Types of Appliances


Elastics (Rubber Bands)

Wearing elastics (or rubber bands) improves the fit of your upper and lower teeth. Wear rubber bands as instructed, and remember that the rubber bands work far more efficiently if they’re worn as prescribed.


Herbst® Appliance – The Headgear Replacement

The Herbst® appliance is an overbite corrector that has taken the place of the dreaded Headgear in many progressive orthodontic offices. It works by accelerating forward growth of the lower jaw, which is exactly the correction that is needed in the majority of cases that have large overbites. In this way, it uses the natural growth of the patient to correct the root cause of the overbite. The Herbst® appliance is used mostly in growing children, although it is sometimes used in adult cases in order to avoid jaw surgery.

The Herbst is cemented to the molar teeth which makes it active 24/7 to ensure a rapid and predictable correction. It’s active component is a tube with a telescoping rod that repositions the lower jaw to the correct position, thus correcting the overbite. It is usually in place from 8-12 months and is incorporated with the use of brackets to reduce overall treatment time by up to 12 months. It fits perfectly with our vision of comfortable, effective and predictable treatment.

Accommodating the a newly placed Herbst is similar to newly placed braces, that is, it requires about 4-7 days. A soft diet is the most critical thing as the ability to chew is initially diminished. After about a week, the chewing muscles have been reprogrammed to this new forward bite and the patient can return to normal foods (chewy and hard foods must still be avoided, just like with braces). We have found that most every Herbst patient does well with accomodating to the new overbite corrector

Bite ramps

Bite Ramps – Accelerating Treatment of Problem Bites

Bite ramps are small acrylic bumps that are added to the upper teeth to accelerate correction of deep bite cases. Deep bite cases are problematic because the upper incisor teeth tend to bite over the lower incisor teeth and damage the brackets placed on the lower teeth. Bite ramps are placed on the inside surface of the upper teeth and are not visible. They are usually used in conjunction with braces and elastics to produce a rapid deep bite correction. After 4-6 months, they are removed in most cases.

Placement of bite ramps causes a temporary separation of the back teeth for a period of 8-12 weeks while the deep bite correction is taking place. The use of softer foods, especially for the first week, will make it easier for you to adjust to your new bite ramps.


E-Arch Expansion Appliance

An e-arch is an expansion appliance that is used most often to correct crowding in younger children, age 8-11. When used to correct crowding it can eliminate the need for permanent teeth extractions in severely crowded dental arches. It does this by correcting the existing crowding of the incisor teeth and then creating additional room for the canine teeth. Severely crowded canines are the primary reason for extracting permanent teeth among teenage patients. It is usually used together with limited braces to control the creation of space in the canine region.

When used only in the upper arch, an e-arch is used to correct a constricted palate. A narrow palate usually results in a dental crossbite where the upper teeth fit improperly against the lower teeth. An uncorrected crossbite can result in damage to the temporomandibular joint on the crossbite side and asymmetric growth of the lower jaw. The e-arch provides a very valuable treatment result for the patient with a constricted palate.



Positioners complete the final tooth movements in your orthodontic treatment. With your full cooperation, you should only need to wear the positioner appliance for 4-8 weeks.


Separators – Also known as Spacers

Seperators are small blue rubber bands that are used to create a slight space around a molar tooth so that a ring-shaped band can be fitted for the molar. Placing a band on a molar tooth is usually the first step in fabricating an e-arch (expansion arch). They are used mostly on younger children undergoing interceptive orthodontic treatment. They will be removed before the molar band is fitted but will be replaced to maintain the space until the appliance is cemented in. Avoiding gum, chewy candies and not flossing where they are placed will ensure that they will do their job.


Retainers – Fixed and Removable

Keeping your teeth in their newly perfected position is very important in our office. You have worked very hard to achieve your beautiful new smile but the process is not COMPLETELY over. Retainers are like insurance policies to prevent teeth from moving out of alignment!

The retainer we use most in our office is the fixed lingual retainer, also known as a “permanent” retainer. Fixed retainers must be well maintained and cared for until a decision is made to remove them. They have the advantage over removable retainers because they can’t be lost. The disadvantage of the bonded retainers is that they require occasional maintenance and willingness by the patient to avoid sticky food and floss diligently around them.

Fixed retainers are usually used together with a removable night time retainer for the upper teeth. This commonly used removable retainer has a wire across the upper front teeth that is attached to a colored area of acrylic that fits over the palate. It will be worn only at night, unless instructed otherwise. We also use removable clear retainers that are thinner, more esthetic and more comfortable than the acrylic type. However, they are more fragile and easier to lose since they are clear.

By following the instructions that you are give about maintaining your new retainers, you will ensure that you new smile will last a lifetime. Now that’s something worth smiling about!

Hawley retainers

Occlusal retainers