Retainers & Appliances

Retainers

When we remove your braces, we will begin the retention stage of your treatment. The retention phase lasts for a minimum of 24 months. Your final orthodontic result depends on your retainers, so follow through with the hard work you’ve put in so far. Remember to remove your retainer before brushing, and brush your retainer before placing it back in your mouth.

Hawley Retainer

The Hawley retainer, one of the most common types, is a removable retainer made of a combination of metal wires and sturdy acrylic, and is designed to keep your teeth in place. This retainer is specially made from impressions of your teeth so that it fits snugly and comfortably in the roof of your mouth, while any wire or acrylic framing keeps your teeth in perfect position. The acrylic can also be personalized with a large number of colors and/or patterns.

Essix Retainer

The Essix retainer is a transparent removable retainer that fits over the entire arch of teeth. Similar to Invisalign® trays, Essix retainers have no wires. They are inexpensive and easier to wear. They can be used for other treatments as well, including tooth movement and bridges.


Bonded Lingual Retainer

Bonded lingual retainers are cemented directly to the inside surface of your lower canines (eye teeth). This is one of the best ways to prevent your lower teeth from shifting as it is permanently attached! Patients with bonded lingual retainers must be careful with their bite as the bonding material may break due to incorrect biting and cause teeth to shift quickly. As with removable retainers, it is important to keep them clean. When brushing, make sure to carefully clean the inside of your lower teeth as well as the wire.

If your retainer breaks at any time during treatment, please do not adjust it yourself. Call us immediately to schedule an emergency appointment.


Orthodontic Appliances

Headgear | MARA | Lower Lingual Arch | Nance Appliance | Distil Jet Appliance | Pendulum Appliance | Thumb/Finger Appliance | Lip Bumper | Tongue Thrusting Appliance | Forsus | Herbst Appliance | Rapid Palatal Expander | Quad Helix


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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MARA

The Mandibular Anterior Repositioning Appliance (MARA) is suitable for treating class II malocclusions, which are characterized by protrusion of the upper front teeth or a lower jaw and or teeth that are positioned back in regard to the upper jaw and or teeth. Using MARA, class II malocclusions are treated more effectively. The MARA is reliable and reduces treatment time.

Generally, the appliance is secured to the patient’s first molars via stainless steel crowns, which are easy to fit and retain more, compared to bands. The appliance features no removable parts, which means patient compliance is not an issue. Also, the orthodontist can more accurately predict the length of treatment.

The upper “elbows” can be removed; which facilitates comfort and advanced adjustments. The appliance can be advanced on one side or both sides.

Sore spots are minimal. Initially, it may feel strange to hold your jaw forward while eating, but within two weeks, chewing will become more natural. We recommend you eat soft foods initially. Do not chew on the elbows. Avoiding candy, hard foods, etc. throughout treatment will help prevent breakage of the appliance.

MARA is generally worn between 15 to 18 months. Your improvements will be noticed immediately!

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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 Appliance

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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Distal Jet Appliance

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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Pendulum Appliance

The Pendulum Appliance is used to correct class II malocclusions by distalizing upper molars. It’s used to correct the patient’s bite on the side of their mouth.

The Pendulum Appliance consists of a plastic “button” that touches the roof of the mouth and resilient wire springs that act in a broad swinging arc to move the molars back. The appliance uses the roof of the mouth as an anchor to move the molars back into their correct positions. Patients usually wear this appliance for 3 to 5 months.

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Thumb/Finger Appliance

Sucking is a natural reflex that relaxes and comforts babies and toddlers. Children usually cease thumb sucking when the permanent front teeth are ready to erupt. Typically, children stop between the ages of 2 and 4 years. Thumb sucking that persists beyond the eruption of primary teeth can cause improper growth of the mouth and misalignment of the teeth. If you notice prolonged and/or vigorous thumb sucking behavior in your child, talk to your dentist.

One solution to thumb sucking is an appliance called a "fixed palatal crib." This appliance is put on the child's upper teeth by an orthodontist. It’s placed behind on the upper teeth on the roof of the mouth. The crib consists of semicircular stainless steel wires that are fastened to molars using steel bands. The stainless steel wires fit behind the child's upper front teeth, and they are barely visible. The crib usually stops the habit of thumb sucking within the first day of use.

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Lip Bumpers

We like to avoid pulling teeth as often as possible, so we use lip bumpers on our patients who need to create more room for their crowded teeth. The lip bumper is a wire on the lower jaw that extends from one molar to another and keeps lips and cheeks from touching your teeth. When you move your mouth or speak, your lips and cheeks push on the bumper, and the bumper applies pressure to the teeth. This pressure pushes the molars back, creating more space for overcrowded teeth.

If you have a lip bumper, please remember to leave it in while eating, but do not eat hard or sticky foods. Proper, thorough brushing should remove any food that gets stuck in your lip bumper.

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Tongue Thrusting Appliance

Tongue thrusting occurs when the patient presses his or her tongue against the front teeth, usually when swallowing, speaking or resting the tongue. If thrusting is constant, this can cause problems with teeth alignment and must be fixed.

We prefer to correct tongue thrusting by giving patients a tongue thrusting appliance. This appliance, similar to a mouth guard, is usually worn at night. Other times, a more permanent appliance is prescribed and can be only be adjusted by our office.

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Forsus

The Forsus appliance is used in order to help move the upper molars back while moving the lower arch forward. Composed of a spring coil rod, the appliance is used while a patient is currently wearing braces. It runs from the upper first molar band down to the lower archwire.

You may notice some discomfort initially, so we recommend a soft food diet for the first few days after the appliance is placed. Regular anti-inflammatory medication may help with any pain, if needed. It is important to keep the appliance clean; you may do this by carefully brushing the coil and other metal pieces of the appliance. Also, we recommend that patients not open their mouths very wide, as the appliance may come apart.

If your Forsus appliance breaks, please contact our office immediately to schedule a repair appointment.

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Herbst Appliance

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.

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Rapid 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, 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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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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