Appliances

SEPARATORS

Separators (or spacers) are small, rubber bands that are stretched to fit between the very back molars of your teeth to create a small space before your appliances are placed. This space is necessary so that bands can be placed around your molars to anchor your braces. Separators may be uncomfortable for a couple days. Dr. Brown recommends Ibuprofen (Advil) as necessary. If a separator falls out, call the office to find out if another needs to be placed.

While separators generally do not fall out of their own accord, patients should avoid playing with the separators with either fingers or their tongue and should not floss in the location of the separators with either fingers or their tongue and should not floss in the location of the separators. In addition, sticky foods such as gum should be avoided.

EXPANDER:

Problem: When the upper jaw has developed with insufficient width, many problems may arise. These include a narrow smile, a crossbite and crowding.
Solution: Fortunately, the expander widens the upper jaw. Expanders are orthopedic appliances that can reshape teeth and bone. An expander works by applying gradual outward pressure on the bone and teeth of the upper jaw. The human skull at birth is like a puzzle; pieces of fully formed hard bone are joined by softer connective tissue. One of these fissures is located in the roof of the mouth. By exerting outward pressure on this seam in the bone, a gap is created which the body naturally fills in with new bone. This creates a wider upper jaw.

The amount of expansion needed varies. After the expander has been fit, Dr. Brown will inform you of how many times it needs to be turned (activated).

While turning the expander a space between the upper front teeth is common, this is temporary.

The expander will remain in the mouth for approximately three to six months in order for the teeth to adapt to these new positions.

Expander Instructions Video:

To turn expander: Find a place in the house that is comfortable, where your son/daughter can lay on their back with their head tilted backward. (Looking up toward the ceiling).

Sitting along side of them, have them open their mouths.
Insert the key into the hole in the expander.
Then turn the key toward the back of their throat.
To complete the turn remove the key STRAIGHT down. Make sure that this is straight down because you do not want to reverse the turn.
HINT: Be sure to turn the key all the way toward the back of the throat. That way, you will be able to properly fit the key in the next hole.
If you are unable to keep your scheduled appointment, stop turning the expander.

HEADGEAR

Problem: When the upper and lower jaws do not grow in harmony many problems may arise. These could include an overbite and a receding chin/jaw.

Solution: Fortunately headgear encourages the lower jaw to grown and catch up to the upper jaw. Other alternatives to headgear could include jaw surgery and tooth extractions.

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 minimum of 14 hours per day. Dr. Brown asks that you keep record of how many hours per day you wear your headgear. If you need another score card download and print one here (pdf of headgear card). Always bring your headgear and score card to your appointments.
Headgear should never be worn while playing sports or wind instruments and should also be removed while eating meals and brushing your teeth.
The end of the headgear fits into the tube on the upper back molar on both sides. The neckstrap is put behind the neck and fastened to the hook on the other side.

Please check the back molar band frequently and call for a repair appointment if the band is loose. Do not wear headgear with a loose band.

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REVERSE HEADGEAR (Facemask)
Problem: When the upper jaw is too far back and the lower jaw is too far forward this is called an underbite.

Solution:
The expander, combined with the facemask can correct the underbite, and harmonize the position of the jaws and teeth. This will lead to a highly aesthetic, functional, and healthy smile.

The expander will be placed first. Dr. Brown will inform you how many times it needs to be activated. Once those turns are completed the facemask therapy will begin. Facemasks come in different colors. Have fun with yours by decorating or adding stickers.

The facemask gently helps the upper jaw grow downward and forward. This helps the upper teeth move in front of the lower teeth, which is a normal overbite. The facemask helps slow down the growth of the lower jaw.

In order for the teeth to adapt to their new positions, the expander will remain in the mouth for 6 to 8 months. The facemask is worn only at home.

HOLDING ARCH (Lingual Arch or Space Maintainers)

Problem: The lower jaw has insufficient space for all the teeth. This lack of space leads to crowding, overlapping, and poor alignment. Or an upper or lower primary tooth is lost prematurely and the back molars must be held back in position.

Solutions: Fortunately, the holding arch creates space for the lower teeth often avoiding extraction of permanent teeth. The use of such appliances at an early age can prevent more expensive or intensive orthodontic treatment later in life.
The holding arch “holds” the adult molars from moving forward when the larger baby molars are lost. This allows the smaller premolar teeth to erupt and the permanent teeth to unravel naturally by drifting into the “held” space.

The holding arch may be worn until all the permanent teeth erupt. It typically stays in place 12 – 18 months.

The holding arch will not cause discomfort and is easy to care for.

While wearing the holding arch, patients should avoid sticky foods such as gum or caramels and hard foods such as hard candy or hard, crusty breads.