Expansion appliances are used to broaden the upper jaw and teeth, usually to correct a cross-bite (which means the upper jaw is narrower than the lower jaw). There are two main types which are used, both of which are bonded/glued to the teeth at the back of the mouth, usually with a ring each side of the back tooth (molar).
In younger patients, we usually use an appliance called a Quad-helix which looks like a ‘W’ shaped metal/wire framework which sits up in the roof of the mouth. This appliance does not need any adjusting by patients. It would typically remain in place for 6 months and during this time you would need to come in to have the appliance checked and adjusted every 6-8 weeks.
In teenage patients, when all the permanent teeth are through, we tend to use an appliance called a Hyrax, which is also bonded to the back teeth with a ring each side, and also glued to two teeth closer to the front of the mouth. This appliance needs to be turned at home once each night, usually for the first 5-6 weeks after it has been placed. It would typically remain in place for 3 months before braces are placed on the teeth.
If you have a Hyrax appliance – you will need to turn it once each night with the ‘key’ provided. Always remember to turn it a FULL turn in the direction of the arrow (toward the back of the mouth). When removing the key after you've completed a turn, it is very important to ‘wiggle’ it out gently so as not to pull it back, as this will cover up the next hole at the front - making it difficult, if not impossible, to turn it the next night. To fix this problem you will need to find the hole from the previous night (toward the back of the appliance) and place the key into that hole with the wire part bent at an angle, to finish the incomplete turn and therefore correctly line up the new hole at the front.
A few helpful hints to help you manage your expansion appliance:
• Firstly, you will find that you talk a little funny, especially in the beginning – this won’t last very long as your tongue will get used to the appliance.
• You may also find that your saliva flow will increase initially – this is entirely normal and will settle after a few days. It is just the way your mouth adapts to something new and different.
• It is important to make sure that you keep your appliance and teeth squeaky clean so as to avoid any decay and to keep your gums healthy, which will also make your adjustments more comfortable.
Please avoid all sticky foods as this can damage or dislodge your appliance.
If you find the appliance ‘pops’ out at the back or lifts off one of the back teeth, just try and pop it back in by placing it directly over the back tooth which it was attached to and pushing it back up on to the tooth. If you’re not sure where it goes, just copy the other side. This should make it comfortable and keep the appliance out of harms way. It should be able to stay back on the tooth which it belongs by itself, although you’ll have to be careful eating and stay with soft foods and definitely nothing sticky. Please call our rooms to make an appointment as soon as possible so that we can re-attach the appliance to the back teeth.
It is normal to feel a bit sore initially as your teeth are moving. The soreness won’t last longer than 2-3 days and Panadol or Nurofen and softer foods to eat should help ease it.
If the appliance rubs or causes any ulcers just roll up a piece of wax, dry the area that’s causing the sore spot with a tissue and push some wax over it. To help the healing process rinse your mouth out with warm salty water as well. Don’t worry if you get marks on your tongue as this is normal and they will disappear once the appliance is removed.