Along with traditional braces, there are many different types of orthodontic appliances that can be used to help facilitate proper dental alignment. Some are used alone or before braces to intercept any furthering orthodontic issues. Others are used in conjunction with braces so that an ideal result can be achieved.
The rapid palatal expander (RPE) is commonly placed in many children and young adolescents whose upper jaw is too narrow. The palatal expander gently widens the upper arch (palate) by stretching the center palatal connective suture. This appliance is fixed and cannot be removed by the patient. Once the palate is widened, the patient will continue to wear the appliance for 6 months as the suture knits together and heals. Everyone adapts to a palatal expander differently, although most patients become used to this appliance in a few days.
The Nance Appliance is used to prevent the upper molars from rotating or moving forward to allow the bicuspid teeth to come in (erupt). This appliance is fixed and cannot be removed by the patient.
Habit/finger Reminder 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.
The habit appliance is used to deter patients from thumb sucking. It is fixed on the roof of the mouth and cannot be removed by the patient.
Wearing a Herbst, MARA, or Forsus Appliance
A Herbst, MARA, or Forsus Appliance is placed to help facilitate proper growth and alignment of the upper and lower jaws. 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 appliances like the Herbst, MARA, or Forsus appliance help this happen.
This fixed appliance prevents the lower jaw from moving backward, while easily allowing opening and closing movement to occur. Everyone adapts to these appliances differently, although most patients become used to them quickly.
Facemask or Headgear
A Facemask is often used to put pressure against the upper teeth and jaw to help move them into better positions. Your facemask is usually just worn at night time for a period of 6-12 months depending on the patient and the goals we are trying to achieve.
A Spring Hawley is typically used to move one or more teeth. This appliance can be removed by the patient and has a metal spring that can be activated to apply more pressure to a specific tooth.
A Bite Plate is used along with braces to open the bite in order to facilitate tooth movement. Once the desired movement is complete, the patient will no longer have to wear the bite plate.
A fixed appliance used to hold space for an unerupted permanent tooth after a primary (baby) tooth has been lost prematurely due to accident or decay.