Orthodontic Appliances

Lower Lingual Arch | Nance Appliance | Rapid Palatal Expander | Thumb/Finger Appliance | Tongue Thrusting Appliance | Elastics | Forsus Appliance

Lower Lingual Arch

A Lower Lingual Arch acts as a space maintainer to keep the molars from drifting forward, and prevent them from blocking the space where permanent teeth will eventually erupt. This appliance is commonly used in cases of premature loss of baby tooth or when the lower teeth of a growing child are slightly crowded and no permanent teeth are extracted to correct the problem.

You should expect soreness the first day or two, and it may hurt to chew. We recommend a soft diet initially. You may take Advil or Tylenol to relieve the pain. Avoid sticky or hard foods, and please monitor how many foods you eat that are high in sugar. Brushing and flossing daily is very important. Be sure to clean around the bands that are connected to the molars and the wire on the tongue side. This will prevent the formation of cavities or infection of the gums. The duration of wear varies. We will monitor the eruption of new teeth and make adjustments. Generally, the Lower Lingual Arch is removed following the eruption of all the permanent teeth.



Nance Appliance

nance.jpgThe Nance Appliance is used to prevent upper molars from rotating or moving forward after you’ve worn a headgear, a Wilson’s arch 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.

The 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.

Thumb/Finger Appliance

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, 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.

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.

Tongue Thrusting Appliance

tongue.jpgTongue 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. We prefer to correct tongue thrusting by giving patients a tongue thrusting appliance. This appliance, similar to a mouth guard, is usually worn at night. Other times, a more permanent appliance is prescribed and can be only be adjusted by our office.


Elastics, also known as rubber bands, are attached to brackets and use pressure to move teeth and/or adjust the bite. Elastics are a crucial step in the orthodontic treatment process. In order for them to work effectively, elastics should be worn constantly and need to be changed every 12 hours, or twice a day. Elastics can be worn while eating. If it becomes too difficult, remove the elastics while eating and replace them immediately when finished. In order to prevent the delay of treatment, elastics should be worn exactly as instructed. Elastics should be removed only when brushing after meals and replaced immediately.



Forsus Appliance

The Forsus appliance by 3M Unitek is used for Class II bite correction. A Class II bite is when the upper and lower back teeth are unable to chew or bite correctly. One of the jaws is usually shorter or longer than the other, resulting in an overbite. The appliance helps move the upper molars back while moving the lower arch forward. It is used while a patient is currently wearing braces and consists of a spring coil rod that runs from the upper first molar band down the lower archwire.

Patients usually adapt quickly to the new way of opening and closing their jaw, as well as to chewing food. Patients should avoid opening their mouths too wide, however, because the appliance can come apart. If the Forsus appliance breaks, please contact our office immediately to schedule a repair appointment. The Forsus appliance should not be removed except by the orthodontist. It is important to keep the appliance clean by carefully brushing the coil and other metal pieces of the appliance. Patients should brush around the bands and appliance daily.