and the wire on the tongue side. This will prevent the formation of cavities or infection of the gums.
The duration of wear varies. We will monitor the eruption of new teeth and make adjustments. Generally, the Lower Lingual Arch is removed following the eruption of all the permanent teeth.
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Nance
The Nance Appliance is used to prevent upper molars from rotating or moving forward after you’ve worn a headgear, a Wilson’s arch or any other appliance to move your molars back. Some patients wear the Nance Appliance while they are awaiting their bicuspids to grow into place.
The appliance is made of two bands that are cemented onto the first molars and a wire spans the roof of the mouth from one molar to the other. An acrylic pad or “button” covers the wire that touches the roof of your mouth directly behind your front teeth.
Patients should always brush around the bands daily. Do not eat sticky, chewy candy as it can loosen your appliance.
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