SEPARATORS

What are separators?

Separators, sometimes called spacers, are small donut-shaped elastic rings that are placed between your teeth to create space to fit molar bands.

How are separators placed?

The separators are wriggled between the teeth, much like wriggling floss between your teeth.

How will separators feel?  Do they hurt?

At first they might feel like a piece of food stuck between your teeth.  That feeling usually goes away after a couple of days.  Your teeth may become sensitive, but this will only last a few days.  If you wish, you may try whatever medication you typically take for a headache to help relieve some of the pain.

How will I eat with separators in?

You can eat just like you normally do, except of course the sticky and chewy foods, which you should avoid during orthodontic treatment!

Should I brush and floss the teeth that have separators by them?

Even with separators in place, you need to continue brushing as usual.  You should, however, avoid flossing between those particular teeth.

How long will the separators need to stay in?

Typically, separators only need to be in place for about one week, which is long enough to create space for your molar bands to be placed more comfortably.  The separators usually are never in ‘too long’, as they will not do any damage being left between the teeth for several weeks.  Sometimes the separators may fall out on their own.  This is okay too, provided you have a banding appointment within the next few days.

HERBST APPLIANCE

Why the Herbst?

This appliance encourages the lower jaw to grow in a forward direction by positioning it forward and holding it there. It also has the ability to push the upper molars backward. We can control the difference.

How will it feel?

At first, it may feel like a mouthful but within one to two weeks it will become quite comfortable. It may irritate the inside of your cheeks at first but soon the tissue will toughen up to the appliance and not be a problem. Please call us to report any prolonged cheek or tongue irritation.

What about eating?

Chewing will be awkward at first. You may want to stay with softer foods for a day or two, but soon you will be back to a normal diet (with the exception of sticky and brittle foods, of course).

How long will I wear it?

Normally, the Herbst appliance is in for an average of 12 months.

What is the best way to get used to it?

First, don't play with it with your tongue or fingers. Secondly, don't fight it! Let your jaw go where the Herbst takes it. Don't try to force your jaw where it is difficult to do so.

Can it come apart?

Yes. The most common way is for the rod to slide out of the tube (see illustration). If this happens, simply open wide enough to slide it back in the tube. Another way it can come apart is for the screws to come undone. If this happens, call us right away. Save any parts you can.

Other things to report immediately:

1. If a rod gets stuck inside a tube limiting movement of your jaw.
2. Crowns that come loose from the tooth.
3. Any other breakage.

ELASTICS (Rubber Bands)

What are elastics?

Quite simply, elastics are special "rubber bands" that supply the pressure needed to move teeth and jaws into their correct position. Elastics are attached using hooks that are part of the bracket or the bands.

Are they important?

Elastics must be worn to move your teeth and jaw into the proper position. They are the engine that move the teeth. That's why it's important to wear your elastics 24 hours a day, 7 days a week, unless otherwise instructed.  Proper wearing of your elastics will help give us the best possible treatment in the shortest amount of time.

May I take them off?

If you wear your elastics for several hours, then take them off for several hours, put them back on, etc., you will experience back and forth movement, and your teeth can set up a resistance that slows or stops your progress (OH NO!). Wearing elastics is much like pushing a ball up a hill; if you stop halfway the ball rolls right back to where you started. Only by constantly wearing your elastics as instructed will you reach your treatment goal. Remove them only to brush your teeth or to change your elastics. They should be in place when you eat a snack, play and sleep.

How will they feel?

They should only bother you for 2-3 days and no more if you wear them continuously. After that you will find that they will not hurt if you wear them all of the time.

Other tips:         

• Eat with them in place. It may be difficult at first, but it does get easier and teeth will move even faster!
• If your supply is low, call the office and we can mail you some.  
• Change the elastics at least every 12 hours - that's twice a day, and it's easiest after brushing.
• If you happen to forget to wear your elastics one day, don't double up the next day. Just follow your regular instructions.

HEADGEAR

Why the headgear?

The headgear is one of the best ways of moving upper teeth.  When worn well it will greatly reduce your overjet by backing up your upper teeth and jaw. 

How will it feel?

You can expect your upper molars to be sore the first night or two that you wear it.  Sticking with it and wearing your headgear as instructed will soon get you past the uncomfortable stage!

When do I wear it?

We recommend you wear your headgear 12-14 hours out of the 24 hour day.  Wearing it while sleeping is the easiest way to get a significant number of hours in.  We also recommend wearing your headgear while you’re reading a book, watching TV, or playing video games.  Never wear your headgear during rough play and contact sports.  Remember:  The more your wear your headgear, the better the response and the fewer months it will ultimately need to be worn.  When you miss a day it takes three days to get back to where you were.

Always release the strap from the facebow before placing or removing the Headgear.

Always bring your Headgear to each appointment so the doctor can adjust it.

RETAINERS

What type of retainer will I need to wear?

When your braces are removed, we will provide you with a set of retainers made of a material called lexan.  This is a thick, clear, firm plastic material formed to your teeth to hold them in their corrected place. 

For additional instructions and information about retainers, please see our
Questions After Treatment section.

Expanders

A device that painlessly spreads the halves of the upper jaw apart. New bone fills in between the two halves and the upper jaw remains permanently wider. Expansion of the upper jaw allows more space for permanenent teeth.