Types of Appliances

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.

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.

Expanders

Either attached to the upper molars through bonding or by cemented bands, or removable, palatal expanders are orthodontic devices 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.

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.

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.

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.

Expect soreness the first day or two. 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. Monitor how many foods you eat that are high in sugar. Brush and floss daily. 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.

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.