Expanders
An Expander is recommended for patients whose jaws are too narrow. An upper expander may be used if the upper jaw is too narrow compared to the lower jaw (crossbite). Early correction of a crossbite will allow the lower jaw to grow more symmetric. Upper and lower expanders may be used to develop the width of both jaws to eliminate overlapping of teeth (crowding) and to make the jaws the proper size for the permanent teeth. These appliances can be used to help eliminate the need for extractions of permanent teeth or jaw surgery.
The upper expander gently widens the upper jaw (palate) by stretching the center palatal connective suture. Once widened, the suture knits together. A parent or the patient adjusts the upper expander daily as instructed, until the palate has been widened enough. After the jaws are the proper width, the upper expander is left in place for about four months without further adjustment while new bone fills the center palatal suture. After this period, the upper expander is removed and a retainer is placed to hold the width of the upper jaw.
A lower expander gently pushes the baby and permanent teeth into wider positions. Then, when the permanent teeth replace the baby teeth, they also erupt into a wider position. The lower expander is adjusted by the doctor at each appointment. When a lower expander is used and the expansion is complete, it is left in place to hold the new width of the lower teeth and acts as a retainer.
Herbst
The Herbst Appliance is a functional appliance commonly used in some growing patients to stimulate the growth of the lower jaw.
The Herbst Appliance consists of crowns cemented over your back teeth. The upper crowns have tubes attached to them that are connected to rods on the lower crowns. This postures your lower jaw forward. The arms are connected to the crowns but you can still move your jaw forward, open and close, but you cannot move it back. This over time will shift the bottom teeth forward to meet the upper teeth and correct the bite.
Lower Lingual Arch
This appliance is used to help reduce the amount of crowding in the lower arch by preserving the natural size difference between some baby and permanent teeth.
Serial Extraction
Serial extraction is a technique that is used for people with severe crowding. This technique uses early extractions to allow the front and back teeth to erupt into better positions thus making the alignment improved and reducing the amount of tooth movement with the braces.
Finger Habit Appliance
This appliance is used to help a child stop sucking their thumb or finger. By doing so, it will allow more normal growth of jaws reducing the severity of their bite in the future.
Reverse Headgear
A Reverse Headgear is an orthopedic appliance with the goal of accelerating the growth of the upper jaw to improve its relationship with the lower jaw in people with underbites.