Types of Braces & Appliances

Metal Braces

Metal braces are the most common type. They are made of high-grade stainless steel. Today's metal braces are smaller, more comfortable and more attractive.

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Clarity™ Braces

Many patients enjoy the combination of ceramic and metal because it is simultaneously attractive and sturdy. In fact, these braces are so sturdy that many doctors will recommend them to their patients who play sports. Patients are allowed to engage in most everyday activities without fear of delaying or impeding their progress.

Also, because they have a semi-transparent color that will not stain, patients can proceed with necessary orthodontic treatment without having to feel self-conscious. In addition, Clarity braces’ smooth, rounded shape allows for greater patient comfort.

These features are designed for patients regardless of age. If you have questions about Clarity, consult your orthodontist.

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Herbst

One of the most common problems orthodontics treat is the discrepancy that occurs when the upper teeth protrude beyond the lower. 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 braces like the Herbst appliance help this happen.

Even though the Herbst appliance prevents the lower jaw from moving backward, opening and closing movement still occur easily, and patients do not have any problems learning to chew their food with their lower jaw in this new position.

As with all kinds of braces, patients with Herbst appliances need to be careful about what they eat. For instance, cold foods such as ice slushes, Popsicles and ice will freeze the cement and make the brace loosen. Sticky foods such as caramels, bubble gum and candy suckers will pull the brace away from the teeth. Hard foods like crisp vegetables and hard candies will bend and loosen the Herbst appliance, too. So stay away from these foods during your orthodontic treatment.

Your Herbst appliance will be checked and adjusted at your appointments. If, sometimes between appointments, you develop some sore areas on the inside of your cheeks, please do not try to adjust the appliance yourself. Call for an appointment so that the necessary adjustments can be made.

Wearing an Herbst Appliance

At first, your mouth will feel unusually full and speaking will be awkward. But if you practice reading aloud, your ordinary speech will return quickly. You may also notice more saliva than normal, but this will decrease as you become accustomed to the appliance.

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Distal Jet Appliance

The Distal Jet Appliance is a non-removable lingual appliance that is used to move upper teeth backward faster and more predictably than headgear. The Distal Jet distalizes molars and corrects teeth that have rotated. This appliance corrects class II problems.

The Distal Jet Appliance uses a solid track wire and two sets of locking screws on each side. The appliance is self-limiting by design because it has a distal stop attached to the tracking wire. The Distal Jet can be converted to a Nance Appliance by tightening the distal and anterior locks against the track wire and adding a Nance holding arch.

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Pendulum Appliance

The Pendulum Appliance is used to correct class II malocclusions by distalizing upper molars. It’s used to correct the patient’s bite on the side of their mouth.

The Pendulum Appliance consists of a plastic “button” that touches the roof of the mouth and resilient wire springs that act in a broad swinging arc to move the molars back. The appliance uses the roof of the mouth as an anchor to move the molars back into their correct positions. Patients usually wear this appliance for 3 to 5 months.

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Thumb/Finger 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. If you notice prolonged and/or vigorous thumb sucking behavior in your child, talk to your dentist.

One solution to thumb sucking is an appliance called a "fixed palatal crib." This appliance is put on the child's upper teeth by an orthodontist. It’s placed behind on the upper teeth on the roof of the mouth. The crib consists of semicircular stainless steel wires that are fastened to molars using steel bands. The stainless steel wires fit behind the child's upper front teeth, and they are barely visible. The crib usually stops the habit of thumb sucking within the first day of use.

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Nance Appliance

The Nance Appliance is used to prevent upper molars from rotating or moving forward after you’ve worn a headgear, a Wilson’s arch or any other appliance to move your molars back. Some patients wear the Nance Appliance while they are awaiting their bicuspids to grow into place.

The appliance is made of two bands that are cemented onto the first molars and a wire spans the roof of the mouth from one molar to the other. An acrylic pad or “button” covers the wire that touches the roof of your mouth directly behind your front teeth.

Patients should always brush around the bands daily. Do not eat sticky, chewy candy as it can loosen your appliance.

