Herbst Appliance and MARA Appliance
One common issue that The Super Dentists treat is an overbite — when the upper teeth protrude beyond the lower ones. While many people think upper teeth protrude because the upper jaw and teeth are too far forward, many times it is because the lower jaw is too far back. The Herbst appliance and MARA appliance (Mandibular Anterior Repositioning Appliance) are types of orthodontic appliances that help the lower jaw to catch up in growth.
A Herbst appliance or MARA appliance is secured into placed by The Super Dentists with dental cement and cannot be removed by the patient. At first, it may be feel unusual and make it awkward to speak and chew. These types of orthodontic appliances may also cause extra saliva production. These issues will go away in about a week or two, after getting used to having the appliance in the mouth. The Herbst appliance and MARA appliance work in the same ways. The MARA is slightly smaller but is more likely to break. Both appliances will take some time to get used to wearing.
Those with a Herbst appliance or MARA appliance will be checked and adjusted by The Super Dentists at each appointment.
Rapid Palatal Expander
A rapid palatial expander is placed on the upper arch to eliminate crowding and cross-bites. It is designed to widen the palate to make room for permanent teeth and improve the way the top and bottom teeth meet. The Super Dentists will use a rapid palatial expander to avoid extracting teeth. While some people may think this orthodontic appliance looks odd, it is commonly used and relatively painless when placed. Some patients say they feel a little pressure when their expander is activated, which usually fades quickly.
Until your child is used to having the rapid palatial expander in his/her mouth, serve soft foods that don’t require much chewing. While your child has a rapid palatial expander, it is best to avoid sticky foods that can get stuck in the expander and to practice good oral hygiene.
The Super Dentists will stress that for the rapid palatial expander to do its job, it needs to be turned with a key on a schedule.
To turn the rapid palatial expander:
- The child should lie on his/her back looking toward the ceiling and open his/her mouth wide
- The parent will insert the key into the hole in the expander, and then turn the key toward the back of the child’s throat. Be sure to turn the key all the way toward the back of the throat so you will be able to properly fit the key in the next hole
- To complete the turn, remove the key straight down
- If you are unable to keep your scheduled appointment, stop turning the expander
Once the rapid palatial expander has widened the upper jaw and enough time has passed that the bone is securely in place (usually three months), The Super Dentists will remove the expander.
A lingual arch space maintainer is designed to maintain the position of the molars as the baby teeth are lost. By preventing the molars from moving forward, some space can be maintained to relieve crowding of the teeth. The Super Dentists will place a lingual arch by cementing bands onto two molars and attaching a U-shaped wire to hold teeth into place. A lingual arch is worn until all permanent teeth have erupted. The Super Dentists will use a lingual arch as a preventative treatment to reduce the need to extract permanent teeth and relieve crowding.
The purpose of twin blocks is to correct the relationship of the jaws. Twin blocks are made from a model of the patient’s mouth and will fit and fix only the patient’s jaws. The appliance is activated each time patients move their jaws, swallow or talk by creating gentle pressure on the teeth, arches and jaws. Wearing twin blocks will posture the patient’s jaws in a corrected position to influence the way cheeks, lips and tongue function to create a change in the patient’s growth pattern.
If The Super Dentists recommend twin blocks for you or your child, it may take a few days to get used to wearing the device. Your mouth may feel strange, your teeth may be sore, it may be difficult to speak clearly and you may have extra saliva. By reading out loud, eating soft (soup, eggs) and not chewy (meat, bread) foods, these issues should be alleviated after a few days. It’s best to avoid any hard or sticky food while wearing your twin block. If a wire or the acrylic part breaks, don’t try to adjust the appliance yourself. Bring it to the office for The Super Dentists to fix.
You should wear your twin block at all times, even when sleeping or eating. The exceptions will be when you remove the appliance to clean it and when playing an active sport where you need to wear a mouth guard. Clean your twin block when you wake up, after eating and before bed by holding it in the palm of your hand under cold running water and gently scrubbing with a toothbrush using toothpaste or soap. Once it is cleaned, return it to your mouth. When not wearing your twin block to play sports, always store it in a carrying case. It is fragile and could easily break if wrapping in a napkin or putting in your pocket. A broken twin block could lead to additional expense and extending your wearing time.
Orthodontic elastics are rubber bands that are used to apply the continuous pressure necessary to move teeth and jaws to where they should be. These little rubber bands are an important component to line up the top and bottom teeth. Orthodontic elastics are connected to the brackets of the braces with tiny hooks. The orthodontic elastics help to align the teeth and jaws and should be worn 24/7 for the best results.
The Super Dentists will provide the patient with a supply of orthodontic elastics so that they can be changed each day and replaced throughout the day if they break. The only time the rubber bands should be removed is for cleaning. Even eating with orthodontic elastics is recommended. The benefit of wearing orthodontic elastics 100 percent of the time is to shorten the treatment time in braces. While you may think that doubling up on elastics will make treatment even quicker, but that is not true. The Super Dentists say it is best to use one rubber band at a time.
Rapid Palatal Expander (RPE) FAQs
Why is this sometimes necessary?
- To expand the upper jaw for a proper fit with the lower jaw
- To make room for crowded teeth
- To broaden your smile
Will I feel it moving?
Most people feel a little bit of pressure or nothing at all!
How to activate your appliance?
- insert the key carefully into the hole in the middle of your appliance
- Push the key firmly from the front to the back of the throat. Remove the key towards the throat.
*pushing the key back as far as possible brings forward w new keyhole position and now you are ready for the next activation
How many turns do I need to complete?
The amount of turns is prescribed by your doctor and is different depending on your occlusion. You can expect typically between 14-28 turns. Please do not exceed the number prescribed. If you do not remember how many turns were prescribed please call the office.
What happens if I turn the expander too many times?
One or two extra turns are not significant. More than that is not advised. If you think you have done too many turns it is best for you to schedule an appointment with your orthodontist.
What happens if I miss a turn(s)?
It’s ok! No need to double up. Continue as prescribed. When your orthodontist sees you for a check-up they will determine if more turns are needed.
What happens if the turn gets stuck mid-way and I can’t find the hole again?
This usually happens when removing the key and the key accidentally turns backward slightly. Your crew member can usually find the hole and complete the turn allowing the hole to reappear. If you want to try to do this yourself but are unsuccessful please call the office and we can schedule you to be seen sooner
How long can I expect the expander to stay in?
This is different for each patient, but typically 6-12 months.
My tongue is getting an imprint on it. Is that normal?
Yes, this is normal. Please wash and clean your tongue normally. The imprint will resolve once we remove the expander. However, please let your orthodontist know if your tongue becomes red or hurts.
Are there foods that I need to stay from?
Please stay away from chewy and sticky foods like gum, fruit snacks, and taffy that might break the bond of the appliance off your teeth! Be careful when you are first getting used to swallowing. Soft foods and small bites are best as you are getting used to eating with your new expander.
Important: Please visit our Patient Education resources for a detailed instructional video