Separators or Spacers
Separators have been placed between your teeth in order to move them apart slightly so that orthodontic bands (the metal rings around the back teeth) may be placed at your next appointment. Separators are removed prior to placement of the orthodontic bands.
If the separators become loose before your next appointment, please call our office in order to see if they need to be replaced. You should make every effort to keep the separators in place by avoiding sticky foods like chewing gum, and avoiding flossing in the areas with the separators (this will be one of the few times we ever tell you NOT to floss). Visit this website as well
The tenderness associated with the separators usually diminishes after a few days. In the meantime, whatever medication you usually take for a headache (Advil, Tylenol, or aspirin) can be used to take care of any discomfort.
A Palatal Expander is designed specifically to expand and widen your upper jaw.
Any interference with your speech due to the appliance usually resolves over time. Sometimes activating the expander causes some slight pressure near the nose or out toward the cheekbones. This sensation usually subsides within 30 minutes. Advil or Tylenol may be needed for the first 3 nights.
To activate the expander:
Place the key into the key hole in the center screw and gently push the key toward the back of the mouth which will turn the center screw.
If the key has been moved all the way to the back of the mouth, the next hole should be visible in the front. When one hole is visible, turning the key so that you can see the next hole is considered one “turn” or “activation”.
Please do not pull the key forward to remove it. If that happens, you “undo” the expansion.
Because the hole is difficult to see, the activation usually needs to be done by someone other than the patient. We recommend someplace with good lighting (like a bathroom) or a flashlight for the best visibility.
Turn the appliance once per day for as many days as the doctors’ instruct. We will schedule an appointment to see you evaluate your progress and determine if any more turns are necessary.
The expander may cause the separation of the two front teeth. This is normal and space may close on its own when the key turning is stopped. Otherwise, space will eventually be closed with braces.
After the expansion is completed, the patient will continue to wear the appliance for a period of time to allow the bones to get used to the new position.
Headgear is used in the treatment of patients whose upper teeth are ahead of the lower teeth and guides the growth of the teeth and jaws.
It is important to wear the headgear 12-14 hours per day, every day, with the majority or the time while sleeping. In order to comfortably “work up to” those ideal hours, follow this schedule:
DAY 1: 4 hours
DAY 2: 6 hours
DAY 3-7: 8 hours (including all night, while sleeping)
DAY 8: 12+ hours
At this point, the 12+ hours should be maintained daily until instructed otherwise.
NOTE: The hours the headgear is worn do not have to be consecutive.
To place the headgear:
Placing the headgear in your mouth should be done carefully.
Attach the elastic strap to the hook on one side of the headgear.
Using the side that is attached to the strap, place the headgear into the tube attached to the band in the back of your mouth. The bumps or loops on the headgear should point down.
Insert the other side of the headgear into the tube on the band on the other side of the mouth.
Hold the headgear in front of the mouth with one hand while using the other hand to attach the elastic strap to the hook on the other side of the headgear.
Bring your headgear to every appointment so we can check and adjust it. Each headgear is custom-fitted and adjusted. You should not change yours in any way. Please call us if you feel it’s not fitting correctly.
It is normal if your teeth are tender for the first few days the headgear is worn. This tenderness will disappear as you and your teeth get used to the pressure. Wear the headgear consistently and do not remove it frequently.
Please remove the headgear before engaging in physical activity. Wearing the headgear while playing sports or wrestling may injure you or others.
Be careful when removing the headgear. If the headgear does not easily slip out when you try to remove it, stop! Go to a mirror and gently remove it. Twisting and forceful pulling may bend the headgear or loosen the bands.
The elastic strap is hand washable. Hang to dry (do not place in a dryer).
Elastics or “Rubber Bands”
Elastics, or “rubber bands”, are used to help improve the fit and bite of the upper and lower teeth. How well the rubber bands work, and therefore how quickly your teeth fit together appropriately, is determined by how well you wear the rubber bands.
The rubber bands should be worn every day, 7 days a week.
They can be removed to eat. After you eat, you should throw away the old rubber bands and place new ones. Since a rubber band is not as effective after being in the mouth for more than 12 hours, please try to change them 3-4 times per day.
The rubber bands need to be worn exactly the way we showed you. Wearing them in a way other than shown can result in tooth movement different than intended, and even opposite of what we want. If you are not sure how you’re supposed to be wearing them, ask us.
Advil or Tylenol may be used if the rubber bands cause the teeth to be sore.
Occasionally, wearing rubber bands can cause the jaw joints to become sore or start making noises when you open and close your mouth. If that happens, call our office and we will make an appointment to see what is going on with your jaw joints.
If you notice that you are running low on rubber bands, call our office. You can either come by to pick up some more or we can mail them to you.
The retainer can be either removable or cemented in place behind the teeth.
For Removable Retainers:
Wear the retainer as instructed by the doctor. Usually, the retainer is worn 24 hours a day immediately after the braces are removed. Only take them out when eating, brushing and flossing, or when playing contact sports. This means all day and all night.
Brush your retainer with toothpaste and water when you brush your teeth (which should be at least twice per day). Calculus is a hard white substance that can build up on the retainer. If it does, soak the retainer in 1 cup of vinegar for 4 to 8 hours and then brush as usual with toothpaste and water. NEVER soak your retainer in ANYTHING except vinegar or some type of denture cleanser!
If your retainer is not in your mouth it should be in the case we provided. NEVER wrap your retainer in a napkin or place it in your pocket, because it can be easily broken, thrown away, or lost.
Do not bite the retainer into place, or “click” the retainer in and out of your mouth with your tongue. This can either bend the wire or break the plastic.
Do not immerse the retainer in hot water, as plastic will distort and the retainer may no longer fit.
Dogs and cats love to chew on retainers! Keep them out of reach of your pet’s mouth.
If a retainer is broken, irritates the mouth, does not fit, or is lost, call our office immediately.
The cost of your first retainer was covered in the orthodontic treatment fee, however; if we need to make you a new one there is a replacement fee per retainer. If you break the retainer, please save the pieces and bring them with you. Sometimes they can be repaired for a lesser fee. PLEASE KEEP IN MIND that we will need to see you twice for any repair or replacement, as a new impression has to be made to either repair or replace a broken retainer.
For Cemented or “Permanent Wire” Retainer
Your permanent retainer is cemented to the tongue side of your front teeth and is not removable. It is designed to last many years with proper care.
Please remember that it is a delicate appliance and certain precautions need to be taken while eating:
Avoid hard or sticky foods. Many of the foods you have been avoiding with braces on, you will still need to avoid.
Things like fresh vegetables and fruit should be cut up into smaller pieces. This is so you can chew them with your back teeth and avoid biting them with your front teeth.
Do not poke the retainer or chew on pens or pencils. They can break the retainer or knock it loose.
If you notice that the retainer is loose, please contact our office as soon as possible. We want your teeth to remain straight, but if the retainer is loose, your teeth could move. Additionally, a loose retainer makes it easier to get cavities underneath the retainer. Please brush your teeth and retainer them thoroughly. You will need to use a floss threader to get the floss under the retainer wire. Just make sure you are careful and do not pull “up” on the retainer with the floss, as this could distort or loosen it.