Palatal Expander | Palatal Bar | Headgear | Distal Jet | Lip Bumper | Mara | Retainers
Palatal Expander
The palatal expander is specially made to expand the upper jaw. Usually the appliance expands the upper arch in 15 to 20 days; however, the appliance is kept in longer until new bone is generated in the expanded arch. After the appliance is placed on the arch, you may experience some pressure and soreness, especially when chewing. If the pain is severe, stop turning and call the office immediately. You will also notice a space forming between the two front teeth. This is natural and the space will close naturally.
Turning Instructions:
Once the appliance is cemented, it needs to be activated as instructed; usually twice a day, once in the morning and once in the evening.
1. Carefully insert the key into the hole or slot in the middle of the appliance.
2. Gently and steadily push the key from the front toward the back of your mouth. Do not turn the key forward; only turn backward. Remove the key toward the throat. You automatically bring a new keyhole position forward by pushing the key as far back as possible. It will then be ready for the next activation.
What’s Normal:
-Some changes in speech and excess saliva for the first few days until the tongue has a chance to get used to the appliance.
-Food getting caught between the palate and the appliance. Make sure to brush the roof of your mouth well to get out any food that may be stuck there.
-A space developing between the two front teeth after turning has begun.
-Some pressure or tightness immediately after turning; usually subsides shortly after turn.
What’s Abnormal:
-Any sharp or severe pain. If this occurs, stop turning and call the office immediately.
Click here to view a video if you're having trouble with your RPE
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Palatal Bar
A palatal bar is an orthodontic appliance that is placed on the inside of the bands to rotate the upper molars into their correct position. If you have a palatal bar, make sure that you do not press on it with your tongue.
What’s Normal:
-Some soreness or tenderness of the molars, especially when eating the first few days. You may try Tylenol or Advil to help reduce the pain.
-Some changes in speech and excess saliva for the first few days until the tongue has a chance to get used to the appliance.
-Some irritation of the tongue until it gets used to the appliance.
What’s Abnormal:
-The bar should not be loose or at any time slide in and out of the band that it is attached to. If this happens, a tie has come loose. Please call the office so we can replace the tie.
-Any mark in the tongue caused by the bar. If you play with the bar too much with your tongue, you may get an indentation in the tongue. If this happens, call the office so we can add acrylic to the bar to protect the tongue.
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Headgear
Headgear provides a special force that guides the growth of the face and jaw, and it is also used to move the teeth into the proper position. There are different types of headgear, which provide different kinds of force depending on which kind of correction is needed. It is important that it is worn on a regular basis, as instructed by Dr. Moin. Failure to comply may result in prolonged treatment.
There are some important rules to follow when wearing headgear:
-Be careful to insert and remove it as instructed by Dr. Moin.
-Never try to remove it until the elastics have been disconnected.
-Never try to lift it over your face.
-Never wear it when running or playing sports.
-Never allow anyone to grab or pull on your headgear/neckgear.
What’s Normal:
-Some soreness or tenderness of the teeth the first few days. You may try Tylenol or Advil to help reduce the pain. Do not stop wearing the headgear because it is painful. Continue wearing the headgear every night to allow teeth to get used to the force, and after a few days the soreness will go away.
-Difficulty sleeping the first few nights until you get used to having the headgear on.
-Irritation or redness on the forehead or neck, depending on the type of headgear you have. If this happens, try using baby powder on the area before putting headgear on. You may also try using cotton or a face cloth to pad the area before putting headgear on.
What’s Abnormal
-Difficulty putting headgear on, or taking it off. This can be caused by tooth movement or by bending of the wires. If this happens, please call the office so headgear can be adjusted.
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Distal Jet
A distal jet is an appliance that we use to move the upper molars back into a proper position. It also allows us to gain space so that we may unravel crowding or pull back an over jet.
What’s Normal:
-Some soreness or tenderness the first few days until you get used to the appliance. You may try Tylenol or Advil to help reduce soreness.
-Some changes in speech and extra saliva the first few days until the tongue gets used to the appliance. You may try reading aloud to yourself to get some practice if you are concerned with this.
-Some irritation inside of the lips, cheeks, and/or tongue as they get used to the new appliance. You may try placing wax on the area that is irritated to make it more comfortable until you get used to the appliance.
What’s Abnormal:
-Anything sharp or poking into the tongue, cheeks, or palate. If this happens, please call the office.
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Lip Bumper
A lip bumper is an appliance that we use in the lower arch to push back the molars and gain space to unravel crowded teeth. The lip bumper is removable for brushing and cleaning purposes, but is meant to be worn 24 hours a day otherwise.
What’s Normal:
-Some soreness or tenderness for the first few days until the teeth get used to the appliance. You may try Tylenol or Advil to help reduce the pain.
-The lower lip protruding slightly. The lip bumper is not meant to rest up against the gums. This may make it look like the lower lip is sticking out slightly at first, but as teeth move, the lip bumper will push back and the lip will return to normal.
-Some changes in speech and excess saliva for the first few days until the mouth gets used to the appliance.
What’s Abnormal:
-Anything poking or digging into the gums or cheeks. If this happens, a wire may have been bent while putting in or taking out the lip bumper. Please call the office so that we may adjust the appliance.