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Headgear

Headgear 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.

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Active LLHA (Dewey Arch)

Also known as a Lower Lingual Holding Arch, or LLHA, this device is a fixed retainer. It acts as a space maintainer to keep the 6-year molars from drifting forward, and prevent them from blocking the space where adult canines, first premolars and second premolars permanent teeth will eventually erupt. The Dewey Arch is only placed on lower teeth, typically when the patient has a combination of both baby teeth and adult teeth. It is commonly used in cases of premature loss of baby teeth, when the lower teeth of a growing child are slightly crowded and no permanent teeth have been extracted to correct the problem or on patients who have completed Phase I or early interceptive treatment.

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Band and Loop

A Band and Loop is a metal appliance used to maintain space for a permanent molar to erupt. It is a metal band attached to the molar behind the space with a metal loop reserving the space in front.

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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.

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Habit Appliance

Tongue thrusting occurs when the patient presses his or her tongue against the front teeth, usually when swallowing, speaking or resting the tongue. If thrusting is constant, this can cause problems with teeth alignment and must be fixed.

We prefer to correct tongue thrusting by giving patients a tongue thrusting appliance. This appliance is glued behind the teeth and has a roller on the end. The patient must play with and flip the roller as well as place his or her tongue behind the roller when swallowing in order for the appliance to work properly.

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Lingual Arch

A Lingual Arch acts as a space maintainer to allow side adult permanent teeth to erupt. This appliance can also be used when baby teeth have been lost prematurely, and the space for the new permanent teeth has been lost.

Expect soreness the first day or two. 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. Monitor how many foods you eat that are high in sugar. Brush and floss daily. 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 Lingual Arch is removed following the eruption of all the permanent teeth.

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Lip Bumper

We like to avoid pulling teeth as often as possible, so we use lip bumpers on our patients who need to create more room for their crowded teeth. The lip bumper is a wire on the lower jaw that extends from one molar to another and keeps lips and cheeks from touching your teeth. When you move your mouth or speak, your lips and cheeks push on the bumper, and the bumper applies pressure to the teeth. This pressure pushes the molars back, creating more space for overcrowded teeth.

If you have a lip bumper, please remember to leave it in while eating, but do not eat hard or sticky foods. Proper, thorough brushing should remove any food that gets stuck in your lip bumper.

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Lower E-Arch

A Lower E-Arch is used to widen a patient’s lower jaw in order to make room for the eruption of permanent teeth. Two bands or crowns are attached to molars on opposite sides of the mouth. Coming from one side is a metal L-shaped sleeve, and a metal L-shaped arm comes from the other side. Between the two is a spring that widens the jaw by adding pressure.

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Quad Helix Expander

The Quad Helix is a fixed orthodontic appliance used for upper arch expansion. Bands are cemented to your back molars to keep the appliance in place while four helix springs help widen the arch. This appliance is ideal for patients with crowding in the upper arch or to correct a posterior crossbite.

It is important to maintain a good oral hygiene regimen while wearing the Quad Helix. Patients should brush around and under the appliance and also floss and rinse thoroughly to remove any food particles.

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Trans Palatal Arch

The Trans-Palatal Arch is an orthodontic appliance used to maintain the upper jaw’s arch width and move molars into positions that wires alone can't. The appliance is banded around the first molars on each side of the mouth, and a thin wire spans across the roof of the mouth.

Patients should be sure to brush and their appliance daily. Also, avoid sticky, chewy or hard foods as these can get caught between the appliance and the roof of your mouth. These foods may also break the Trans-Palatal Arch.

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Wilson 3D

The Wilson 3D Distalizing Arch has many purposes and functions. The arch controls the arch length and is a multidirectional arch modifier, in order to control the movement of molars and/or incisors when a madibular anchorage is used.

Other functions of the Wilson 3D include rapid bicuspid distalizing, palatal expansion, rapid maxillary anterior retraction, rapid anterior intrusion, rapid anterior advancement, functional arch increase and release of posterior locked mandible to allow forward growth.

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