Separators (Spacers)

  • Separators are small rubber rings that are placed between your back teeth to create sufficient space prior to fitting your bands. Your teeth may be sore for one to three days after the placement of separators. You may take whatever medication you would normally take for a headache.
  • Make sure you avoid sticky or chewy foods that may dislodge your separators. Do not floss where the separators are located.
  • Call the office immediately if the separator comes out so that we may determine if it needs to be replaced.

Elastics (Rubber Bands)

  • The purpose of the rubber bands is to move the upper and lower teeth so that they fit together better.
  • Rubber bands are generally worn 24 hours per day (except for eating and brushing), unless otherwise instructed. You should use a fresh set of elastics each day or if they break. Before you run out of elastics, please call our office and we will send you more.
  • Remember to replace the elastics after eating and brushing. Failure to wear elastics as instructed can cause damage to your teeth and extend your treatment time.

Palatal Expanders

  • A palatal expander is used to widen the upper jaw when it is too narrow.
  • We normally request that the expander screw is turned once per day unless otherwise instructed.
  • During the active phase of expansion, we will generally see you every two weeks.
  • When sufficient expansion has been obtained, the expander will remain in the mouth for 3-6 months.
  • A space will develop between your upper two front teeth during widening. This is normal and will usually go away after you stop turning the appliance.
  • Make sure you brush your teeth and gums well. Clean your expander with your toothbrush to avoid inflammation or infection of the gum tissues or the roof of your mouth.
  • There may be some minor discomfort to the teeth, upper jaw, or bridge of nose during the active widening phase. If necessary, you may take whatever medication you would normally take for a headache.
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Herbst Appliance

  • It will take a week or two to become accustomed to eating and biting with the appliance. Teeth and jaw muscle soreness is normal during this time. Be patient. Anytime something new is put in the mouth it takes time to get used to it.
  • Sores may develop where the lower front screws are pushing out into the lip. Wax may help. If the sores do not heal within a week or appear to be getting worse rather than better after several days please call our office to have the screws adjusted.
  • Inner cheek sores may also develop where the arms are extending out the back of the sleeves in the upper molar regions if the arms are too long. If these sores develop, please call to have the arms shortened.
  • Occasionally the rods may come out of the tubes when you open very wide. Simply put the rod back in the tube if you can. If you are unable, call our office and we will do it for you. If this is happening excessively, please call and we will determine if longer rods can be placed.
  • Due to the complexity of this appliance it is very important to try and minimize breakages. Repairs are many times difficult, time consuming, and expensive. Please try to minimize breakages as much as possible by being careful with the appliance.
  • Please call immediately if anything breaks, if bands or crowns come loose, or wires break.
  • The Herbst appliance is normally left in nine months. Occasionally it will be left in longer in order to achieve the desired correction.




  • A headgear is an appliance used to pull the upper teeth/jaw bone back to a more correct position relative to the lower teeth/jaw.
  • Generally, you will be asked to wear your headgear while at home and sleeping, approximately 12-14 hours per day (continuous wearing is better). You DO NOT need to wear the headgear to school or outside your home.
  • Do not wear the headgear during active sports because it could cause injuries.
  • Keep the headgear in the provided case when not wearing it. A separate charge may be assessed for broken or lost headgears.
  • If one of the metal bands on the back teeth becomes loose or broken, stop wearing your headgear immediately and call our office.
  • If the headgear gets bent and does not fit correctly between visits, please call us for an earlier appointment to have it adjusted.
  • Always bring your headgear to your appointments.


  • Wear your retainers as instructed by the doctor.
  • Take your retainers out when eating... and always put retainers in their case! (Most appliances are lost in school lunch rooms or restaurants.)
  • Clean retainers thoroughly once a day with a toothbrush and toothpaste. Use cool (NEVER hot) water. Brushing retainers removes the plaque and eliminates odors. Efferdent or other orthodontic appliance cleaners can be used, but these do not take the place of brushing.
  • When retainers are not in your mouth they should ALWAYS be in a retainer case. Pets love to chew on them!
  • Initially, you may find it difficult to speak. Practice speaking, reading, or singing aloud to get used to them faster.
  • Retainers are breakable, so treat them with care. If retainers are lost or broken call us immediately.
  • If you have any questions or concerns about your retainers, or your retainers need adjusting, call us. Do not try to adjust them yourself.
  • Always bring your retainers to your appointments.
  • Retainer replacement is expensive…with proper care they will last for years!
  • Remove retainers when swimming.
  • Keep retainers away from hot water, hot car dashboards, pockets, the washing machine, and napkins.
  • Your original retainers are included in your treatment fee. A separate charge may be assessed for broken or lost retainers.

Bonded Retainer

(a wire permanently bonded to the back of the front teeth)

  • Care must be taken to try and avoid breaking the bonded retainer by watching what you bite into with your front teeth. Please do not bite into anything hard or chewy.
  • Each tooth is attached to the wire with a small pad of white bonding material. Please inspect these bonds several times a week and call us immediately if one is missing or has come unattached from a tooth. Once a tooth comes unbonded it is free to move and often will do so. If this occurs the bonded retainer will have to be repaired or remade.
  • Please make sure to brush around the bonded retainer thoroughly twice a day removing all visible plaque. It should also be flossed daily by using a floss threader as instructed.
  • Bonded retainers are usually left in place for several years to stabilize the teeth, but are not usually meant to last a life time. We generally decide to remove them at some point especially if they contribute to hygiene problems or experience frequent breakage.
  • Please understand: It is the patient’s responsibility to care for the bonded retainer by being careful of what you eat, to inspect it regularly for loose bonds, to call immediately if there are problems, and to keep it clean.

Clear Retainers

  • When inserting clear retainers, apply equal pressure and make sure they are seated all the way.
  • Clear retainers are to be worn as directed.
  • Clear retainers are to be kept in the provided retainer case whenever out of the mouth. This will prevent you from losing or breaking them. Keep them out of reach of children and pets. Likewise, do not boil them or leave them in the car because the heat will distort them.
  • If you should lose or break a clear retainer, call our office immediately in order to get a new one made. There may be a charge to replace the retainer.
  • Clean the clear retainer with a toothbrush and cool (NEVER hot) water after removing each morning.
  • Bring your clear retainer(s) with you to each retainer check appointment.
  • Please keep all retainer check appointments. This is very important in order to make sure the retainers are fitting well and the teeth are staying straight.
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