Type of Appliances
Braces
Braces are small metal or ceramic brackets that are cemented directly onto your tooth surface.
Orthodontic wires are then placed to span between the brackets and are held in place by small coloured elastics.
We move from thin flexible wires to thicker stiffer wires to bring your teeth into alignment. Once your treatment is complete we remove your braces and polish away the cement.
Having your braces placed is not a painful procedure but your cheeks and lips will be held out of the way with a plastic mouthpiece to keep your teeth dry and allow the orthodontist to see clearly.
Once we place your braces we will show you how to keep them clean with brushes and flossers and go over what foods are best to avoid during your treatment.
Clear Aligners
Clear aligners work like braces to improve the alignment of your teeth. We design a series of custom aligners that slowly move your teeth using pressure points programmed into the plastic.
Small tooth coloured attachments will be cemented onto most of your teeth to provide pushing surfaces to help optimize tooth movement.
While the aligners are removable they only work when they are in your mouth so unless you are eating or brushing your teeth you are expected to wear your aligners.
The expected commitment to wear time to achieve predictable tooth movement with clear aligners is 22 hours a day.
One aligner is worn for ~7 days at a time before progressing to the next aligner in the series.
We may require at least one “refinement” scan completed at the end of your first series of aligners. We then design a new series of custom aligners that can pick up any additional movements still required.
Attachments on the teeth may be changed at this time and turn around time to receive the new aligner series may be 2-4 weeks during which you will remain in the last aligners from your current series.
Elastics
Elastics are a hugely important part of orthodontic treatment. While braces can make your teeth straight by improving their alignment, we rely on your help to fix your bite by having you wear elastics.
Orthodontic elastics attach to hooks on your braces, wires or aligners and typically stretch between your top and bottom teeth.
We will ask you to wear your elastics either full time (20hrs/day) or part time (12 hrs/day).
You should know that poor compliance with elastic instruction is one of the main reasons people have extended treatment time and unsatisfactory outcomes.
There are several patterns of elastic wear. Here are the most common types:
Class II Elastics
This type of elastic works to bring your top teeth back and your lower teeth forward.
Class III Elastics
This type of elastic works to bring your top teeth forward and your lower teeth back.
Triangle Elastics
This type of elastic works to settle your bite into place vertically.
Rapid Palatal Expander (RPE)
This appliance is cemented in place on your top jaw and helps broaden your upper arch and resolve crossbites.
We will show you how to activate the appliance at home with a special tool. Typically, we will ask for a single turn every night OR every other night. Please follow the schedule your orthodontist has recommended.
This appliance will remain cemented inside your mouth for at least 6 months after your last turn. This is called the passive expansion phase where the RPE acts as a retainer for the expansion we have achieved.
To prepare you for your RPE, we place small rubber o-ring separators on either side of your upper molars for ~1 week. After 1 week, we will remove the o-ring separators, size metal bands around your molars and take an impression. We will then replace the o-ring separators until we get you back to cement the appliance in your mouth. Usually, we need 2-5 days to make the RPE Appliance.
Lower Holding Arch Appliance (LHA)
A “Lower Holding Arch Appliance” or LHA consists of bands around both lower first molars and a bar that runs along the inside of your lower teeth.
This appliance helps us hold the position of your lower molars after your first baby or “primary molars” naturally fall out and is typically placed when they just begin to get mobile or wiggly.
Your posterior baby teeth or primary molars are slightly wider than the adult teeth that replace them and we refer to this extra space as “leeway space”.
The LHA works to hold onto the extra/leeway space available in the lower jaw after you lose your remaining baby teeth and helps give us space to resolve any crowding.
This appliance is typically in place until your adult teeth grow in at around 12 years old.
To prepare you for your LHA , we place small o-ring separators in front of your lower molars for ~1 week. After 1 week, we will remove the o-ring separators, size metal bands around your molars and take an impression. We will then replace the o-ring separators until we get you back to cement the LHA once it is made. Usually, we need 2-5 days to make the LHA Appliance.
Headgear Appliance
Diligent use of a Headgear Appliance can assist us in avoiding extractions of upper permanent teeth by pulling back or “distalizing” the upper adult molars. This creates space for the permanent canines and premolars to erupt.
Headgear Appliance is also used to help harmonize the rate of growth between the upper and lower jaws of growing patients. Headgear Appliance limits the growth of the upper jaw so that the lower jaw can “catch up” and helps to reduce the distance between your top and bottom front teeth, which is called “overjet”.
Headgear Appliance consists of two rings or “bands” cemented on your upper adult molars and a bow shaped component that inserts into these bands and then wraps around the back of your head with a cloth strap.
We only expect you to wear your Headgear Appliance at home but a minimum of 12 hours/day every single day is required to achieve the desired outcome.
Less than optimal Headgear Appliance wear will lead to longer treatment times
Carriere Motion Appliance
This appliance helps move your upper posterior segments of teeth into the ideal bite.
Specialized metal bars (Carriere Motion Appliance) will be bonded onto your upper molars and canines (or premolars). Additionally, small attachment buttons will be placed on your lower molars.
Elastics are then attached between the Carreire Motion Appliance and the lower attachment buttons to move the upper posterior tooth segments into the ideal bite with the lower teeth.
We will ask you to wear your elastics full time (min 20hrs/day) to achieve your bite correction.
You should know that poor compliance with elastic instruction is one of the main reasons people have extended treatment time and unsatisfactory outcomes.
Herbst Appliance
The Herbst Appliance promotes growth of your lower jaw, which works to improve your bite by bringing all of your lower teeth forward.
This appliance consists of separate upper and lower components which are cemented into your mouth and are attached to each other by arms on the cheek sides of your teeth.
To prepare you for the Herbst Appliance we take a digital scan of your mouth and send it to be made in a dental lab.
One week prior to the Herbst Appliance’s arrival at our office we will place o-ring separators between the upper and lower molars. These separators remain in place until we can cement your Herbst Appliance.
The Herbst appliance is slowly activated with small crimps over time to bring your lower jaw forward and will be in place for ~12 months.
FORSUS Springs
This appliance is used to improve your bite and reduce the distance between your top and bottom front teeth or your “overjet”.
Your bite is corrected as the FORSUS Springs push your upper teeth back and bring your lower teeth forward.
FORSUS Springs are a combination of small springs supported on a rod that are then fixed to the braces in the upper posterior and lower anterior area. The FORSUS Springs will rest along the cheek sides of your teeth and are not removable.
The springs are activated with small crimps over time to slowly improve your overjet.
Facemask or Protraction Headgear Appliance
The Facemask Appliance helps bring the upper jaw forward (protraction) and assists in offsetting excessive forward growth of the lower jaw (“Class III growth pattern”).
The Facemask Appliance is made of two components – an Expander Appliance, which is cemented onto the upper teeth and a Protraction Headgear that is supported from the chin and the forehead.
Elastics from the Expander Appliance are attached to the Protraction Headgear to pull the top jaw forward.
We only expect you to wear your Headgear Appliance at home but a minimum of 12 hours/day every single day is required to achieve the desired outcome.
Less than optimal Facemask Appliance wear will lead to longer treatment times.
Retainers
Following your orthodontic treatment, the long-term stability of the your tooth alignment and your bite correction is best maintained with consistent use of retainers.
Retainers can be cemented in place or removable and are designed specifically for you based on the type of bite your have and the amount of spacing or crowding your started with.
To avoid any changes to your tooth alignment and your bite, wear your retainers as instructed and be sure to bring them with you to your regular retainer checks.