Space Maintainers (Lower or Upper Lingual Holding Arches)
A lingual holding arch (Phase I treatment) is recommended for children who have lost baby “primary” teeth too soon. Primary teeth are considered mother nature’s way of space maintenance. In the instance that a baby tooth is extracted, damaged, or falls out too soon a space maintainer is recommended. The lower lingual holding arch appliance will hold the permanent molars in place while baby teeth are falling out and permanent teeth are erupting.Two bands (braces) are cemented to two lower molars. Attached to the bands is a U-shaped bar. The appliance will remain in the mouth until all permanent teeth have erupted and the patient is ready to begin Phase II- comprehensive orthodontic treatment.
Rapid Palatal Expander (RPE)
A palate expander (Phase I treatment) is an appliance that widens the upper jaw. This widening or “expansion” is usually indicated to correct an upper jaw that is too narrow with a malocclusion called a “crossbite.” The upper jaw can also be widened to create space for crowded or blocked out teeth.
The appliance has a screw-type mechanism that is turned with a special key that we provide. It can be turned by either the patient or parent. You may notice that a space develops between the front teeth during the expansion. This will close after the widening is complete. Once the necessary expansion is achieved, the expander is stabilized and left in place for 4 – 6 months.
Temporary Anchorage Devices, or TADs
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. Contact us if you’d like to know more about TADs and how they can potentially prevent you from needing orthodontic headgear.
Forsus Appliance
The Forsus appliance (composed of a spring coil rod) is a Class II correction device used while the patient is wearing braces. The appliance is used to help move the upper molars back while moving the lower arch forward. The appliance continuously applies light force without any need to make daily changes or adjustments.
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.