Types of Appliances

Elastics (Rubber Bands) Wear:

During various phases of treatment, small elastics or rubber bands are used as a gentle but continuous force to help individual tooth movement or the aligning of one arch to the other to help the teeth fit together better.

It may take a couple of days to get used to putting in our elastics. But after that, you'll probably be able to hook them up with your eyes closed. For the first week, your mouth may be a little sore or you might develop a slight headache. Over-the-counter pain relievers may be used to help you feel better.

Elastics can break. You might feel one snap in your mouth. Once in a while, you might even swallow one. This isn't a problem. Just remember to replace the broken elastic with a new one.

What you have to do:

• Wear your elastics on the right teeth all the time, day and night, unless otherwise instructed (we'll show you which teeth you have to connect and we'll give you a diagram to take home).
• If you wear the elastics one day and left off the next or they are worn "just to bed," your treatment slows to a standstill or stops. Why? Because the teeth "jiggle" back and forth; this actually sets up a resistance that virtually prevents normal movement. Follow instructions EXACTLY, and you will get better, faster, more comfortable results. You may be surprised at how quickly your treatment will progress, and possibly your overall time in braces may be less than expected.
• Change your elastics every 12 hours to keep the forces constant. You may remove them to eat, but remember to replace them after you brush your teeth. Always carry a bag of elastics with you when you are out and about.
• If you are running low, please call the office. We'll have a bag waiting for you at the front desk or in the mailbox. Don't run out of elastics. It will just slow down your treatment.
• Usually, after about two days, any discomfort from the elastics disappears. But if you leave them off "to give my teeth a break and allow them to feel better," you have done exactly the wrong thing! Stick with them.

Herbst Appliance:

One of the most common problems orthodontists treat is the discrepancy that occurs when the upper teeth protrude beyond the lower, commonly called an "overbite". Ordinarily when we see someone with the upper teeth protruding, we tend to think that the upper jaw and teeth are too far forward; but, more often than not, this condition is due to a small lower jaw that is further back than it should be. For these patients, we would like to "encourage" the lower jaw to "catch up" in growth, and orthodontic appliances like the Herbst Appliance help this to happen.

A first, your mouth will feel unusually full and speaking will be awkward. But if you practice reading aloud, your ordinary speech will return to normal quickly. You may also notice more saliva than normal, but this too will decrease as you become accustomed to the appliance.

Even though the Herbst Appliance prevents your lower jaw from moving backwards, opening and closing movements still occur easily and you do not have any problems learning to chew food with your lower jaw in this new position.

Please don't play with the appliance with your tongue or fingers! More appliances are damaged by these careless habits than from any other thing. As with all kind of braces, patients with Herbst Appliances need to be careful about what they eat. For instance, cold foods such as ice slushies, popsicles and ice cubes will freeze the cement and make the supporting braces loosen. Of course, sticky foods such as caramels, bubble gum and candy suckers will pull the brace away from the teeth so avoid them like the plague! Hard foods like crisp vegetables and hard candies will bend or loosen the Herbst Appliance, too. So, stay away from these foods during your orthodontic treatment.

Your Herbst Appliance will be checked and adjusted at your scheduled appointments. If sometimes between appointments you develop sore areas on the inside of your cheeks, please do not try to adjust the appliance yourself (other than placing wax on the irritation). Call for an appointment so that the necessary adjustments can be made.

Forsus Appliance:

Another type of “overbite corrector” Dr. Organ may suggest is a “Forsus” Appliance. It is similar to a Herbst appliance in that it is attached to the braces and is not removable. However, unlike the Herbst appliance, the Forsus is implemented after all the braces have been placed. Instead of using a piston-like apparatus, the Forsus uses a special type of spring which provides a backward force on the upper jaw and teeth while encouraging forward development of the lower teeth and jaw.

Typically, the Forsus Springs are worn for 8–10 months, with adjustments every 6–8 weeks. The springs may cause some slight spaces to open between the teeth, but these will be closed once the springs are removed. Since the forces the springs apply to the teeth are light, little added discomfort is reported.

Initially, some patients experience mild irritation and soreness of the lips and cheeks, but this usually subsides in a few days. We will provide cotton rolls and soft wax to help cushion the springs from rubbing against your cheeks. In a few days, your cheeks and lips will accommodate to the new appliance.

As with all kinds of braces, patients with the Forsus appliance need to be careful about what they eat. Sticky foods such as gum, caramels, gummys, candy suckers, licorice, etc, will pull on the braces and/or Forsus and possibly distort or break them. As you know, constant breakages can only delay the time when your braces can be removed. Hard food like crisp fruits and vegetables should be cut into smaller bite size pieces.

