Orthodontic Appliances | Portsmouth, VA, Elizabeth City, Ahoskie, Nags Head, NC

Distal Jet

The Distal Jet appliance is utilized to correct a Class II bite by moving the upper first and second molars back. Limited expansion can be attained using the Distal Jet.

What to Expect

Soreness of the teeth for 48 to 72 hours following placement.
Due to the space the appliance occupies on the roof of the mouth, swallowing may feel awkward and speaking may be difficult, temporarily.
Most patients adapt to the changes within the first weeks of wear.
Spacing may develop between the upper bicuspids and molars. This is normal and only temporary. When the distal jet is no longer being activated, the space typically closes.
You may feel pressure for a short time following the initial activation and adjustment period, but should feel little to no discomfort.

Guidelines for Use & Care

Avoid eating chewy or hard candy.

Activating the Appliance

Place the wrench on the hex part of the middle cylinder of the expander. The wrench should be near the top of the teeth.
Turn the wrench down from the top teeth so that it meets the lower teeth. (front to back of the mouth)
Turn the wrench over. Repeat the turn.

Your doctor will tell you how many turns to perform daily and when to stop activating the appliance, and at each visit will activate the molar distalizing part of the appliance. Please follow instructions carefully.

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Lower Dewey

The Dewey Arch acts as a space maintainer to keep the molars from drifting forward, and prevent them from blocking the space where permanent teeth will eventually erupt. This appliance is commonly used in cases of premature loss of baby tooth or when the lower teeth of a growing child are slightly crowded and no permanent teeth are extracted to correct the problem. The duration of wear varies. We will monitor the eruption of new teeth and make adjustments. Generally, the Dewey Arch is removed following the eruption of all the permanent teeth.

What to Expect

Soreness the first day or two, and it may hurt to chew. We recommend a soft diet initially. You may take Advil or Tylenol to relieve the pain.

Guidelines for Use & Care

Avoid sticky or hard foods.
Monitor how many foods you eat that are high in sugar.
Brushing and flossing daily is very important. Be sure to clean around the bands that are connected to the molars and the wire on the tongue side. This will prevent the formation of cavities or infection of the gums.

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Elastics-Rubber Bands

Rubber bands and elastics are utilized to help move teeth into proper alignment. Failure to wear rubber bands as instructed can prolong treatment time.

What to Expect

Elastics can be difficult to put on at the beginning of treatment. However, after a few days of practice, the process gets easier.
Initially, elastics can cause the teeth to become sore. This soreness typically lasts for a few days. Wearing them infrequently causes soreness and makes tooth movement difficult.

Guidelines for Use & Care

Wear your elastics 24 hours a day, unless instructed otherwise.
Remove them only to brush or while eating. *Placing one around your finger will help you to remember to put it back in after eating or brushing.
To avoid losing wear time, contact us if you lose your elastics or need more. We can mail them or you may pick them up from the office.
Because elastics lose their strength after a period of time, please change them at least three times a day.

Lack of wear delays results and prolongs treatment time. Please call us if you have questions about putting in elastics or if you have any problems.

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Forsus Appliance

This appliance is custom-made for you. It is designed to position the jaw into proper alignment, and is an efficient method of obtaining a stable bite. If this appliance is placed during jaw growth, it can correct teeth and jaw alignment. You must wear the Forsus for 2 to 8 months to receive optimal results. We will check it every four weeks.

What to Expect

As with any new appliance, you will have to get accustomed to the Forsus, and may experience discomfort for several days. Take Motrin or Advil to alleviate discomfort.
Also, you can reduce discomfort during the first few days of wear by:
- Eating soft foods slowly using the front teeth.
- Not forcing the back teeth together.
- Avoiding ice, pencils, pens or fingernails.
- Applying pink wax around the cheeks when you notice irritation.

Though the Forsus appliance is very sturdy, it can break. The rod can easily separate from the spring when yawning. You can replace the rod by simply opening your mouth wide and threading it back into the opening of the spring. If any part of the appliance breaks, do not panic! Simply remove the loose rod or spring. Be sure to bring them to your next visit. If it breaks after hours and causes discomfort, call us. As long as all pieces are removed, most emergencies can be addressed the next day.

Guidelines for Use & Care

Be sure to brush your mouth thoroughly, especially at the back of the mouth and behind the back teeth. Brush around the springs and brush the springs themselves.

