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Lower Lingual Arch

The 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 these situations.

To maximize the lower lingual arch treatment, patient and parents must know how to care for it properly by following these instructions:


  1. no hard or sticky foods (corn chips, hard candy, caramel, gum, taffy, peanuts, etc.)
  2. 3-4 carbonated drinks (coke, root beer, 7-up etc.) per week
  3. monitor highly sweetened foods (cake, pie, ice cream, cookies) brush after or rinse with water.


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


Spring Retainer

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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Pendulum and Pendex


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 your bite".


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.


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.


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 upset.


You may talk funny with the herbst at first. Reading aloud or spending a lot of time on the phone will solve this problem.


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.


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).


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 your child.

If you have any questions regarding your appliance or treatment, do not hesitate to ask.

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© Copyright 2003 - Dental WebSmith, Inc., Tom C. Sexton, DMD, PA (Florida), and Tom C. Sexton, DMD, PA (Georgia). All rights reserved. Disclaimer: The information provided within is intended to help you better understand dental conditions and procedures. It is not meant to serve as delivery of medical or dental care. If you have specific questions or concerns, contact your health care provider.