It is possible, in some cases, for the lower rods that insert up into the spring portion to disengage by opening your mouth too wide. This can easily be corrected by opening wide again, compressing the spring, and reinserting the rod back into the spring.

MARA Appliance:

Dr. Organ may have prescribed a MARA Appliance for you. This works similar to the Herbst Appliance in that it "encourages" the lower jaw to "catch up" to the growth of the upper jaw.

At first, it will feel awkward to hold your jaw forward while eating. Your teeth will not fit together well initially, and chewing will be a challenge. But after 7-10 days, your teeth will start to come together and chewing will become more natural. Initially, you should eat only soft foods which do not require much chewing.

MARA Appliances are usually worn for about 15–18 months, similar to headgear. One of the first things you will notice is the improvement in your profile, without the use of bulky or noticeable appliances. In time, your lower jaw grows to a more balanced position, reducing a receding chin. Remember, the arms or elbows of the MARA are only guides to show you where to bite. Do not band or chew on them or they will become loose or bent, rendering them ineffective. Patients who are careful and remember to avoid candy, hard foods, pens, etc., easily last the entire MARA Appliance phase without any breakages. If any parts of the MARA come loose or just don't feel right, call the office for a "check" appointment.

If your cheeks become sore from the MARA, place a small piece of cotton batting over the area, especially when you sleep. If this doesn't help, call the office so that Dr. Organ can check the appliance.

Your bite will change over the next few months, and the MARA will require adjustments. These will be done as your treatment progresses. You may also notice small spaces developing between your lower teeth or in front of the upper molars. These will be closed later with the braces.

Removable Orthodontic Appliances:

Care and Use of the Removable Orthodontic Appliance ("Bite Plate" or "Retainer")

The removable appliance that is often prescribed to correct minor orthodontic problems or during the initial stages of comprehensive treatment is precisely made and delicate; it must be handled with care when out of the mouth. It took a great deal of time and careful work to construct it. (Please take good care of it and handle with care!)

• The appliance must be worn as instructed by Dr. Organ. This includes wearing it during the day and night, including when sleeping. In some cases, it may even be necessary to wear it while eating. It should not, however, be worn while swimming or when participating in any contact sports. Keep the appliance safe by storing it in the container that was given to you when it is not being worn. Eating and speaking will probably be a little daunting at first. We advise eating a soft diet initially, avoiding chewy meats, hard fruits and vegetable as well as hard, crusty breads/pizza crusts. Within a few days, most foods will be able to be eaten and with a little practice, speech will return to normal.
• The appliance may simply be rinsed or, better still, scrubbed after each meal/snacks; it should be cleaned with toothpaste after dinner or before retiring each night. Clean the appliance by holding it in the palm of one hand over a sink of warm water while gently scrubbing it with a tooth or soft bristled hand brush. Try making it a habit to brush your teeth every time you clean your appliance.
• Soreness of certain teeth is quite common during the first few days with the appliance or after an adjustment. The tenderness should completely disappear after two to four days. Should a wire become bent or distorted accidentally, or the acrylic becomes chipped or broken, make no attempt to adjust it yourself. Phone the office for an emergency appointment. As an added note, keep the appliance away from your family pet.
• The appliance may have to be worn for an extended period of time. Try not to become discouraged during the first few days. Remember, speech will improve dramatically after the initial period of adjustment. Just be patient and relax.

Foods:

We want to be able to complete your treatment in the least amount of time possible, and with your help, we will be able to do just that. One of the most important things you can do is to prevent your braces from coming loose or having the archwire become distorted or broken. These events happen most frequently when the wrong foods are eaten or hard objects are chewed.

Some things to consider:

• Biting onto hard objects such as pencils or pens is the single most damaging habit.
• Avoid putting you fingers in your mouth for either nail biting or just exploring or playing with your appliances and wires.
• Sticky, chewy candies such as gum (even the sugarless kind!), toffee, caramels, Skittles, wine gums, jelly beans, Jujubes, licorice, sours, etc., should be eliminated from your diet. Your dentist will also thank you.
• Meat should be cut from the bone (e.g., ribs, chicken wings), not eaten off the bone.
• Corn should be cut from the cob, not eaten off the cob.
• Ice cubes or nuts should not be cracked with your teeth.
• Cut hard fruits and vegetables, such as apples, pears, and carrots into smaller, bite size pieces.
• Hard rolls, buns and bagels should be broken up before eating, Avoid the hard crust of pizzas.
• Be careful eating fruits with pits such as peaches, plums, cherries, etc.
• Be extra careful with "healthy snacks" such as Fruit Roll Ups or Granola bars.

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