lower lingual holding arch is a holding appliance. It prevents the permanent
molars from shifting forward allowing crowded teeth to spread out. It
remains in place until permanent teeth begin erupting.
Two bands are cemented to two lower molars. Attached to the bands is a
U-shaped bar. The patient may experience slight discomfort when first
placed. Whatever household pain reliever you prefer, may be used to remedy
To maximize the lower lingual arch treatment, patient and parents must
know how to care for it properly by following these instructions:
- no hard or sticky
foods (corn chips, hard candy, caramel, gum, taffy, peanuts, etc.)
- 3-4 carbonated
drinks (coke, root beer, 7-up etc.) per week
- monitor highly
sweetened foods (cake, pie, ice cream, cookies) brush after or rinse
1. Brush teeth at
least 3 times daily.
2. Use a water pick or floss, to remove food caught underneath the appliance.
3. Watch diet and contact office if bands come loose or anything breaks
or wire gets bent.
4. Warm salt water rinses for sores.
5. 'Rescue' wax for bands until cheeks get used to new appliance
The Spring Retainer is used for alignment of rotated incisors. Up
to four anterior teeth first are reset into ideal alignment on the
working model. A resilient wire framework, with added acrylic, provides
the necessary corrective forces to move the teeth. This simple design
provides an efficient removable appliance for correction of irregular
or relapsed incisors, and is one of the more
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This appliance is
a unique way of correcting the side bite of the teeth. In certain situations
when an orthodontist feels that your growth is near completion and headgear
is less efficient, a Pendulum appliance can be used. This appliance uses
the angle at the roof of the mouth as an anchor to move the molars back
into their correct bite.
A large acrylic pad touches the roof of the mouth and very resilient wire
springs act in a broad swinging arc to move the molars back. If the upper
jaw needs to be widened somewhat, an expansion screw is incorporated into
the Pendulum, it is now called a Pendex. The Pendulum appliance is somewhat
cumbersome and takes a little getting use to, but it is so beneficial
in the overall treatment of many malocclusions. It will be in the mouth
for about 3 to 6 months.
After molars are moved
back into their proper bite, another appliance called the Nance will be
placed into the mouth to anchor the molars into the position we have moved
them. The Nance will stay in the mouth for several months while the other
teeth are brought into their correct position.
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Your expander works
by making your dental arch larger. This will help to straighten your crowded
teeth, and also create room for the rest of your permanent teeth to erupt
without them also becoming overcrowded. It can also work by correcting
the way your teeth fit together-this is sometimes called "correct
The Hyrax expander
consists of two rings (bands) or stainless steel crowns covering your
back molar teeth on each side of your mouth. Welded to these bands or
crowns are strong wires that are attached to a rectangular shaped expansion
screw. For the upper expander, the screw is located in the palate. The
upper expansion screw is usually activated one turn each day for two weeks,
preferably the same time of day each day.
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The Herbst consist
of four stainless steel crowns covering you back molar teeth-one in each
corner of your mouth. Attached to the upper crowns are two metal cylinders
or sleeves. Attached to the lower crowns are two metal bars running parallel
to your lower back teeth, and two metal rods or arms that slide into the
sleeves hanging down from the upper crowns. Your appliance may also have
an expansion screw located in the middle of your palate.
HOW DOES IT WORK?
The appliance works by using the metal sleeves and rods to hold your lower
jaw forward to correct your overbite. In the next few months, your lower
jaw will grow into this new correct position, and your overbite will disappear!
It takes about 9 to12 months for this magic to occur. The expansion screws
are used to make room for crowded teeth by making the dental arch wider.
THINGS THAT RUB
The lower bar will sometimes irritate the cheek or lip in the lower front
corner of your mouth. Place cotton rolls there to cushion the area for
the first 1 to 2 days. The metal attachments on the outside of the upper
stainless steel crowns can sometimes rub the cheek in the back of your
mouth. Try to keep some wax on these areas, especially the first 1-3 nights.
The expansion screw may irritate your tongue at first. Be careful not
to rub your tongue against it constantly-this will only keep your tongue
You may talk funny
with the herbst at first. Reading aloud or spending a lot of time on the
phone will solve this problem.
DROOLING AND OTHER MINOR DISCOMFORTS
Swallowing may seem difficult at first, but it gets better. Do keep swallowing-it
is the best cure for the initial drooling response, which will decrease
after about 24hrs. Your gum tissue around the stainless steel crowns may
be sensitive during the first day. Warm salt water (8oz water +1/2 tsp.
Salt) rinses help this tremendously. Your teeth or jaws may become sore
when you turn your expansion screw. For this soreness, or just general
discomfort when getting adjusted to your new Herbst, take the appropriate
dosage of Advil, Tylenol, etc.
AS THE SCREW TURNS
Not everyone needs
expansion with the Herbst, but if you are the lucky one, the expansion
screw is generally turned once per day-usually the same time of day is
preferred. See detailed instructions on turning the
expansion screw (LETS GET CRANKING).
Occasionally the Herbst
will come apart when the lower rod comes out of the upper sleeve-especially
when you yawn too wide or when you are trying to show your friends how
wide you can open your mouth! Avoid these two activities. Usually, you
can reassemble the two pieces following the instructions given to you
by Dr. Sexton. See instructions on how
to clean your Herbst (THE PLAQUE PATROL).
A LAST WORD FOR
The Herbst appliance
has worked miracles for hundreds of children in our office. Keep this
fact sheet in mind during the first week of treatment! Your child will
eventually accept this mechanical distraction, and things will return
to normal again. Call us anytime if you have
a question, problem or concern. Your partnership is invaluable to us and
you have any questions regarding your appliance or treatment, do not hesitate
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