Elastics (Rubber Bands)
Wearing elastics (or rubber bands) improves the fit of your upper and lower teeth. Rubber bands are often necessary during treatment with both braces and with aligners. Wearing rubber bands as instructed is essential to the timing completion of your treatment. In many cases, treatment cannot be completed without them. The most common reason for extended treatment time is not following the orthodontist’s instructions with rubber band wear.
The Forsus Fatigue Resistant Device is an alternative to rubber bands in certain cases. These springs enable the orthodontist to correct excessive certain types of bites, known as Class 2 bites, with fewer rubber bands and less patient compliance.
Headgear is used restrain upper jaw growth and / or hold or retract the upper molars for the correction of Class 2 bites (upper jaw forward of the lower jaw). Drs. Carroll and Sutton rarely use headgear due to their inefficiency, tendency for relapse, and because most Class 2 bites are due to a lower jaw deficiency and not upper jaw excess. More modern orthodontic techniques are used in our office for these types of bite correction.
Reverse-Pull Headgear (face-mask)
A reverse-pull headgear, or face-mask, can be used in combination with other orthodontic appliances in order to reposition the upper jaw forward in children with an under-bite that is caused by an underdeveloped upper jaw, known as a Class 3 bite. Traditionally, facemasks are worn at nighttime for a year or more in order to correct underbites. This usually results in only forward movement of the upper teeth and flaring of the upper front teeth. Drs. Carroll and Sutton perform a technique to reposition the upper jaw forward using a facemask in only two or three months of nighttime wear, resulting in little in any flaring of the upper front teeth.
The Herbst® appliance is used to correct relatively severe Class 2 bites by posturing the child’s lower jaw forward for 12 to 15 months. This results in moving the upper teeth backwards and the lower teeth forward while possibly stimulating additional lower growth as well.
Rapid Palatal Expander (RPE)
The rapid palatal expander "expands" (or widens) a child’s upper jaw by putting gentle pressure on the upper molars each time an adjustment is made. The left and right halves of a child’s upper jaw are not yet fused, enabling an orthodontist to efficiently widen narrow upper jaws. This type of expansion is useful in alleviating crowding without the need for tooth extractions, correcting crossbites of the posterior teeth, opening up the nasal airway, and increasing tongue space. The latter two benefits are particularly beneficial in correction or prevention of certain types of obstructive sleep apnea (OSA). The active expansion phase of this treatment typically takes about two weeks. The expander must then remain in place for six to 12 months to solidify the expansion and to prevent relapse.
MARPE (Micro-implant Assisted Rapid Palatal Expander)
Many adults can benefit from expansion of their upper jaw. Traditionally, upper jaw expansion in adults required either Surgically Assisted Rapid Palatal Expansion (SARPE) or upper jaw surgery (lefort osteotomy). In many adults, Drs. Carroll and Sutton are able the expand the upper jaw using a modified version of a palatal expander that utilizes small temporary titanium implants know as TADs.
TADs are small (approximately 2mm in diameter) titanium implants that Drs. Carroll and Sutton place into the jaw bone to provide a source of anchorage. This anchorage enables them to achieve tooth and jaw movements that would otherwise require jaw surgery, unnecessary tooth extractions, or would not be possible at all to correct. Once the anchorage is no longer needed, the TADs are simply removed within a few seconds, requiring no anesthetic during removal.
Retainers may be removable or fixed. They hold your teeth in their new, correct positions after your teeth have been straightened. Your orthodontist will instruct you on how to care for your retainer and about the duration of the wear. Wearing your retainer as directed is crucial to prevent relapse of your treatment.
Separators or Spacers
Separators are little rubber doughnuts that may be placed between your teeth to push them apart so that orthodontic bands may be placed during your next appointment. The separators will be removed before we place the bands. Separators do not mix well with sticky foods, toothpicks, or floss.