HOLDING APPLIANCES

Holding Appliances include: Transpalatal Arch (TPA), Nance, Lower Lingual Arch (LLA), and Lingual Arch Developer (LAD).

PURPOSE

These appliances are made to restrict specific teeth from moving while allowing other teeth to erupt. Because these appliances are not removable you need to be aware of the following:

CARE

Use a toothpaste containing fluoride and brush all surfaces after each meal and snacks making sure to remove all food particles from under and around the appliance. Vigorous swishing/rinsing with water is also helpful. Be sure to floss daily to remove any plaque from in between the teeth. Using a fluoride rinse before bedtime is suggested to strengthen teeth.

DIET

Avoid hard foods such as nuts, chewing on ice, and hard candy. Avoid sticky foods such as caramels, taffy, licorice and gum. Minimize sugary foods and beverages, such as pop and sports drinks. Eat soft foods and cut into small pieces, especially carrots, apples, pizza, sandwiches, etc.

This will prevent breakage or bending of appliance bars and allow for easy adaptation of appliance - START OFF SLOWLY!

** Additional fees may apply for broken/loose appliances if diet is not followed **

WHAT TO EXPECT

Difficulty with speech or swallowing is normal at first. Talking and reading aloud as well as frequent, small drinks of water are suggested to improve this quickly. You may experience excessive saliva with this appliance being placed; this too will subside within the first few days. Some brief minor discomfort in face and teeth is expected. When this happens Tylenol or Ibuprofen is recommended. If irritation to gums or roof of mouth occurs, rinse with warm salt water 2-3 times per day. If the appliance is ever loose, call our office immediately.

EXPANSION APPLIANCES

Expansion appliances include: Nitinol Expander, Jet Expander, Quad-Helix Rapid Palatal Expander (RPE).

PURPOSE

These appliances are used to widen and move your upper jaw and teeth. Because these appliances are not removable you need to be aware of the following:

CARE

Use a toothpaste containing fluoride and brush all surfaces after each meal. Food may get trapped in the bars and around the bands of this appliance, though brushing is very important, vigorous rinsing/swishing with water is also suggested. Use floss to clear any trapped plaque or food at least twice per day.

DIET

Cut down on sugary foods and beverages, including pop and sports drinks. Soft foods and small bites are recommended for the first few days to help with adaptation to the appliance. Avoid hard foods such as nuts, pretzels, ice and hard candies. Avoid sticky foods such as taffy, caramel, Tootsie rolls and gum.

** Additional fees may apply for broken/loose appliances if diet is not followed **

WHAT TO EXPECT

Some brief minor discomfort in the face and dental areas is expected with each activation; Tylenol or Ibuprofen is suggested. Difficulty with speech and swallowing is normal at first. Reading aloud slowly and taking small sips of water will improve this quickly. You may experience excessive saliva with this appliance being placed; this too will subside within the first few days. A space may open between the front two teeth. This space is normal and will close due to natural drifting of the teeth once the turns are completed. If irritation to gums or roof of mouth occurs, rinse with warm salt water 2-3 times per day. If appliance is ever loose call our office immediately.

HABIT APPLIANCE

PURPOSE

Your appliance is fixed to your teeth to help you get rid of a thumb/finger or tongue habit more effectively. Since it is not removable, you should be aware of the following:

CARE

Use a plaque control toothpaste that contains fluoride and brush all surfaces after each meal. Be sure to floss daily to remove any plaque from between the teeth.

DIET

Eliminate any food or beverage containing sugars. Soft drinks are particularly dangerous because of their acidity. Stay on a soft diet for the first week to help adjust to the appliance. Avoid hard foods such as nuts, ice and hard candies. Avoid sticky food such as taffy, caramel, Tootsie rolls and chewing gum.

** Additional fees may apply for broken/loose appliances if diet is not followed **

WHAT TO EXPECT

A period of adjustment will be necessary following the placement of the appliance. Difficulty with speech is normal at first. Adaptation to the appliance through reading aloud and talking will improve speech. Small, frequent drinks of water will also help you adjust. If irritation to gums or roof of mouth occurs, rinse with warm salt water 2-3 times per day. If the appliance is ever loose contact our office immediately.

MARA

PURPOSE

The MARA is designed to move your lower jaw forward. You may have to make a conscious effort to bite forward with the lower jaw until the muscles become accustomed to the new position, and it will take a couple of weeks before you are completely comfortable.

CARE

Brush 4-5 times per day. A fluoride rinse twice a day is recommended. Floss once a day.

DIET

Stay on a soft diet for one or two weeks to help adjust to the MARA. Avoid hard foods such as nuts, ice and hard candies. Avoid sticky foods such as taffy, caramel, Tootsie rolls and gum. Eliminate any food or beverage containing sugars.

** Additional fees may apply for broken/loose appliances if diet is not followed **

WHAT TO EXPECT

You may bite your cheeks until you have learned to avoid doing so. Soreness in the cheek area may be experienced but will go away as the tissue toughens and a callus forms. For sore cheeks use a small piece of cotton or wax over the area. And, if it does not improve, call us for an adjustment. Eating may be difficult for one or two weeks and you may be biting on your incisors.

A reminder: The arms of the MARA are only guides to show you where to bite. Do not bang or chew on them or they will become loose. People who use common sense and remember to avoid candy and crunchy foods can easily avoid breakage. If any parts of the MARA come loose, call for an appointment and bring them in at your appointed time for repair. Your bite may change over the next few months from how it is now, and the MARA will probably need to be adjusted occasionally. You may notice some small spaces temporarily between your lower teeth. These will be closed later with braces. There is a possibility of the lower arm getting locked in the upper elbow. This doesn't happen often, but if it does and you cannot disengage it with gentle movement, call the office for immediate assistance.