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Care and Use

In this section you will find care and use instructions for various orthodontic appliances. If you have questions that aren't answered, please feel free to contact our office.

• Separators
• Rapid Palatal Expander
• Elastics
• Twin Block
• Retention
• Schwartz Expander
• Herbst Appliance

Separators

Separators are usually placed between the molars one week prior to fitting braces. The separators may cause slight discomfort for a few hours. They gently wedge the back teeth apart to make it easier to cement the back bands. Do not eat any sticky foods or remove the separators.

Rapid Palatal Expander or Hirax

Rapid Palatal Expander (RPE) or Hirax is for patients whose upper jaw is narrow. Your Rapid Palatal Expander gently widens the upper arch (palate) by stretching the centre palatal connective suture. Once widened, the suture knits together. The rapid palatal expander is prescribed only prior to completion of growth. A parent or the patient adjusts the rapid palatal expander daily as instructed, until the palate has been widened enough.

Before the rapid palatal expander feels comfortable, the patient may sense some initial pressure and expect:

	»	To feel a tingling or itch under the expander.
	»	To feel a tingling sensation across the bridge of the nose.
	»	To feel pressure in the cheek area.

 

A special key is used to activate the Rapid Palatal Expander:

	»	Insert the key into the key slot; the key will not touch the roof of the mouth.
	»	Push the key all the way from front to back. Look for the next hole to rotate forward enough so you will be able to place the key into the next hole to turn your Rapid Palatal Expander.
	»	Turn as you have been instructed.
	»	Remove the key.

 

Remember when brushing:

	»	Use a regular toothbrush.
	»	Brush as usual.
	»	Use a water rinse to flush under the expander.
	»	The use of a waterpik is helpful to dislodge food particles that can become caught in the expander.

Elastics

Elastics move the teeth in a direction that cannot be accomplished by braces alone.
Your teeth and jaws may be tender the first few days of wearing the elastics. This is normal and should begin to disappear within a week. If your soreness persists longer, please call our office. Rinsing with warm salt water will help take away the tenderness.
Attaching your elastics may seem hard initially, however with a little time and patience, you will be able to accomplish this task easily.

Elastic wear must be constant to be effective-24 hours a day-7 days a week, unless otherwise instructed. You may remove the elastics only when eating your meals or brushing your teeth. Leave them in during snacking. Be sure to replace the elastics immediately following mealtime and brushing. Part time wear does NOT move teeth, but it does cause them to be constantly sore.

Change the elastics daily even if they are not broken, after a while elastics lose their strength. Carry extra elastics with you at all times. If you don't have enough elastics to last until your next appointment, please stop by our office and pick more up or call us and we can send more to you. We don't want you to run out.

Elastic wear is an important key to the speed of your treatment and the final results we can achieve. Please call us if you have any questions or concerns.

Twin Block

The Twin Block is made up of an upper and lower plate which work together to correct the bite. It is like wearing two appliances which work together. One fits the upper jaw and the other fits the lower jaw. They work together to bring the lower jaw forward.
To achieve the best and fastest possible correction requires your cooperation. Wear your Twin Block full-time except when cleaning or for active sports. Forgetting to wear your Twin Block will make your treatment take longer and may even affect the final result.

As with anything new, you can expect it to take a little time to get used to wearing your Twin Block. You may notice an affect on eating and speech(reading out loud and tongue twisters help your tongue adapt faster). As with anything in your mouth, the amount of saliva may increase at first. After you get used to wearing your Twin Block, this will settle. You may notice your teeth are sensitive or even loose during wear. Sensitivity usually settles within the first few weeks and loose teeth are the initial stages of your teeth moving and will eventually firm again. You may also experience soreness or ulcers, particularly behind your lower front teeth. If so please call us so we can adjust your plates.

After each meal, remove your plates and brush your teeth, as well as the inside and outside of your plates. Then rinse the plates and your mouth before replacing. To keep your Twin Block extra clean, you may soak your plates in denture cleanser, such as Polident, for 5-10 minutes in warm, not hot, water. Rinse your plates prior to replacing them.

