Types of Appliances

A palate expander is a fixed appliance used at Rockaway Orthodontics to widen your upper jaw. Dr. Melissa Roberto will use this to alleviate crowding when there is a significant discrepancy between tooth size and jaw size. She will also use this when there is a growth imbalance between the upper jaw and lower jaw leading to a crossbite. It is an orthopedic appliance that works by putting gentle pressure on your upper molars each time an adjustment is made. This force is then transferred to the growth plate in the palate for an actively growing individual. Once the desired expansion is achieved, the appliance is left in place for several months to solidify the expansion and prevent regression.

Adjusting the Palate Expander

1. In a well-lit area, tip the patient’s head back.
2. Place the expander key in the hold in the center of the appliance until it is firmly in place.
3. Push the key toward the back of the mouth. You will notice a new hole will appear as you are turning the appliance. The rotation stops when the key meets the back stop of the expander and the next whole is completely exposed.
4. Press back and down toward the tongue to remove the key. The next hole should be clearly visible.

An Arnold expander is a fixed, spring-loaded expander used at Rockaway Orthodontics for the lower arch. Dr. Melissa Roberto will use this to alleviate crowding when there is a significant discrepancy between tooth size and jaw size. It is a dental type of expander that works by putting gentle consistent pressure on the lower molars to move them out over the supporting bone structure. The expander itself has a spring that is compressed when it is inserted. No turns are needed with this type of expander. Once the desired expansion is achieved, the Arnold expander is removed.

Dr. Melissa Roberto will use the cervical type of headgear when there is a significant “overbite”. Most people use the term “overbite” when actually referring to “overjet”, an excessive horizontal overlap of the top teeth forward of the lower. It is used in conjunction with bands attached to the upper molars. The headgear frame is inserted into tubes on the molar bands. A neck strap with spring modules is then placed behind the neck and attached to hooks on the frame. When worn as prescribed, the headgear gently pushes back on the upper jaw to restrict further forward growth, thereby allowing the lower jaw to catch up and re-establish growth harmony.

The reverse type of headgear is used at Rockaway Orthodontics when there is an “underbite”. This is when the lower jaw is positioned forward of the upper jaw. This type of bite will worsen as the patient continues to grow. Early intervention is critical for this type of bite, in an attempt to avoid a more invasive jaw surgery later in life. This appliance works in conjunction with a fixed palate expander that is modified with hooks to receive elastics. The reverse headgear sits on the forehead and chin and has a T bar positioned in front of the teeth. Elastics are then worn between the hooks on the palate expander and the T bar on the reverse headgear to gently pull forward on the upper jaw, thereby accelerating the upper jaw growth and re-establishing growth harmony.