Orthodontic Appliances

Orthodontic treatments require a multitude of devices and appliances to achieve the desired result of a perfect smile. At Morita Orthodontics, we inform our orthodontic patients in and around Honolulu, Aiea of the best practices for using and taking care of their orthodontic appliances. Please click on the links below for each appliance to see instructions for wearing, cleaning and caring for your orthodontics.

Headgear

Wearing your Headgear is one of the most important aspects of effective orthodontic treatment. Please, follow the instructions below along with any specific instruction your orthodontist recommends during office visits for the best results.

  • Your headgear must be worn 10-12 hours each day. Failure to do so will delay the removal of your braces and won’t allow for the best results possible. Help us help you and wear your headgear!
  • Build up your headgear hours to adjust to wearing it more comfortably.
  • The first week: 3 hours daily.
  • The second week: Sleep time only.
  • The third week and on: 10-12 hours a day thereafter.
  • No sports or roughhouse play while wearing your headgear. If your headgear gets hit or pulled it may become distorted and you may get injured.
  • Keep the facebow clean by brushing it daily. The neck strap or head strap may be hand washed in cold water and hung to dry. If there is a spring please remove it before washing. NEVER place straps in dryer.
  • Bring your headgear to every appointment and the most important aspect is to wear the headgear consistently.
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Reverse-Pull Headgear

Often referred to as reverse-pull headgear, the protraction face mask is a removable appliance for patients where the upper jaw is not growing fast enough, resulting in a crossbite or underbite. The device consists of a metal bar attached to pads on the forehead and chin with rubber bands hooked to the face mask and the upper braces to gradually move the upper jaw forward. Patient compliance is extremely important as the face mask must be worn a set number of hours per day or more to obtain the desired results. The face mask device is generally worn for six to 12 months.

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Lower Lingual Arch

A Lower 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.

You should expect soreness the first day or two, and 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, and please monitor how many foods you eat that are high in sugar.

Brushing and flossing daily is very important. 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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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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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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Rapid 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, 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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Elastic Rubber Bands

Wearing your elastics (rubber bands) is essential to achieve desired orthodontic results in a timely manner. Not wearing them will only delay the process. Please follow the directions below for proper elastic rubber band use.

  • Wear elastics 24 hours per day unless otherwise directed.
  • You can remove them when you eat and brush, but please be sure to replace them right after you finish.
  • The elastics must be changed after wearing them for 12 hours, or usually 2 times each day.
  • If the hook should break where you attach the elastics, please call the office to have it replaced. Don’t wait until the next appointment!
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Separators

Separators are small elastic rings or metal wires, that are placed between the teeth to create a small amount of space. This allow us to fit band on the teeth easier and more comfortably.

Separators feels like food stuck between your teeth and may cause soreness for up to 4 days. If necessary you may take over-the-counter analgesics for discomfort.

Please do not floss where the separators are place because you may dislodge or push them under your gums.

Avoid eating sticky foods such as gum or candy.

If any separators should come out before your next appointment, it is usually due to adequate space being created. It is not necessary to come in to have the separator replaced. Please remember how many separators came out as we need to account for all separators.

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Forsus Appliance

The Forsus appliance is used in order to help move the upper molars back while moving the lower arch forward. Composed of a spring coil rod, the appliance is used while a patient is currently wearing braces. It runs from the upper first molar band down to the lower archwire.

You may notice some discomfort initially, so we recommend a soft food diet for the first few days after the appliance is placed. Regular anti-inflammatory medication may help with any pain, if needed. It is important to keep the appliance clean; you may do this by carefully brushing the coil and other metal pieces of the appliance. Also, we recommend that patients not open their mouths very wide, as the appliance may come apart.

If your Forsus appliance breaks, please contact our office immediately to schedule a repair appointment.

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Quad Helix

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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Carriere Distalizer

The Carriere Distalizer is an orthodontic device developed to correct a bite without removing permanent teeth when teeth have erupted incorrectly. With an effect similar to headgear, but without the use of a bulky appliance, the Carriere Distalizer pushes upper teeth back to create a corrected bite prior to the addition of braces.

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Tooth Positioner

Tooth Positioner complete the final tooth movements in your orthodontic treatment. With your full cooperation, you should only need to wear the positioner appliance for 4-8 weeks.

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Herbst Appliance

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 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.

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