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Types of Appliances

Rapid Palatal Expander | Hawley Retainers | Thumb/Finger Appliance | Tongue Thrusting Appliance | Headgear/Facemask | Nance Appliance | Twin Block | Temporary Anchorage Devices | Herbst Appliance | Implants


Rapid Palatal Expander

Attached to the upper molars by cemented bands, the Rapid Palatal Expander is an orthopedic appliance 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 creating a crossbite or if 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.  The expander is activated by simply turning the screw in the center with a special key that we provide.  This gradual outward pressure is placed on both halves of the upper jaw and stimulates the bone to grow between the two halves--thereby increasing the width and length of the upper arch.

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Hawley Retainers

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

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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 placed 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 circular 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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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 corrected.

A tongue thrusting appliance can be fabricated but one must be diligent.  Sometimes, a myofunctional therapist may be recommended it the habit persists.

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Headgear/Facemask

Headgear is often used to correct an excessive overjet or underbite.  This is done by placing pressure against the upper teeth and jaw, which would either 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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Nance Appliance

The Nance Appliance is used to prevent upper molars from rotating or moving forward after you’ve worn a headgear 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 and avoid eat sticky, chewy candy as it can loosen your appliance.

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Twin Block

The Twin Block orthopedic appliance is designed to correct jaw function and position so that the bite is properly aligned. It consists of both upper and lower removable appliances which work together to pull the lower jaw forward.  While suitable for patients of all ages, it is generally used during Phase 1 of orthodontic treatment to treat children who have an underdeveloped lower jaw.  To ensure treatment progresses as planned, the appliance should be worn at all times.  It should only be removed for cleaning and during sport activities.  Patients may experience temporary discomfort and difficulty speaking during the first few days of wear. We will provide specific instructions for any necessary activation.  Patients should follow instructions carefully to ensure that effective results are achieved within the least amount of time.

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Temporary Anchorage Devices

One of the many important advances in orthodontics has been the development of temporary anchorage devices, or TADs.  Made of a bio-compatible titanium alloy, TADs are miniscrew anchors which are inserted into specific places in the mouth to be used as a fixed point from which teeth can move.  Before TADs, orthodontists who wanted to move some teeth while keeping others still, or to achieve orthodontic movement in a mouth with missing teeth, had to rely on headgear for their fixed point.  But TADs now provide an option for that fixed point that is smaller, more discrete, more efficient and requires significantly less work for the patient.

Temporary anchorage devices may not be recommended for everyone, and in fact, anchorage devices may not be needed in all cases.  Contact us if you’d like to know more about TADs and how they can potentially prevent you from needing orthodontic headgear.

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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.

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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Implants

Dental implants are artificial tooth replacements that were first developed half a century ago by a Swedish scientist named Per-Ingvar Branemark.  Implants arose from the patient’s need to secure loose-fitting dentures.  Since the advent of the implant, engineering and enhancements to the implant have enabled dentists to expand the implant’s usefulness, including the replacement of missing or lost teeth.  Today, implant techniques provide a wide range of tooth replacement solutions including:

  • Single Tooth Replacement
  • Anterior Replacement
  • Posterior Replacement
  • Full Upper Replacement

If the missing tooth space has no surrounding teeth, the dentist may decide an implant is the most appropriate treatment choice or option.

Post Implant Care

Although proper oral hygiene is always recommended for maintaining good dental health, it is especially important when a patient has received a dental implant.  Bacteria can attack sensitive areas in the mouth when teeth and gums are not properly cleaned, thus causing gums to swell and jaw bones to gradually recede.  Recession of the jawbone will weaken implants and eventually make it necessary for the implant to be removed.  Patients are advised to visit their dentists at least twice a year to ensure the health of their teeth and implants.  Dental implants can last for decades when given proper care.

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