Other Orthodontic Appliances

Palatal Expander

A palatal expander, also known as a rapid palatal expander, rapid maxillary expansion appliance, palate expander or orthodontic expander, is used to widen an upper jaw that’s too narrow when there’s a discrepancy between the width of the upper and lower jaws, so that the bottom and upper teeth fit together better. The expander works best in young patients (ages 8-15) because the bones of the upper jaw are still pliable.

A palatal expander is custom made for each patient and fits over several top teeth in the back of the mouth. There are two halves to the expander that are connected in the center with a screw. To activate the expander, the screw is simply turned a very small amount each day using a special key. This creates tension at the junction of the two palatal bones, which causes them to gradually move apart. Once the desired expansion is achieved, we will leave the expander in place for a few more months so that new bone can form in the gap to stabilize the expansion.


Sometimes braces alone aren't enough to move teeth into an optimal position or to correct problems with bite or jaw growth. Orthodontic headgear uses an external wire apparatus known as a facebow to gently guide the growth of a patient's face and jaw and to help move teeth into their proper position. The facebow allows the headgear to attach to the braces, and a headcap or straps will anchor the headgear to the back of the head or neck.

Lower Lingual Holding Arch

The lower lingual holding arch (LLHA) is a space-maintaining appliance, holding the permanent molars in place while baby teeth are falling out and permanent teeth are erupting. Two bands (braces) are cemented to two lower molars with a wire, (attached to the bands) that spans in a 'U' shape toward the front teeth. It remains in place until permanent teeth begin erupting.

Nance Holding Arch

The Nance Holding Arch is a fixed orthodontic appliance to prevent the back molars from moving forward. The device consists of two metal bands around each of the upper first molars, connected to an acrylic piece that lies against the palate. This appliance may be used to maintain space when the baby teeth are lost prematurely to prevent the first molars from moving forward.

Bite Plate

The bite plate is used to help correct a deep bite, when the upper teeth overlap the lower teeth too much. The appliance prevents the back teeth from touching, so you will need to use your front teeth for chewing. It may take a few weeks to completely adjust to a bite plate. For optimal results, it should be worn 24 hours a day and removed only for cleaning and brushing. Most of the correction occurs during chewing, making it essential to wear while eating.

Hawley, Essix, and Bonded Retainers

After braces are removed, the best way to ensure long-term stability of the teeth is indefinite retainer wear. There are three types of retainers available in our office: Hawley, Essix and Bonded. The Hawley retainer is durable, easily removed, and can also be adjusted to correct minor tooth movements. The Essix retainer is a transparent removable retainer that fits over the entire arch of teeth. Essix retainers are transparent, have no wires and are very durable. They can be used for other treatments as well, including tooth movement and bridges. Bonded retainers are cemented directly to the inside surface of your lower teeth, which prevents them from shifting. Bonded retainers are cemented directly to the inside surface of lower or upper teeth, which prevents them from shifting. Bonded retainers cannot be removed by the patient and are prescribed when orthodontic treatment has affected the bite and there is a high risk for reversal of correction.