Orthodontics| Murray, Riverton and Magna, UT and Boulder City, NV | Parker Orthodontics | Dr. Justin O. Parker > Treatment

Crossbow

Purpose of Appliance
The Crossbow is our most popular bite correcting appliance. It combines the technology of the forsus springs and expansion to correct Class II malocclusion. The crossbow appliance is specifically designed to help move teeth to proper positions. In some cases, this may help reduce the need to wear headgear or have extractions of permanent teeth. This appliance works 24 hours a day by using continuous gentle forces.

What to Expect

As with any orthodontic appliance, some short-term discomfort may occur. Call our office if discomfort continues or if a sore develops.
With proper care the springs will last the entire treatment period without replacement. If the springs are distorted, it will not function properly. Please avoid hard or sticky food.

Instructions for Appliance Use and Care

Although the crossbow appliance is designed to withstand normal forces in the mouth, like all orthodontic appliances, it can be damaged or broken if proper care is not taken:
- The crossbow is designed to accommodate normal mouth opening for eating and speaking. Opening the mouth too wide however, may damage the appliance. Remember to never open more than two fingers wide.
- If, for some reason, the springs gets between the teeth, do not bite on it. Biting on the springs may deform it or cause breakage.
- Always be careful about what food is eaten. Avoid hard or sticky foods and be sure to cut the food into small pieces.
Use pink wax at the first sign of discomfort on cheeks. The mouth will become accustom to the appliance and discomfort will stop during the first few weeks.

Distal Jet

Purpose of Appliance

This is appliance is used to move upper first and second molars back to correct a class II bite. When used in combination with headgear the correction is achieved more efficiently. Limited expansion can also be achieved with this appliance.

What to Expect

Teeth may be uncomfortable for 48-72 hours after placement of the distal jet.
Swallowing may ne awkward due to the space that the appliance occupies on the roof of the mouth. Speech may temporarily be affected.
Most children adapt and compensate within the first weeks.
A significant space may develop between the upper bicuspids and molars. This is normal and temporary. This space will usually begin to close automatically when the distal jet is no longer being activated.
After the initial adjustment period with activation, the patient may feel pressure for a short time but there should be little, if any, dis comfort.

Instructions for Appliance Use and Care

Have the patient open their mouth as wide as possible.
Place the wrench on the hex portion of the middle cylinder of the expander so that the wrench is near the top of the teeth.
Turn the wrench down from the top teeth to meet the lower teeth or from the front of the mouth to the back.
Turn the wrench over and repeat the turn.
Dr. Parker will indicate how many turns to perform each day and when to stop activating the expander portion of your appliance.
Dr. Parker will activate the molar distalizing portion of this appliance at your office visit but most of the work will be done with headgear compliance.
Avoid eating hard or chewy candy.

Lower Dewey

We are currently gathering information for this section. Please check back with us soon.

Elastics-Rubber Bands

Purpose of Appliance

Elastics and rubber bands are used to help move teeth into proper alignment. If the rubber bands are not worn as directed, the teeth will not move and the treatment time will be prolonged.

What to Expect

Elastics may be difficult to put on in the beginning. After a few days of practice, placing the elastics will become easy.
Sometimes, the teeth will get sore when the elastics are started. Usually this soreness only lasts a few days. Wearing elastics sporadically will also cause tooth soreness and make it difficult to move the teeth.
THE EFFORT MADE EQUALS THE RESULTS ACHIEVED

Instructions for Appliance Use and Care

Elastics should be worn 24 hours a day, unless instructed otherwise.
Elastics should be removed only when teeth are brushed or while eating meals. (Hint: place one around your finger to remind yourself to put it back in after brushing/eating.)
In order to not loose “wear time” please notify us of lost elastics or a need for more. They can be mailed or picked up at our office.
Elastics will lose their strength after a period of time. They should be changed at least three times daily.

Please contact our office for instruction regarding the placement of elastics or for any problems preventing wear. Lack of wear will delay results and increase treatment time.

Forsus Appliance

Purpose of Appliance

This state-of-the art functional appliance has been custom designed for your child. This appliance has several unique advantages including the fact that the patient does not have to remember to place it daily. It positions the jaw into correct alignment and is an efficient method of achieving a stable bite. If timed during jaw growth, the changes occur in both the teeth and jaw position. In order for this appliance to work it will need to be in place for 2-8 months and will need to be checked every 4 weeks.

What to Expect

As with any new device, expect a break-in period that might include a period of discomfort for several days.
To minimize discomfort during the initial days with the appliance:
- Eat soft foods slowly with the front teeth.
- Do not force the back teeth together!
- Do not chew ice, pens, pencils, or fingernails.
- Expect to use Advil or Motrin for any soreness or discomfort during the first week.
- Use pink wax around cheeks at the first sign of irritation.

