Phase 1 Fixed Appliances

Fixed Bite Plate | Fixed Habit | Fixed Expander | Skeletal Expander

Fixed Bite Plate/Openers

The fixed bite plate is a very important part of your orthodontic treatment. It is cemented to your teeth to protect your lower braces and reduce the depth of your bite. This appliance will allow your back teeth to grow while it holds your front teeth. The doctor will remove it after several months when the correction is achieved.

What to Expect

At first the bite plate feels strange on the roof of your mouth. You will feel some tightness against your side and back teeth. These teeth may feel sore or tender for 2-3 days following the placement of the appliance. Eat gently on these teeth until they feel better. Your tongue may develop grooves in it from resting against the appliance, these will disappear when it is removed. Most importantly your back teeth will not touch each other temporarily. You will have to eat gently on your front teeth only. Eventually the back teeth will begin to touch again. Your speech will be different for a couple of days, and then will quickly return to normal.

Do’s

Brush the appliance when you brush your teeth.
Rinse out if you cannot brush to remove food that may get lodged in the appliance.
Use Tylenol or other pain relieving medication for the first couple of days.
Use PhosFlur once a day to protect the teeth covered by plastic.

Don’ts

Do not chew gum, taffy, or sticky candy while you have your bite plate.
Do not pull, bend, or pry your bite plate, this may cause it to angle downward and get in your way.

Fixed Habit

The fixed habit appliance (tongue/finger rake) is a very important part of your orthodontic treatment. It is cemented to your teeth to keep your finger/tongue where they belong. This appliance can discourage finger sucking and guide your tongue to the proper position in the mouth. While at rest and also swallowing the tip of your tongue should be contacting the anterior roof of your mouth and this device can help retrain your tongue to do exactly that. This appliance may look fierce, however it does not hurt the tongue. Finger sucking and tongue thrusting can cause some of the most severe orthodontic problems. (narrow palate, long face, mouth breathing, gummy smile, crossbites and jaw bone problems). If left untreated these habits can require the patient seek surgical correction of their effects.

What to Expect

At first the habit rake feels odd on the roof of the mouth. Eating, speaking, and swallowing will feel very, very strange. In a few days this will subside and it will feel fine. Eat simple foods in the beginning and practice keeping the tip of your tongue right behind the rake on the roof of your mouth.

Do’s

Brush the appliance when you brush your teeth.
Rinse out if you cannot brush to remove food that may get lodged in the appliance.
Keep your tongue behind rake at all times.
Use Tylenol or other pain relieving medication for the first couple of days if necessary.

Don’ts

Do not chew gum, taffy, or sticky candy while you have your habit appliance.
Do not bend, pull, or pry your habit appliance, this may cause it to angle downward and get in your way.
Do not play rough while the appliance is in your mouth.
Avoid sticking your tongue out of your mouth, especially while playing.
Never allow someone to hit the under side of your chin.

Fixed Expander

The fixed expander (Quad helix/pendex appliance) is a very important part of your orthodontic treatment. It is cemented to your teeth to gently broaden your upper arch of teeth. This expander can correct crossbites and gain space for crowded out teeth. This type of expander will not need turning, it is automatic. In some cases the Doctor will remove it after several months, expand it further and re-cement it. When the correction is achieved it will be removed. In some cases a night-time retainer will follow.

What to Expect

At first the expander feels strange on the roof of your mouth. You will feel some tightness against your side and back teeth. These teeth may feel sore or tender for 2-3 days following the placement of the appliance. Eat gently on these teeth until they feel better. Your tongue may develop grooves in it from resting against the appliance, these will disappear when it is removed.

Do’s

Brush the appliance when you brush your teeth.
Rinse out if you cannot brush to remove food that may get lodged in the appliance.
Use Tylenol or other pain relieving medication for the first couple of days.

Don’ts

Do not chew gum, taffy, or sticky candy while you have your expander.
Do not pull, bend, or pry your expander, this may cause it to angle downward and get in your way.

Skeletal Expander

The skeletal expander (Hyrax, Rapid Palatal Expander) is a very important part of your treatment. It is truly one of the best orthodontic devices available today. This expander often gets a bad publicity unfairly. This is probably because patients and parents relate the term skeletal to the expander breaking the “palatal bone”. The “palatal bone” is already open along the middle in young, growing patients. The expander just helps increase the growth, thus widening the upper arch. This device can correct skeletal/dental problems that if left untreated, would require jaw surgery to correct later in life.

What to Expect

At first the expander feels big and strange on the roof of your mouth. It will trap certain foods but it will not hurt. When we start turning it, you will feel tightness or squeezing. Over the next 24 hours your top teeth will feel sore, or tender to bite on. The first 2 or 3 turns at home will feel tender, but then it gets very, very easy and it only will feel tight for a few minutes following each turn. Sometimes your nose will feel tingly, your cheekbones may feel sore, and in very rare cases, slight black eyes appear. These are all normal reactions.

Do’s

Turn the appliance twice a day about 12 hours apart. (ex. 7:00AM, 7:00PM).
This is extremely important. Serious complications will result if the appliance is not turned 2 times a day. If it cannot be turned for whatever reason, stop the turning process and call the office to speak with or to see the doctor.
Be sure to push the key all the way back to complete the turn. If not, the next hole will not become visible and you will not be able to make the next turn.
Brush the appliance with toothpaste and toothbrush. Rinsing or a waterpik will help remove food.
Use Tylenol or other pain relieving medication for the first couple of days if necessary.

Don’ts

Do not stop turning unless instructed to do so.
Do not chew gum, taffy, or sticky candy.
Do not continue turning if a band or the appliance moves on the teeth.