Orthodontic Appliances

Delaire Mask

The Delaire Mask 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 the delaire mask needs to be worn. The key to success with your delaire mask is consistency. The Delaire Mask must be worn a certain number of hours per day, and if not, it must be made up the following day.

The Delaire Mask should never be worn while playing sports and should also be removed while eating or brushing your teeth.

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Interproximal Reduction

Interproximal reduction (IPR) is the removal of small amounts of outer enamel tooth surface between two adjacent teeth. It is a means to acquire additional space to create ideal tooth alignment.

Benefits of IPR:

Creates space to improve tooth alignment.
Helps to improve the bite.
May help to improve the appearance of the teeth, reshaping then for a better esthetic outcome.
Can increase the stability of the teeth, so they will retain their position long term.
Can reduce "black triangles." (This is created by the absence of gum tissue between the teeth and gives the appearance of a dark space or hole.)
IPR in certain cases may alleviate the need for permanent tooth extractions. (IPR may also be used in conjunction during interproximal reduction because of the minimal ammount of enamel being removed.)

The Procedure

Dr. Dellinger will carefully identify which teeth need IPR. Using a dental handpiece, Dr. Dellinger will remove the enamel from the sides of the teeth contacting each other. Approximately half to a full millimeter of enamel can be reduced between two adjacent teeth, still leaving sufficient enamel for the teeth to retain optimal health. Dr. Dellinger will determine how much reduction is necessary for desired result. Generally, there is no discomfort during interproximal reduction because of the minimal amount of enamel being removed.

Risks of IPR

Generally, interproximal reduction will not lead to an increased risk of tooth decay or gum disease. Some patients may experience sensitivity to hot or cold. Overall, this procedure is very safe and effective means of creating ideal tooth alingment.

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Soldered Lingual Arch

A Soldered 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.

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 Lower Lingual Arch is removed following the eruption of all the permanent teeth.

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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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Tongue Thrusting 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, similar to a mouth guard, is usually worn at night. Other times, a more permanent appliance is prescribed and can be only be adjusted by our office.

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Chin Cap

A Chin Cap is often used to help aid in the correction and help prevent excessive underbite. This is done by using the Chin Cap to place light pressure against the chin. This helps hold the chin in a better position. The severity of the problem determines the length of time in which the chin cap will need to be worn. The key to success is consistency. The majority of Chin Cap wear is done at night while the patient is sleeping.

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Rapid Palatal Expander (RPE)

Attached to the 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 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 simple activating the expander through turning a screw in the center of the palatal expander, when a special key we provide, gradual outward pressure is places 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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Elastics & Forsus

Elastics are a vital part of treatment and are also contingent upon patient compliance. Generally worn at all times (excluding eating and brushing your teeth), elastics should be changed at least three times 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 to improve treatment progression as planned. If only one day is missed, it could cause your teeth to shift back to their original position!

Forsus are a spring activated appliance that work much like the Elastics. However, they are not taken in and out by the patient. The Forsus are placed by the technician or doctor and then they are removed once the bite is corrected.

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Herbst

One of the most common problems orthodontists 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 slushies, 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 a 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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