Although the Forsus appliance is very durable, occasionally breakage can occur. The most common problem occurs when the rod separates from the spring while yawning. This most often happens at bedtime! Replace the rod into the spring by simply opening wide and threading the rod back into the opening of the spring. If one of the components breaks, don’t panic! Remove any loose rod or spring and bring them in at your next visit. If it breaks after hours and it causes unusual discomfort, call the ER number listed below. Most orthodontic emergencies can wait until the next morning as long as all loose pieces are removed.

Instructions for Appliance Use and Care

Brush mouth thoroughly. Make sure to brush in the very back of the mouth and behind the back teeth really well. Brush around the Forsus Springs and brush the springs themselves.

Headgear

Purpose of Appliance

The Headgear is the best time-tested appliance used for early correction in Class II interceptive orthodontics. It creates a special force that guides the growth of the face and jaws for proper alignment of teeth. It is an orthodontic appliance that pushes back upper molars into a correct bite.

What to Expect

During the first days of wear, the molars may become tender. An over the counter headache type pain reliever may be appropriate for the first few nights.
A good way to get over initial tenderness is to wear the Headgear for 3 days, 24/7, to become accustom to it. Pain is more common when wear has not been constant enough to adjust to the appliance. Please encourage your child to leave the Headgear in place until morning. Soon it will feel natural and there will be minimal discomfort.
Some children remove the Headgear without fully awakening during the nights. If this occurs, please have the patient make up the lost time during waking hours.
If your child can’t seem to adjust to the “wear schedule,” and has unusual discomfort, please notify the office so we can check the fit and make further adjustments.

Instructions for Appliance Use and Care

The minimum time for daily wear is 12 hours. This can be accomplished by brushing, wearing it after dinner time, and during sleep hours until the next morning. There is no minimal time to wear the headgear. 24 hrs a day wear will reduce the length of time headgear will need to be worn.
For safety reasons, do not allow headgear wear during active sports or roughhousing.
It is imperative the Headgear is worn every night to maintain correction already achieved. Additional hours on weekends, holidays, and vacation time will only hasten the desired correction, and shorten treatment time.
The Headgear can be worn during video games, internet, and homework time. Hours are cumulative and missing too many hours or skipping days will cause relapse. Charting wear hours and earning rewards for consistent wear is motivating for most children. If they approach headgear wear as a game or hour collecting, most children will be positive and cooperative.
When inserting the face bow into the molar band tubes, place one side at a time. Do not shake the face bow up and down to check whether or not the ends are fully inserted. This force can break the cement bonds on the molar bands and will require extra office visits.
Notice the proper number on the springs when the Headgear is originally fit in the office. It may be necessary to occasionally advance the tab to a higher number. The patient will also notice when there is less force after consistent wear.
ALWAYS bring the Headgear to each appointment so that we can check the tension, fit, and make adjustments.

Mara

Purpose of Appliance

The Mara is designed to be a simple and durable Class II corrector. It is an appliance that orthodontist uses to correct overbites. It shifts the lower jaw forward and holds it, directing growth in a forward direction. The advantages of this appliance include increased reliability and shortened treatment time.

What to Expect

The Mara appliance is usually worn at least a year.
At first, it will probably feel awkward to hold the jaw forward while eating. The teeth will not fit together well, and chewing will not be perfect. Adjustment to the new bite comes with time. Eat soft foods that do not require much chewing.
There are some ‘Problem Foods’ that can damage or break the Mara, increasing treatment time. Avoiding these crunchy and sticky foods will help keep treatment on track. See the comprehensive list below.
The arms of the Mara are only bite guides. Do not chew on them, or they will come loose or breaks.
If any parts of the Mara come loose, save them and call our office to schedule an appointment to repair them.
If cheek irritation occurs due to the Mara, place a small piece of wax over the area, especially while sleeping. We’ll provide the wax. If it does not improve, call us and come in for a adjustment.
The bite may change over the next few months and the Mara will probably need to be adjusted occasionally. Some small spaces may temporarily open between the lower teeth. These will be closed later with braces.
Be sure to use wax at first sign of irritation so that the irritation will remain minimal.

Instructions for Appliance Use and Care

Brush mouth thoroughly. Be sure to brush in the very back of the mouth and behind the back teeth really well.

