Orthodontic Appliances

Jasper Jumpers | Headgear | Nance Appliance | Thumb/Finger Appliance | Herbst | Tongue Thrusting Appliance | Orthognathic Appliance |
Rapid Palatal Expander

Jasper Jumpers

  • In order to help correct your malocclusion, Dr. Trammell has installed a product in your mouth, called a "Jasper Jumper"!
  • This appliance has some important advantages over such products as "headgear", not the least of which are cosmetics, safety, and comfort.
  • However, please treat your Jumpers properly. They are expensive and are not indestructible. If you chew on them they will break. If you try to bend them sharply with your fingers or if you try to stretch them by opening your mouth extremely wide they may also break.
  • If treated properly, they should do a great job of improving your bite! Thank you for your cooperation.

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  • Now that you are wearing a headgear, you are playing a very important part in correcting your mal-positioned teeth and jaws. Good cooperation will result in a shortened treatment time and the best result.
  • Your headgear supplies the force that will move your teeth and jaws toward their proper position. It only works while you are wearing it, so the headgear MUST be worn at least 12 to 14 hours every day (unless instructed otherwise)!
  • Be consistent, it won't do much good to wear it for a long period one day and skip the next day. Most patients put it on right after dinner and wear it until breakfast the next morning. Of course, you can wear it any quiet times during the day, such as while reading, watching TV, baby-sitting, doing homework, etc.
  • To aid in determining how effective the headgear is in your case, keep an accurate record of the number of hours the headgear is worn each day on a scorecard.
  • It will take you a few days to get used to the headgear. It is like breaking in a new pair of shoes. After the first few days, your headgear will become much easier to wear provided you wear it consistently and as instructed.
  • Care should be taken in inserting and removing the "face bow" or metal part of the headgear. Always remove the strap or elastics before removing headgear from the mouth. Not doing this could result in serious injury.
  • When removing the face bow, pull straight out of the tubes gently, but firmly. Never yank, twist or wiggle the face bow up and down to remove it from your mouth.
  • For your safety and protection: Always remove headgear for sports or other physical activities and do not "horse around" or "rough house" with the headgear on.
  • If any part of your headgear should break or bend so that it does not fit properly, be sure to call the office and make an appointment to have it repaired. If the bands on the teeth should become loose, call us also.
  • When not in use, keep the headgear in the case provided and in a safe place away from small children and pets. This will help prevent loss or breakage. Remember to clean your headgear regularly with warm water and soap. Both the strap and the face bow can be hand washed.
  • Please bring the headgear (and the scorecard) to the office at each visit so that they can be checked and/or adjusted.

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Nance Appliance

The Nance Appliance is used to prevent upper molars from rotating or moving forward after you've worn a headgear, a Wilson's arch or any other appliance to move your molars back. Some patients wear the Nance Appliance while they are awaiting their bicuspids to grow into place.

The appliance is made of two bands that are cemented onto the first molars and a wire spans the roof of the mouth from one molar to the other. An acrylic pad or "button" covers the wire that touches the roof of your mouth directly behind your front teeth.

Patients should always brush around the bands daily. Do not eat sticky, chewy candy as it can loosen your appliance.

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Thumb/Finger Appliance

Sucking is a natural reflex that relaxes and comforts babies and toddlers. Children usually cease thumb sucking when the permanent front teeth are ready to erupt. Typically, children stop between the ages of 2 and 4 years. Thumb sucking that persists beyond the eruption of primary teeth can cause improper growth of the mouth and misalignment of the teeth. If you notice prolonged and/or vigorous thumb sucking behavior in your child, talk to your dentist.

One solution to thumb sucking is an appliance called a "fixed palatal crib." This appliance is put on the child's upper teeth by an orthodontist. It's placed behind on the upper teeth on the roof of the mouth. The crib consists of semicircular stainless steel wires that are fastened to molars using steel bands. The stainless steel wires fit behind the child's upper front teeth, and they are barely visible. The crib usually stops the habit of thumb sucking within the first day of use.

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One of the most common problems orthodontists treat is the discrepancy that occurs when the upper teeth protrude beyond the lower. Ordinarily, when we see a patient with the upper teeth protruding, we tend to think that the upper jaw and teeth are too far forward; but, more often than not, this condition is due to a small lower jaw that is further back than it should be. With these patients, we would like to encourage the lower jaw to catch up in growth, and braces like the Herbst appliance help this happen.

Even though the Herbst appliance prevents the lower jaw from moving backward, opening and closing movement still occur easily, and patients do not have any problems learning to chew their food with their lower jaw in this new position.

As with all kinds of braces, patients with Herbst appliances need to be careful about what they eat. For instance, cold foods such as ice slushes, Popsicles and ice will freeze the cement and make the brace loosen. Sticky foods such as caramels, bubble gum and candy suckers will pull the brace away from the teeth. Hard foods like crisp vegetables and hard candies will bend and loosen the Herbst appliance, too. So stay away from these foods during your orthodontic treatment.

Your Herbst appliance will be checked and adjusted at your appointments. If, sometimes between appointments, you develop some sore areas on the inside of your cheeks, please do not try to adjust the appliance yourself. Call for an appointment so that the necessary adjustments can be made.

Wearing a Herbst Appliance

At first, your mouth will feel unusually full and speaking will be awkward. But if you practice reading aloud, your ordinary speech will return quickly. You may also notice more saliva than normal, but this will decrease as you become accustomed to the appliance.

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Tongue Thrusting Appliance

Tongue thrusting occurs when the patient presses his or her tongue against the front teeth, usually when swallowing, speaking or resting the tongue. If thrusting is constant, this can cause problems with teeth alignment and must be fixed.

We prefer to correct tongue thrusting by giving patients a tongue thrusting appliance. This appliance, similar to a mouth guard, is usually worn at night. Other times, a more permanent appliance is prescribed and can be only be adjusted by our office.

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Orthognathic Appliance

An orthognathic appliance, or growth appliance, is used to correct discrepancies in the growth patterns of the jaws and/or cleft palate. There are a number of different growth appliances available to correct these problems. Certain appliances are designed to gently encourage the upper palate to expand allowing for more room for the permanent teeth to grow in, while others are designed to correct overbites that occur due to growth problems. Orthognathic (growth) appliances are designed to create more room for incoming permanent teeth, promote a better bite and/or enhance the facial profile. They are sometimes used for less complex cases that do not require orthognathic surgery.

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Rapid Palatal Expander


  • Turn the appliance per doctor's instructions:
    ___ 1 turn every other day for a total of 16 turns.
    1st turn was completed in the office. Leaving 15 turns to be completed.
  • After each turn there will probably be some tightness in the cheekbone, palate, and teeth areas. This discomfort may last just a few minutes or longer.
  • Use Advil, Tylenol or something similar if needed for pain.
  • You may notice space developing between the two front teeth. This is expected.
  • Occasionally, patients experience a feeling of pressure build-up followed by a sudden release. Do not worry, this means the expansion is working.
  • You may have some irritation to the inside of your cheeks. Place the soft wax over anything sharp or irritating for as long as necessary.
  • Brush after you eat and use the plastic syringe to clean under your appliance.
  • Follow the food list given to you. If anything breaks, please call and let us know.

Dennis W. Trammell, DMD, MSD, LLC

Print RPE Instructions Here.


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