There are many different orthodontic appliances available to aid in reaching treatment goals. Some appliances are Fixed, or cemented to the patient’s teath – typically the first molars. Others are Removable. Both types have their own advantages and disadvantages.
While the list below includes those that are common options, it is very important to note that each patient has different needs. Appliances will be chosen based on what issues should be addressed for each patient and which appliance will do the best job in reaching our treatment goals. The specifics of each appliance will be discussed during the Orthodontic Consult appointment, as well as during the delivery of the appliance after is has been fabricated.
Reverse Pull Headgear
In some cases, to move teeth to their optimal position or correct problems with bite or jaw growth, braces are not enough. Reverse pull headgear is worn to correct certain types of improper jaw position. This type of headgear works to move your upper jaw, or maxilla, forward slowly over time. The headgear attaches to a fixed appliance with two small elastics and has pads that rest on the forehead and chin. These pads are connected with a facebow. There are no straps that wrap around the head or neck. It is generally only worn at night; however, consistent use is very important and will have a better result.
Palatal expanders go by many names including: orthodontic expander, rapid palatal expander, palate expander, or rapid maxillary expansion appliance. This appliance is used to widen a narrow upper jaw when a discrepancy exists between the width of the upper and lower jaws so the upper and lower teeth are able to fit together better. This appliance works best for patients between the ages of 7-15 because their upper jaw bones are still pliable.
Palatal expanders fit over top teeth in the back of the mouth and are custom made for each patient. Most expanders are made up of two halves that connect with a screw in the middle. The screw is turned a small amount with a key each day to activate the expander. Tension is then created where the two palatal bones meet, gradually causing them to move apart. Other expanders are placed in the mouth and adjust on their own – they do not require the use of a screw for expansion to occur. The expander is left in the mouth a few months after desired position is achieved, allowing new bone to form in the gap and stabilize the expansion.
If a patient requires expansion, the most appropriate appliance will be chosen based on treatment goals.
Incisor blocks are tooth colored pieces of composite that are fixed to the back of the upper central incisors. They are generally placed as part of treatment when a patient has a deep bite that needs to be corrected. Incisor blocks allow the patient’s bite to open, which eliminates any friction or opposing occlusal interference. This provides the upper molars the freedom to super-erupt (come down farther into the mouth) slowly over time. With orthodontic treatment with brackets and wires, the lower molars will be moved up to touch the upper molars. Eventually, the natural teeth will meet and open the patient’s bite, thus eliminating the need for the incisor blocks. Speech and chewing may be impacted when the incisor blocks are placed, but these issues are usually remedied with time – usually within a week.
Hawley, Essix and Bonded Retainers
The best way to ensure stability of the teeth after braces is indefinite retainer wear. Although there are several options for retainers, our practice typically recommends a Bonded upper and lower retainer. This decision is made on a case-by-case basis, and options will be discussed as treatment is coming to completion. The three types of available retainers are: Bonded, Essix, and Hawley.
- Bonded retainers cement to the inside surface of your upper and lower anterior teeth and prevent shifting. They cannot be removed by patients; therefore there is no need to worry about compliance or the retainer being lost or thrown away. Bonded retainers allow the back molars to settle into final occlusion after orthodontic treatment has been completed.
- Hawley retainers are easy to remove and durable. They can also be adjusted to correct minor movement of the teeth.
- Essix retainers are transparent, removable retainers that fit over the teeth’s arch. They are durable and have no wires. They are also used for bridges and tooth movement.