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Mara (Mandibular Anterior Repositioning Appliance)
This appliance is used to encourage forward growth of the lower jaw.
What’s Normal:
Some discomfort from the Mara elbows on your cheeks and tongue. You may bite the sides of your cheeks for the first day or so until you get used to the appliance in your mouth. You may also experience some tenderness in your teeth. This will subside. Use the wax given to you at your appointment to make certain areas more comfortable.
What’s Abnormal:
The elbows of the appliance may become locked. If this happens, try to remove the arm and/or call the office. If the office is closed, you may follow the prompts to have someone paged.
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Retainers
Essix/Slip Cover (Clear Retainers) | Permanent Retainers | Acrylic Retainers
Clear retainers are removable and are used after braces to hold teeth or for minor tooth movement.
Schedule for Use:
The first month, your clear retainer should be worn 24 hours a day. It should be removed when eating and be sure to rinse after drinking to avoid staining. After the first month, your retainer should be worn 12 hours at night for six months. After that time, you can slowly decrease wearing your retainer to twice a week at nighttime or as instructed by Dr. Moin. Because teeth continue to move throughout life, it is recommended that you continue to wear your retainers as instructed..
If you miss a night or two, wear the retainer full time and bite down to seat it fully. The teeth may be a little sore, but the teeth should realign. If they don’t and the retainer does not fit, call the office immediately.
Retainer Care:
Clean your retainer with soap, water and Q-tips. Do not brush the retainer with toothpaste because it will dull the brilliance. Soak the retainer in Efferdent or denture cleaner using cool water once a week for twenty minutes. Place a bead of fluoride gel in the retainer once a week, prior to bedtime and leave it there overnight. This will strengthen the teeth.
Retainer Storage:
When not being worn, you should always keep your retainer in the case you have been given. DO NOT wrap the retainer in a napkin as that is the most common way they are lost.
What’s Normal:
Some soreness or tenderness the first few days until teeth get used to the appliance. You may try Tylenol or Advil to help reduce the pain.
Some changes in speech and excess saliva for the first few days until the tongue gets used to the appliance.
What’s Abnormal:
Difficulty getting retainer in. If the retainer is hard to get in, or is causing pain in the teeth after the initial adjustment period, you may not be wearing it enough and there may be some minor movement of the teeth. If this happens, try to wear the retainer all the time to see if things adjust. If they do not or if you can’t get the retainer in at all, please call the office so we can adjust the retainer.
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Permanent Retainers
A fixed retainer, or splint, is a retainer that is cemented in place on the backside of the teeth. They are usually placed on the upper two front teeth (if space existed previous to braces), or on the lower six front teeth (if there was a lot of crowding previous to braces).
Schedule for Use:
As long as you are doing a good job keeping the fixed retainer clean, it may remain in your mouth indefinitely.
Retainer Care:
It is very important that you brush and floss thoroughly paying special attention to the fixed retainer. You will be given flossing instructions using super floss or floss threaders for that area. Be certain that you understand how to use them and floss daily! Your general dentist or dental hygienist can check the fixed retainer at each of your oral hygiene visits. If your fixed retainer becomes detached from any of the teeth, please call the office immediately.
What’s Normal:
Some changes in speech and excess saliva for the first few days until the tongue gets used to the appliance.
What’s Abnormal:
Anything sharp or poking the tongue. If this happens, the wire may have broken. Please call the office so we can check the retainer.
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Acrylic Retainers
There are two types of acrylic retainers, wraparounds and hawleys. A wraparound is a removable retainer that we use, mostly at the end of treatment to hold teeth. This type of retainer may also be used to help close some spacing. A hawley is a removable retainer that we use for a lot of different types of tooth movement, and also to hold teeth once movement is complete.
Schedule for Use:
Your retainer should be worn 24 hours a day for the first six months. It may be removed when eating; always be careful to store it in the case you have been given. After the first six months, you can decrease wearing your retainer to twelve hours at night for another six months, unless instructed otherwise. After that time, you can slowly decrease wearing your retainer to every other night or twice a week at nighttime unless instructed by Dr. Moin. Because teeth continue to move throughout life, it is recommended you continue wearing your retainers as instructed.
Retainer Care:
Clean your retainer with a toothbrush and toothpaste. Soak the retainer in Efferdent or denture cleaner using cool water once a week for twenty minutes.
Retainer Storage:
When not being worn, you should always keep your retainer in water in the case you have been given.
General Tips
Dogs love the acrylic material so always store your retainers in a case when not being worn.
Do not wrap the retainer in a napkin or place it on a lunch tray or on the table when eating out. This is one of the most common ways that retainers are lost.
Do not swim with an acrylic retainer, water can flush them out.
In the event that a retainer is lost, please contact the office immediately to schedule an appointment and find out about replacement costs.
What’s Normal:
Some soreness or tenderness the first few days until teeth get used to the appliance. You may try Tylenol or Advil to help reduce the pain.
Some changes in speech and excess saliva for the first few days until the tongue gets used to the appliance.
What’s Abnormal:
Any irritation or digging into the gums. A wire may have bent while placing or removing your retainer. If this happens, please call the office for adjustment.
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