Types of Appliances

Elastics (Rubber Bands)

Did you know that improper rubber band wear is the number one cause of treatment delays and poor treatment outcomes in orthodontics? Orthodontists can straighten the upper teeth and the lower teeth in the office, but rubber bands are usually what improves how the upper teeth and lower teeth fit together. Be sure to wear rubber bands as often as instructed, and remember that proper rubber band wear will help you get your braces off as quickly as possible.


Headgear is used to treat patients whose teeth are in an overbite, with the upper jaw forward of the lower jaw, or an underbite with the lower jaw forward of the upper jaw. Although headgear is rarely recommended these days, there are several types of headgear that still play a role in treating certain cases. The headgear shown above gently “pulls” on your teeth to restrict further forward growth of your upper teeth and jaw.

Herbst® Appliance

The Herbst® appliance reduces overbite by encouraging the lower jaw to grow forward and the upper molars to move backward. This fixed appliance is used mostly for younger, growing children and can be worn for about 9-12 months.

Twin Block Appliance

The Twin Block appliance consists of upper and lower jaw removable appliances that have plastic blocks covering the back teeth. These blocks force the lower jaw to bite into the ideal relationship with the upper jaw. It is usually worn for twelve months and, because it is in two parts and is clasped to the teeth, it should be worn during eating. We also use the Twin Block frequently for adult patients who have jaw joint disorders


A Bionator is a removable appliance that is custom designed to advance the lower jaw in growing children. Generally a Bionator is used to correct a deficient lower jaw resulting in a large overjet. A Bionator is worn for 9-12 months and is often used in conjunction with Phase 1 orthodontic treatment.

Bite Plate

A bite plate is a type of retainer that is used to correct a deepbite. When front teeth overlap too much, this “deepbite” can cause accelerated wear on the edges of the incisors and can also cause irritation of the soft tissue palate.

Tongue Crib

Some kids and adults develop what is called a “tongue thrust”, where the tongue pushes against teeth during swallowing. With this condition, the tongue becomes a powerful tooth mover, and can cause gaps, openbites, or tipped teeth. Did you know that the average person swallows up to 3000 times a day? A tongue crib is used to keep the tongue from pressing against the upper and/or lower teeth during swallowing.

Thumb Crib

Thumb sucking habits in young children can have devastating consequences on the growth of the upper jaw. A thumb habit past the age of 4 can collapse the palate, leading to posterior crossbites, tongue thrusting, anterior openbites, and misshapen upper and lower jaws. If not corrected, such abnormal jaw development may need surgical correction. Similar to a tongue crib, a thumb crib helps to keep the thumb out of the mouth so that the upper jaw can return to a normal growth pattern.


A w-arch is the lower jaw equivalent to a palatal expander. The w-arch is activated (widened) and then cemented to the lower molars. The spring action of the w-arch gently widens the lower teeth to reduce crowding and improve the shape of the lower jaw.

Carriere Distalizer

The Carriere Distalizer is used to correct a large overjet (overbite) at the beginning of orthodontic treatment. By doing the “heavy lifting” right up front, patients can reduce the overall amount of time that they are in braces.

Palatal Expander

The palatal expander “expands” (or widens) your upper jaw by putting gentle pressure on your upper molars each time an adjustment is made. This type of expander is fixed, or cemented, to the molar teeth in order to create true palatal expansion. Your orthodontist will instruct you about when and how to adjust your expander. When you achieve the desired expansion, you will continue to wear the appliance for up to six months more to solidify the expansion and to prevent relapse.


Retainers may be removable or fixed. They come in a variety of designs and are made to hold your teeth in their new, correct positions after your teeth have been straightened. Your orthodontist will instruct you on how to care for your retainer and about the duration of the wear. Wearing your retainer as directed is crucial to prevent relapse and to protect your investment for a lifetime. For this reason, after an initial period of fulltime wear, most patients will wear their retainers at night for the rest of their life.

Separators or Spacers

Separators are little rubber doughnuts that may be placed between your teeth to push them apart so that orthodontic bands may be placed during your next appointment. The separators will be removed before we place the bands. Separators do not mix well with sticky foods, toothpicks, or floss.