	»	Wear your plates as directed. Usually this is full time. Less than this reduces its' effectiveness dramatically. The more you wear your Twin Block, the sooner your treatment will be complete and the better the final result for you.
	»	Make sure you keep your Twin Block clean and in its case when you are not wearing it. Tour Twin Block is fragile and expensive, so DO NOT put it in your pocket or wrap it in a napkin.
	»	DO NOT put your Twin Block in hot water or near heat, as the plastic will warp.
	»	DO NOT soak your plates in mouth rinses or disinfectants, as this may affect the plastic( and make them taste strange).
	»	DO NOT leave your TWIN Block lying around where others or your family pet can get to it. A dog will chew it given the opportunity.

Retention

Removing braces signals the start of the retention and observation period of your orthodontic care. Please remember that this part of your orthodontic treatment is just as important as the active movement phase in determining the ultimate success of your treatment. Once the teeth have been moved into their desired positions, a period of time is needed to stabilize the teeth so that the surrounding bone and soft tissue can conform to your new dental alignment. When braces are removed, it is a good time to review several important aspects of care.

Patients in the retention phase are seen periodically in our office during the first year after braces are removed. Patients will continue to see the doctor until he feels they can be dismissed from treatment. It is then the patient's responsibility to wear a retainer as prescribed. Please call our office if you have any concerns regarding your retainer.

Typically retainers are worn 12 hours daily for the first 3 months, thereafter while sleeping. A bonded retainer may be used on the inside of the lower front teeth and in some cases on the inside of the upper front teeth. This bonded retainer will be worn indefinitely as long as there are no problems with oral hygiene. If a decision to remove your bonded retainer is made, a removable retainer may be fabricated and will be worn while sleeping.

For lasting success from orthodontic treatment:

	»	Wear your retainer as prescribed.
	»	Don't let your retainer get bent or otherwise damaged.
	»	Don't let your retainer get bent or otherwise damaged.
	»	Keep your retainer clean. Efferdent, Polident or white vinegar soaks may help remove stains from the retainer.

Schwartz Expander

The Schwartz Appliance is a functional appliance used to expand the upper and/or lower dental arch by stimulating growth of the bone in width. Once widened, the suture knits together. The Schwartz Appliance is prescribed only prior to growth. The Schwartz Appliance is adjusted as instructed, until the palate has been widened enough. It is then left in place for about four months without further adjustment while the bone fills the centre palatal suture or healing occurs.

Speech is different the first few days with any orthodontic appliance. Try practicing talking or reading out loud, saying "s" words to practice placement of your tongue. If your appliance gets food stuck to it while you are eating, try to take small sips after each bite of food to help wash the food down. Don't worry, after just a few days your appliance will feel like an old friend.

Before the Schwartz Appliance feels comfortable, you may sense some initial pressure and expect:

	»	To feel a tingling or itch under the appliance
	»	To feel a tingling sensation across the bridge of the nose
	»	To feel pressure in the cheek area
	»	To see a space appear between your upper front teeth

 

A special key is used to activate the Schwartz Appliance:

	»	Loop the string on the key around your finger or wrist so you don't swallow it.
	»	Insert the key in its slot, it won't touch the roof of your mouth.
	»	Push the key all the way from front to back.
	»	Turn as you have been instructed.
	»	Remove the key.

 

Cool water, toothpaste and a toothbrush are needed to clean your appliance. If your appliance is cemented in, brush it as you would your teeth, paying attention to the bands that hold it in. Brush gently along the gum line to remove the plaque. If your appliance is like a retainer, take it out of your mouth and brush it with the same brush and toothpaste as you would your teeth. Plaque sticks to plastic better than teeth, so extra brushing is important, especially where the wires join the plastic. Brush often, at least three times per day for two minutes at a time.

If your appliance becomes loose, or if you have any questions, please give us a call. If a band rubs your cheeks, place wax over it to protect your cheeks

Herbst Appliance

This appliance is usually attached using stainless steel crowns. Metal side bars and some front braces are often part of the appliance. Some appliances may have an expansion screw in the middle of the pallet to help widen the upper jaw.