Orthodontic Appliances

Headgear | Rapid Palatal Expander | Upper Transpalatal Appliance | Lower Lingual Arch | Elastics | Spacers


v-braces2.jpgHeadgear 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.

Rapid Palatal Expander

Attached to the upper molars through bonding or by cemented bands, the Rapid Palatal Expander is an orthodontic device 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 of the palatal expander, 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.

Upper Transpalatal Appliance

Upper transpalatal appliances are used to either rotate the molars or keep them stationary. During the first few days using the appliance, you may notice some difficulty speaking – this should resolve itself soon on its own as you continue wearing the device. You may also notice general soreness. Advil or Tylenol can be taken if needed. Bands are cemented to your teeth which may also irritate the inside of your mouth. If so, you may place wax over the band: this will make the surface smoother and more comfortable. If you notice a cut or hard knot on your tongue when using the appliance, please contact our office immediately.

Be sure while using an upper transpalatal appliance to brush regularly and around the appliance after every meal. Also use a fluoride mouthwash – you may need to swish forcefully to remove food from between the roof of the mouth and the appliance. Check the appliance occasionally and report any irregularities such as looseness to us as soon as possible so that we can repair the appliance.

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.

You should expect soreness the first day or two, and 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, and please monitor how many foods you eat that are high in sugar.

Brushing and flossing daily is very important. 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.


Elastics are a vital part of treatment and are also contingent upon patient compliance. They add extra pressure to the braces to help move the teeth. Generally worn at all times (excluding eating and brushing your teeth), elastics should be changed at least once a day. They come in various sizes as they are each used for a specific purpose. We will provide you with the appropriate size.

It is important to wear them consistently or treatment setbacks may occur. If only one day is missed, it could cause your teeth to shift back to their original position! If you miss a day, do not try to make up for it by doubling time the next day – simply follow the instructions we have given you. Also, be sure to replace elastics according to our schedule, as they can wear down and become ineffective even when not broken.

Call our office if you have any problem with your elastics, such as frequent breakage or broken appliances.


Spacers are small elastics that fit snugly between certain teeth to move them slightly so bands can be placed around them later. You may experience some discomfort the first few days while wearing them, but this is normal and can be counteracted with Tylenol, Advil and warm saltwater rinses. While wearing spacers, you should avoid eating hard or sticky foods.

Spacers can fall out on their own if enough space has already been created, however, this is not always the case. If a spacer falls out, try to replace it yourself before calling our office. Simply thread two pieces of dental floss through the spacer and pull on both ends, inserting the spacer between the teeth. If you cannot replace the spacer yourself, we will be happy to replace it, or determine whether a replacement is necessary.