Other Appliances

 

Separators

 

Purpose:
To separate tight tooth contacts and create space between teeth.

 

How do they work?
Tooth contacts must be separated to place braces (bands) around the teeth.  Separators gently push the teeth apart.

 

When and how to place:
We have placed rubber separators between your teeth. The space must be opened or we cannot fit your bands. Take a rubber separator from your envelope, then thread two pieces of dental floss through the separator so you can stretch it like a rubber band. Work the separator back and forth through the contact like flossing your teeth with the rubber separator. Continue until it pops through the contact so the bottom is under, the top is over and the sides are around the contact point.

 

How do they feel?
Separators feel like food caught between your teeth and will make the teeth anywhere from slightly tender to quite sore. Take Tylenol or Advil at the first sign of discomfort and continue as necessary. Discomfort generally lasts three to five days.

 

TIPS!

 

• Once space has been created, separators may become loose and fall out. They are harmless if swallowed. We need space to accurately fit your braces, so the separators must be replaced as the contact re-tightens. Call the office if you cannot do this.
• Avoid sticky or chewy foods, flossing, and picking at the separators which will cause them to come out prematurely.
• Continue to brush normally.

 

Call if you have problems or questions…we are here to help!

 

Bands

 

Bands are metal rings fitted on the back teeth to help secure appliances in place. They are used mainly when treatment calls for adjunct appliances. They may also have braces attached them and used to connect to the braces with an archwire. They are also used to secure braces to silver and gold fillings and crowns. Porcelain crowns can be bonded to just like natural tooth surface.

 

Lingual Arch / Lower space maintainer

 

Placed as a temporary lower retainer to hold the molars from drifting forward after baby tooth loss. Saving the space can be used to treat crowding as the adult permanent teeth are smaller then the baby teeth and space differential can be used to straighten the teeth.

 

The Pendulum Appliance

 

This appliance is a unique way of correcting the side bite of the teeth. In certain situations when an orthodontist feels that your growth is near completion and headgear or a functional appliance is less efficient, a Pendulum appliance can be used. It also eliminates the need to wear a headgear or a functional appliance. This appliance uses the angle at the roof of the mouth as an anchor to move the molars back into their correct bite.

 

A large plastic button touches the roof of the mouth and very resilient wire springs act in a broad swinging arc to move the molars back. If the upper jaw needs to be widened somewhat, an expansion screw is incorporated and is activated by the patient exactly as the doctor instructed. The pendulum appliance is somewhat cumbersome and takes a little getting used to, but it is so beneficial in the overall treatment of many malocclusions. It will be in the mouth for about 3 to 5 months.

 

After molars are moved back into their proper bite, a permanently cemented retainer is used to anchor the molars against the roof of the mouth. A small plastic button is attached to the molar teeth and is in place for several months while the other side teeth are brought into their correct position.

 

Tongue Trainers

 

Today you received two to four tongue training braces placed on the back of the lower front teeth. The purpose of these are to discourage the forward posturing of the tongue which has contributed to the vertical space between the upper and lower front teeth, known as an open bite.

Please cover these braces with the wax we have given you for at least the first 48 hours. It is important to dry them off with tissue to help the wax stay in place. It is alright to continue using the wax longer than the first 2 days.

 

Please be careful not to bite into any hard foods, such as french breads, carrots, or hard pizza crust. Please avoid candy such as tootsie rolls, starbursts. These foods can bend and break off the tongue guards, resulting in extra appointments to replace them. You may wish to eat softer foods and take smaller bites the first few times

 

Exercises:

 

• Hold a small piece of sugar free candy between the roof of your mouth and your tongue until it dissolves – do not chew it.
• Practice drinking water holding a small candy against the ridges on the roof of your mouth.
• Practice short clicking sounds with your tongue on the roof of your mouth.

 

TIPS!

 

• Speaking, eating and swallowing will improve after 2-3 weeks.
• Position the top of your tongue against the roof of your mouth all of the time. Avoid thrusting your tongue forward between you front teeth.
• Practice breathing through your nose and keeping your lips together.
• Clean thoroughly behind your front teeth.
• Call our office if anything becomes loose.

 

Stick with it! Your tongue will soon learn to avoid the reminder braces. Repeated stimulation retrains the tongue permanently. When the tongue, fingers or thumb are not resting between the teeth, open bites close down quickly. The quicker we can close the bite the sooner your braces come off.

 

Removable Appliances

 

Removable appliances, unlike conventional braces, are used to retain teeth in their corrected positions and in some cases, to influence growth of the jaws in order to effect changes in facial structure. In addition, they are often used before and in conjunction with fixed appliances.

 

Removable appliances are not utilized to treat all orthodontic problems. It takes skill, and experience to recognize conditions that will respond favorably to removable appliances. Timing of such therapy also is very important.

 

Although removable appliances can easily be taken out by the patient, there may be a tendency not to wear them as we have prescribed. This means your teeth, jaws and muscles may move back toward their original positions.

 

Removable appliances require care. Although you may notice an effect on eating and speaking along with an increase in the flow of saliva, you will eventually adjust to the appliance.

 

Expander

 

Rapid Palatal Expander (RPE)

 

Purpose: Widening the back teeth and jawbone.

 

How does it work?
Turning the miniature jack-screw applies pressure through the teeth to expand the jaw bone. The upper screw is in the center of the palate while the lower is behind the front teeth.

 

How long will the expander be needed?
Upper expansion is generally completed within one month while lower expansion requires approximately three months. Removable expanders take longer. Expansion must be retained, often with the same expansion appliance, for a minimum of four months. Most expanders are left in place six to nine months.

 

How does it feel?
Excess saliva will make you "slurpy" until your mouth adjusts to your appliance. You will feel pressure on the teeth or roof of the mouth after turning the screw. The pressure lasts one to five minutes. There should be no discomfort after the first week. If pain develops, turn the screw backwards until it is comfortable and call the office.

 

“Due to the nature of the bone structure, upper expansion is usually rapid with 1 turn every day and lower expansion is slower usually 1 to 2 turns per week.”

 

TIPS!

 

• Count every turn. Never turn more than the recommended turns.
• Always turn in the direction of the arrow until the next hole appears, then remove the turning lever.
• If the expander is loose, stop turning this screw. Loose bonded expanders should be worn as if it is removable, but the expander must be removed and the teeth cleaned after every meal. Rinse the uncovered teeth nightly with fluoride. Call for an appointment so we can re-cement it back in.
• A rather large space may open between the front teeth. This space will reduce on its' own once the turns are stopped.
• If the screw resists turning, offers no resistance, or pulls apart, stop the turns and call our office for an adjustment.
• Be sure to brush around the appliance very thoroughly, check for plaque and use your fluoride toothpaste daily.
• Speech will be slurred and swallowing difficult at first until the tongue adjusts to the appliance. Practice reading out loud.