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Rapid Palatal Expander (RPE)

As the name suggests, the Rapid Palatal Expander is designed to “expand” the upper arch, in cases where it is so narrow that it does not fit properly within the lower arch. It does so by applying force. In growing patients, the upper jaw bone contains growth centers called “sutures.” These sutures are soft cartilage. The mid-palatal suture separates the roof of the mouth into right and left halves. Pressure applied to this area in a controlled manner can widen it significantly, thus correcting crossbites and creating room for proper teeth eruption and alignment.

The expander is 100% customized for each patient, and activated at home. Parents must assist younger children with the activation process. The upper arch widens within 2-4 weeks of wearing the appliance. Patients must continue to wear the expander for 3-4 months to hold the expansion as new bone forms.

What to Expect

Initially, the back teeth may feel uncomfortable. This typically continues 48-72 hours after the appliance is placed.
Swallowing may feel awkward and speaking may be difficult, temporarily.
Most children adjust to the expander within a few weeks.
Significant spacing may develop between the upper front teeth. This is common and usually temporary. The space should begin to close when the expander is no longer being activated.
After the initial activation of the appliance, you may feel pressure for a short time, but little to no discomfort.

Guidelines for Use & Care

Avoid eating chewy or hard candy. Do not chew on ice. Do not play with the expander using your tongue or finger.

Activating the Appliance

Place the wrench on the hex part of the middle cylinder of the exapnder. The wrench should be near the top of the teeth.
Turn the wrench down from the top teeth so that it meets the lower teeth. (front to back of the mouth)
Turn the wrench over. Repeat the turn.

Your doctor will tell you how many turns to perform daily and when to stop activating the appliance

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Separators

Separators are designed to create space between neighboring teeth so that the bands can be fitted on the molars.

What to Expect

Your mouth will be tender. Some patients feel that this is the most difficult part of orthodontic treatment, because no one is used to having anything on or in between their teeth. Your mouth will adjust overtime.
A few hours after placement, you may experience discomfort. Advil or Motrin, or any over-the-counter pain medication can alleviate temporary discomfort.

Guidelines for Use & Care

Call us if a separator falls out. You may wait to call us on Monday if it happens over the weekend. Sometimes the separator may not need to be replaced.
Avoid playing with the separator. Keep your fingers out of your mouth.
Brush daily as normal, but do not floss the areas where separators have been placed.

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TADs

Temporary Anchorage Devices (TADs) are used to move specific teeth within a desired direction without moving adjacent teeth. During a surgical procedure, TADs, small titanium screws, are placed in gingival tissue, with minimal discomfort. TADs efficiently reduce treatment time and the need for additional appliances. When they are no longer needed, they are removed.

Guidelines for Use & Care

Keep the area around the TAD clean.
The tissue surrounding the TAD may become inflamed or infected, so the soft tissue can grow over it.
If you experience puffing, swelling or pain, please call the office. Your doctor can prescribe antibiotics or recommend antimicrobial rinses.

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Wedge

The Wedge is an acrylic pad used to correct excessive overbite. It is typically cemented to the back of the upper front teeth while the molars are erupting. When you bite together, the lower front teeth hit the pad; thus eliminating the deep bite. The Wedge can help reduce overbite, and significantly shorten the second phase of orthodontic treatment.

What to Expect

Temporary discomfort of the front teeth.
Trouble biting into food.
For the first few weeks, speaking will be difficult.

Guidelines for Use & Care

Even though the Bite Tubo is capable of withstanding normal biting forces, it can become broken or damaged if it is not properly cared for.
Do not eat hard or sticky foods.
Brush thoroughly to keep the area free from plaque and food.
Avoid biting down too forcefully. This can break the Bite Tubo.

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Herbst Appliance

One of the most common problems orthodontists treat is the discrepancy that occurs when the upper teeth protrude beyond the lower. Ordinarily, when we see a patient 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. With these patients, we would like to encourage the lower jaw to catch up in growth, and braces like the Herbst appliance help this happen.

Even though the Herbst appliance prevents the lower jaw from moving backward, opening and closing movement still occur easily, and patients do not have any problems learning to chew their food with their lower jaw in this new position.

As with all kinds of braces, patients with Herbst appliances need to be careful about what they eat. For instance, cold foods such as ice slushes, Popsicles and ice will freeze the cement and make the brace loosen. Sticky foods such as caramels, bubble gum and candy suckers will pull the brace away from the teeth. Hard foods like crisp vegetables and hard candies will bend and 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 appointments. If, sometimes between appointments, you develop some sore areas on the inside of your cheeks, please do not try to adjust the appliance yourself. Call for an appointment so that the necessary adjustments can be made.

Wearing a Herbst Appliance

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

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