Appliances
Rapid Palatal Expansion (RPE)
The appliance that has been placed in the roof of your mouth is called a rapid palatal expander (RPE). The purpose of this appliance is to widen the upper jaw. The RPE appliance is activated with a wire key, which fits into a hole in the middle of the RPE.
- The key should be inserted into the key slot in the appliance and turned from the front of the mouth to the back of the mouth, where the key should be removed from the hole. This is considered one full turn, and at this point, the next hole will be visible in the front.
- When a turn is made, pressure may be felt — it often feels like someone is squeezing the bridge of your nose. This pressure should last only a short period; if prolonged pain is felt after turning the key, call your orthodontist.
- A few days after the appliance has been placed, you can expect a space to appear between the upper front teeth. As more turns are made, the space will get larger, but it will close due to natural drifting of the teeth once all of the turns have been made.
A period of adjustment will be necessary following the placement of the RPE. A soft diet may be helpful because chewing will be more difficult since the teeth will come together differently. Speech may be difficult for a few days, but will become easier with practice – call your friends or read out loud to become used to talking. Oral hygiene will be more difficult, and you should spend time brushing the RPE every time you brush your teeth. A Waterpik, in addition to your toothbrush, may be helpful to clean around your RPE appliance.
Mandibular Anterior Repositioning Appliance (MARA)
The MARA appliance is a bite/jaw advancer worn in the mouth to correct your overbite/overjet most predictably and efficiently. Initially, it will feel different, and you will not chew as you are accustomed to. Remember, there is an adjustment period, so even though it feels awkward now, you will be used to the appliance in a few days. Your bite will change over the next few months, and the MARA will need to be adjusted occasionally. Small spaces may be noticed between your teeth, but they are temporary and will be closed later with your braces.
A few things to remember:
- If you experience difficulty eating, be sure to cut your food into small pieces. It will take about 7-10 days to get used to everything.
- You may also experience an increase in saliva. This will decrease in a few days.
- The “elbows”, or the “C” shaped wire in the back, are only guides to show you where to bite. Do not bang or chew on them, or they will come loose.
- Avoid any side movements of your jaws as this weakens the arms of the appliance, causing excess breakage.
- Avoid sleeping on your side as the “elbows” may become uncomfortable with the pressure on your cheek.
- If necessary, use the orthodontic wax your clinician gave you, and if you need, you can get oral gel at the local pharmacy to ease any gum/cheek discomfort. You may also take an over-the-counter pain reliever.
If the MARA becomes loose or sticks in an uncomfortable position, please call your orthodontist to have the appliance adjusted. Save any parts that may become loose and bring them with you to your appointment.
Reverse-Pull Headgear
Reverse-Pull Headgear provides a special force where braces alone cannot. This removable orthodontic appliance is used to correct class III malocclusion, also known as an underbite. This helps with the growth of the upper jaw by pulling it forward, allowing it to catch up with the lower jaw.
This appliance is best worn as much as possible while at home, especially at night while sleeping, to avoid orthognathic surgery as a teen or adult. Patient compliance is very important, so please keep these in mind:
A few things to remember:
- Headgear must be worn at least 12 hours a day, put on in the evening, and worn until the next morning.
- There may be some tenderness at the beginning, but over-the-counter pain relievers can be taken to minimize discomfort and should subside in under a few days.
- If anything happens to your headgear — whether it’s lost, broken, or has loose bands — call your orthodontist as soon as possible.
Please bring your headgear to each visit so it can be adjusted and we can ensure that it is working properly.
Myofunctional Therapy
Offered solely at our Texas practices, myofunctional therapy involves training the muscles in the face and mouth to help with mouth breathing, tongue thrusting, and incorrect swallowing. This form of therapy can improve problems relating to sleep-disordered breathing and growth disorders by addressing functional issues using myofunctional oral appliances, such as Myobrace.
Myobrace Instructions:
- Be sure to wear the Myobrace for at least 1-2 hours a day; it does not have to be a full hour. You can wear it for 10 minutes while you are getting ready, 20 minutes while you are watching TV, etc. It’s helpful to make sure you are wearing it while doing something in order to keep your mind off of it.
- After 2 weeks, if you can wear it for an hour a day, then you can start sleeping in it. When you wake up, it may not be in your mouth. This is normal and will eventually resolve itself once you continue wearing it through the night. The more successful you are during the day, the better it will stay in at night.
- To clean it, use warm water and dish soap. Avoid using mouthwash as this will make it sticky. Please make sure it is clean and completely dry before placing it back into the case.
- If you have dogs or cats, be sure to keep the appliance in a safe place.
