Rapid Palatal Expander | Tongue Thrusting | Thumb-Finger Appliance | Temporary Anchorage Devices | Headgear/Facemask | Nance Appliance | Interproximal Recontouring
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 of the palatal expander, 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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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.
Dr. Hollis prefers to correct tongue thrusting by giving patients a tongue thrusting appliance. This appliance, similar to a mouthguard, is usually worn at night. Other times, a more permanent appliance is prescribed and can be only be adjusted by Dr. Hollis.
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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, please 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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Temporary Anchorage Devices
One of the many important advances in orthodontics has been the development of temporary anchorage devices, or TADs. Made of a bio-compatible titanium alloy, TADs are miniscrew anchors which are inserted into specific places in the mouth to be used as a fixed point from which teeth can move. Before TADs, orthodontists who wanted to move some teeth while keeping others still, or to achieve orthodontic movement in a mouth with missing teeth, had to rely on headgear for their fixed point. But TADs now provide an option for that fixed point that is smaller, more discrete, more efficient and requires significantly less work for the patient.
Temporary anchorage devices may not be recommended for everyone, and in fact, anchorage devices at all may not be needed in all cases. Contact us if you’d like to know more about TADs and how they can potentially prevent you from needing orthodontic headgear.
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Headgear 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 headgear needs to be worn. The key to success with your headgear appliance is consistency. Headgear must be worn a certain number of hours per day, and if not, it must be made up the following day.
Headgear should never be worn while playing sports and should also be removed while eating or brushing your teeth.
In some cases where an underbite is present, we may recommend using facemask or reverse headgear as part of the treatment plan. This appliance is designed to fix the discrepancy between your upper and lower jaws by moving the upper jaw forward to correct the malocclusion.
For the results to be successful, patient compliance is of the utmost importance. It may take several days to become accustomed to the appliance. With practice, it will become easier to place and remove the facemask. We will determine the length of time you should wear your appliance, but it is generally 10-14 hours per day, which can include wearing while you sleep. You should not wear your facemask while participating in sporting activities.
Sometimes your chin may get irritated from the facemask. If this happens, you should always keep the area clean and often change the insert in the chin cup. If the skin becomes very dry, the use of moisturizing cream twice a day can be helpful. If your jaw joints are extremely sore or you cannot open and close your mouth without difficulty, stop wearing the appliance and contact us for further instructions as we may need to fit you with a different appliance. Also, if your facemask breaks or is bent, call us so we can fit you in with a repair appointment so your treatment will not be delayed.
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The Nance Appliance is used to prevent upper molars from rotating or moving forward after you’ve worn a headgear 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.
This 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. If you have any problems with your Nance Appliance, please call our office immediately.
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Interproximal recontouring refers to a procedure in which Dr. Hollis will reshape your teeth by sculpting the sides of the teeth. This can correct cracked, chipped, crooked or misaligned teeth. Instead of braces, crowns or veneers, you can choose to have interproximal recontouring to change the shape and look of your teeth to enhance your smile!