Care and Use of Appliances
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.
Elastics move the teeth in a direction that cannot be accomplished with 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 your task easily.
Elastic wear must be constant to be effecitve – 24 hours a day – 7 days a week, unless otherwise
indicated. 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.
Phase I – Treatment with Headgear
One of the ways we are going to move your jaw bones and teeth is through the use of an appliance
called a headgear. It helps us move your teeth in a way that braces alone can’t. The headgear uses
the back of the neck or the back of the head to move the teeth and help create a beautiful smile.
Some common uses of the headgear are: to move the teeth back to create more space, to anchor
molars during treatment, to bring the upper teeth and jaw backward or to lift and hold the upper
front teeth in order to open a deep bite. Depending on the type of headgear you are wearing, it will
either fit in tubes on the molar bands, attach to an expander appliance, or hook to the archwire.
Headgear is a removable appliance that is usually worn during the evening and nighttime hours. The
more you wear headgear the better it works.
Phase II – Treatment with Headgear
When braces are in place, headgear is used in many ways to redirect jaw growth:
• To move the upper molars back to fit with the
• To hold the upper molars back while the upper
front teeth are moved back into position.
When headgear is prescribed:
• Patients do not need to wear their headgear to school, work or during active sports.
• It must be worn at least 14 hours each day (unless otherwise instructed).
• Consistent daily use is essential to achieve success in treatment.
• Never allow the headgear to be damaged, do not roughhouse with headgear on.
When wearing headgear, expect:
• To feel some pressure when the strap is attached to the facebow, and relief of the pressure when
the strap is detached.
• The molars to ache and be slightly loosened as tooth movement occurs.
• A band to become loose. If this happens please call our office for an appointment to have your
At each appointment in our office:
• Bring your headgear so we can check and adjust it.
• We will measure the space the headgear is creating, and can tell from this measurement how
well the headgear is being worn.
• How well you wear your headgear determines how long you need to wear it.
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.
Rapid Palatal Expander
Rapid Palatal Expansion (RPE) is for patients whose upper jaw is narrow. Your Rapid Palatal
Expander gently widens the upper arch (palate) by stretching the center 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 that can become caught in the expander.
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 three 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.
• Call for a repair appointment if your retainer is damaged or loosened.
• Keep your retainer clean. Effordent, Polydent or white vinager soaks may help remove deposits
from the retainer.
• Keep your retainer in its case when not being worn.
• Be committed to maintaining your beautiful smile.