Types of Appliances

Palatal Expander and TPA

The upper jaw (maxilla) is made up of two bones connected by a suture in the middle. This suture does not close until the late teenage years. The palatal expander can be used to widen the upper jaw to correct crowding, arch constriction, and crossbites.

This appliance will be turned once or twice a day for a prescribed amount of turns. During this process, a gap will open between the two front teeth as the suture is widened. This gap will close by itself as soon as the expansion is completed. After expansion, the expander must stay in place for six months for the upper jawbones to grow back together and form a new suture.

Habit Control

An appliance can help and eliminate harmful oral habits. Habit connectors can be fixed or removable.

  • Tongue Thrust
  • Thumb Sucking
  • Lateral Tongue Thrust
  • Cheek Biting
  • Lip Biting


The forsus is used in Class II correction, which is when a patient’s upper teeth are significantly too far forward in relation to the lower teeth.  It is typically only used in the more extreme cases when the orthodontist thinks normal orthodontic elastics may not be effective or when the forsus would correct the Class 2 much faster. This can reduce time in braces by limiting or, basically, eliminating the use of regular orthodontic elastics.  The forsus helps patients who may not remember to wear headgear or elastics and can possibly prevent the need for expensive jaw surgery in some cases. The appliance is designed to move the upper teeth back and the lower teeth forward while promoting the proper jaw growth in patients.

Permanent Retainer

After teeth have been moved, they are very unstable initially, so retainers must be utilized to prevent the teeth from “relapsing.” The benefit of a permanent retainer is to keep teeth from shifting without relying on patient compliance. A permanent retainer is a wire bonded to the inside surface of the upper and lower front teeth and provides full time retention. Permanent retainers are especially useful because they help prevent shifting of teeth and help prevent retreatment in the future. Additionally, unlike removable retainers, they can’t be lost, broken, chewed up by the pet dog, or simply just not worn enough.