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Orthodontic Appliances


Purpose: To separate tight tooth contacts creating space between teeth.

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

When and how to place: 
We have placed rubber separators between tight contacts. If a separator comes out, check the contact with dental floss. If it is tight, space must be opened or we cannot fit your bands. Thread two pieces of dental floss through the separator so you can stretch it like a rubberband. 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 meat 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.


  • Once space has been created, separators may become loose and fall out. They are harmless if swallowed. We need space to accurately fit your bands, 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!

Rapid Palatal Expander (RPE)

Purpose: To widen the upper arch.

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.

How long will the expander be needed?

Upper expansion is generally completed within one month. Expansion must be retained, often with the same expansion appliance, for a minimum of three months. Most expanders are left in place four to six 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, call the office.


  • 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 the screw.

  • A rather large space may open between the front teeth. This space will reduce on it’s 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.

  • Keep track of the turns you have made and bring your scorecard to each visit.

Protraction Facemask

Purpose: To stimulate forward movement of the upper jaw.

How does it work? 
The facemask is a frame supporting rubberband traction to the upper teeth. The jaw can be moved because bony sutures have not yet fused.

How long will I wear the Facemask? 
If worn fourteen hours per day (at home only), movement can generally be accomplished in 6 to 9 months. If goals are not met in nine months, the facemask will be discontinued. In cases of unfavorable response, two periods of traction or a completely different treatment plan will be required.

How does it feel? 
The facemask is not uncomfortable, simply inconvenient. It takes time to learn to sleep with it.


  • To minimize skin rash, place a tissue between the pads and your skin. Irritating hooks or elastics can be adjusted.

  • Your facemask should be worn after school and all night. It may be difficult to sleep at first! The facemask should be worn as much as possible.

  • Do not wear your facemask if you are participating in any activity where you may get hit in the face.

  • If your expander becomes loose, discontinue the facemask if it pulls the expander off the teeth. Continue to wear the expander (back off a turn or two if necessary) and call the office immediately.

Herbst Appliance

Purpose: To encourage forward growth of the lower jaw and backward movement of the upper teeth.

How does it work? 
The rods hold your lower jaw forward stimulating bone growth. Reciprocal action of the facial muscles push the upper molars back.

How long will I wear the Herbst? 
A minimum of twelve months is required for most orthopedic changes to be stable. Over-correction is required because the lower jaw will settle back 3-4 millimeters after advancement. If the problem is severe or Herbst therapy is started before permanent cuspids erupt, two Herbst appliances may be required.

How does it feel? 
The Herbst is a mouthful, but after the first week it will become quite comfortable. It may irritate the inside of your cheeks initially, but soon the tissue will callous and will not be a problem.

What about eating? 
Chewing will be awkward initially because the back teeth do not touch. You may want to eat a soft diet for a day or two, but soon you’ll be back to your normal diet.


  • Avoid playing with the Herbst with your tongue or fingers.

  • Let your lower jaw go where the Herbst rods position it.

  • If a screw comes out, save it and call the office.

  • Do not clench or grind your teeth. Clenching causes the rods to bend and stick inside the tube, limiting jaw movement. Grinding causes the crowns to loosen.

  • Crowns may come loose from the teeth. If a loose crown doesn’t stay on your tooth, remove it. Call the office for re-cementation.

If any of these problems occur (but are not causing discomfort or dysfunction), you can wait until the next day or over the weekend. However, if you cannot function normally, please contact the office and we will correct the problem as quickly as possible.



Tongue/ Thumb Habit Appliance

Purpose: To establish correct tongue posture and/or stop thumb or finger habits.

How does it work? 
A wire “crib” behind the upper front teeth blocks abnormal tongue function and thumb or finger sucking. Constant reminding reaches the subconscious level, and as you learn to avoid the wires, bad habits are broken.

How long will I need to wear my reminding appliance?
Your appliance will be cemented in place for 12-18 months to assure proper training.

How does it feel? 
The wires will “prick” your tongue when it is postured too low or comes forward between the teeth.


  • 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 your front teeth.

  • Practice breathing through your nose and keeping your lips together.

  • Clean thoroughly behind your front teeth.

  • Call our office if bands become loose.

Stick with it! Your tongue will soon “learn” to avoid the reminder wires. Repeated stimulation retrains the tongue permanently. When the tongue, fingers or thumb are not resting between the teeth, open bites close.

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