PROBLEM FOODS:

Hard, sticky, chewy, gooey candy (caramel, taffy, Jolly Ranchers, Starburst, Skittles, Jawbreakers, Now and Laters, etc.)
Gum, nuts, popcorn
Bagels, beef jerky, hard rolls, pizza crust, chicken bones
Apples and carrots (unless sliced or steamed)
Soda pop and any other sugar beverages or snacks
Pens and pencils

Rapid Palatal Expander (RPE)

Purpose of Appliance

When the upper arch is too narrow to fit properly with the lower arch, expansion of the upper arch is often indicated. In many cases, the most stable way to accomplish the expansion is by applying orthodontic force to the upper arch to achieve skeletal rather than dental expansion. The upper jaw bone in growing patients has growth centers called “sutures”. These are soft cartilage. The mid-0palatal suture separates the roof of the mouth into left and right halves. When pressure is applied in a controlled manner, the mid-palatal suture can be significantly widened correcting crossbites and creating more room for the eruption and alignment of teeth.

The appliance used to expand the maxilla is called a “Rapid Palatal Expander” (RPE). This appliance is custom made for each patient. It is activated at home by parents with younger patients, or the older patients can do it themselves. Expansion of the upper arch is accomplished in 2-4 weeks. The appliance remains in the mouth for approximately 3-4 months to hold the expansion while new bone formation takes place.

What to Expect

The back teeth may be uncomfortable for 48-72 hours after placement of the RPE.
Swallowing may be awkward due the space that the appliance occupies on the roof of the mouth. Speech may temporarily be affected.
Most children adapt and compensate within the first weeks.
A significant space may develop between the upper front teeth. This is normal and temporary. This space will usually begin to close automatically when the RPE is no longer being activated.
After the initial adjustment period with activation, the patient may feel pressure for a short time but there should be little, if any, discomfort.

Instructions for Appliance Use and Care

Have the patient open their mouth as wide as possible.
Place the wrench on the hex portion of the middle cylinder of the expander so that the wrench is near the top of the teeth.
Turn the wrench down from the top teeth to meet the lower teeth or from the front of the mouth to the back.
Turn the wrench over and repeat the turn.
Dr. Parker will indicate how many turns to perform each day and when to stop activating the RPE.
Avoid eating hard or chewy candy. Do not chew ice. Do not allow the patients tongue or fingers to play with the RPE.

Separators

Purpose of Appliance

To create space between adjacent teeth so that orthodontic bands may be fitted to the molar teeth.

What to Expect

Many patients feel that this is the most painful part of the entire orthodontic treatment. The mouth will be tender, especially since the patient is not use to having anything additional on or between their teeth.
Within a few hours of placement, the patient will experience discomfort. An over the counter pain medicine may alleviate discomfort.
Remember, the separators (spacers) create space for the bands to fit onto the teeth more easily. After the initial appointments, the patient and the mouth will adjust to the appliance that will ultimately create a beautiful smile.

Instructions and Care

If a separator falls out, please contact our office. If it happens over the weekend, wait until Monday. There are isolated circumstances where the spacer may not need to be replaced.
Do not play with the separators. Fingers should be kept out of the mouth.
Brush, like normal, but do not floss in the area where the separators are located.
Do not chew gum or eat sticky food as it will dislodge the separator.
It is normal for the separators to fall loose or mobile.
Use Advil, Motrin, or other over the counter pain medicines if discomfort persist.

Lower Space Maintainer

We are currently gathering information for this section. Please check back with us soon.

TADS

Purpose of Appliance

A Temporary Anchorage Device (TAD) is used by the orthodontist to move teeth in desired direction without moving adjacent teeth. These small titanium screws are placed in the mouth through gingival tissue into the bone through a simple surgical procedure with minimal discomfort. TAD’s effectively shorten treatment time and lessen the need for additional appliances.

What to Expect

TAD’s are removed once they are no longer needed.

Instructions and Care

Keep the area around the TAD clear from food and clean.
It is possible that the tissue around the device could become inflamed or infected, or the soft tissue could grow over the device.
Should puffiness, swelling, or pain occur please contact our office. Use of antibiotics or antimicrobial rinses may be prescribed.

Wedge

Purpose of Appliance

The wedge is used to correct an excessive over bite. It is an acrylic pad that is cemented to the back of the upper four front teeth while the molars are erupting. When biting together, the lower front teeth hit the acrylic pad, which in turn eliminate the deep bite. Treatment time will vary depending on the severity of the overbite. The wedge will help reduce overbite and the time that the patient will spend in the second phase of treatment.

What to Expect

Short-term discomfort of front teeth.
Difficulty biting into food.
Talking will be difficult for the first couple of weeks.

Instructions for Appliance Use and Care

Although the wedge and turbobite openers are designed to withstand normal forces in the mouth, like all orthodontic appliances, it can be damaged or broken if proper care is not taken.
Avoid hard or sticky foods
Brush very well and keep area clean of food and plaque
Be very careful when eating, do not bite down to forcefully when eating as this may cause breakage.