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Helping Smiles Grow with the Right Tools at the Right Time
At Virginia Family Dentistry, our orthodontists use a variety of specialized appliances to guide proper jaw growth, maintain space for permanent teeth, and support long-term treatment success. These appliances are often used alongside or before braces or clear aligners, depending on each patient’s needs. Below are some of the most common orthodontic appliances and how they work.
Palatal Expander
Widening the Upper Jaw for Better Alignment
A palatal expander is used to gently widen the upper jaw by gradually expanding the roof of the mouth. This creates space for permanent teeth to come in properly and helps correct bite issues. Expanders are most often used in children while the jaw is still developing.
Adjusting to a Palatal Expander
- Speech may sound different for the first 5–10 days. Reading aloud can help speed up the adjustment.
- Swallowing may feel awkward at first due to increased saliva. Drinking with a straw can help train the tongue.
- Eating: Avoid long or stringy foods (like spaghetti) that can wrap around the appliance. Cut foods into small bites and rinse with water while eating to help keep the mouth clean.
- Cleaning: Use a toothbrush to clean around the appliance, but for areas it can’t reach, we strongly recommend using a Waterpik to flush out food and prevent decay or bad breath.
Gaps Between Front Teeth
It’s normal to notice a temporary gap forming between the front teeth as the palate expands. This is expected and will be corrected during the full course of orthodontic treatment.
Turning the Expander
Your orthodontist will show how and when to turn the expander using a special key. You may feel mild pressure or soreness for a few minutes after turning. Be sure to follow your provider’s schedule to avoid over-expansion.
Lower Lingual Holding Arch (LLHA)
Maintaining Space for Permanent Teeth on the Lower Jaw
A Lower Lingual Holding Arch (LLHA) is a space maintainer used in the lower jaw to prevent molars from shifting while new teeth erupt. The appliance is anchored to the back molars with a wire that runs behind the lower front teeth.
Adjusting to an LLHA
- Initial discomfort is normal and may last up to 7 days. Wax can be applied to reduce irritation, and warm salt water rinses or Orabase/Canker-X can soothe sore spots.
- Speech and swallowing may feel different for the first few days. Practice reading aloud, and sip water through a straw to help the tongue adjust.
Eating with an LLHA
To protect the appliance:
- Avoid sticky foods like gum, gummies, and caramel
- Skip hard foods such as nuts and ice
- Rinse with water while eating to keep the mouth clean
Cleaning
Brush thoroughly around the appliance, and consider using a Waterpik to clean hard-to-reach spots. This helps prevent plaque buildup, tooth decay, and gum irritation.
Space Maintainers
Holding Space for Incoming Permanent Teeth
A space maintainer is a small orthodontic appliance used to hold open the space left by a baby tooth that has been lost too early. By preserving this space, the appliance ensures that the permanent tooth has enough room to come in properly—helping to prevent crowding or misalignment in the future.
Why Space Maintainers Are Important
When a baby tooth is lost prematurely, the surrounding teeth may shift into the space left by the missing tooth. This can block the path for the permanent tooth or create bite problems that may require more extensive treatment later. Space maintainers help guide proper tooth eruption and support long-term dental alignment.
Types of Space Maintainers
- Fixed space maintainers are cemented into place and remain in the mouth until the permanent tooth begins to erupt.
- Removable space maintainers may be recommended in certain cases and function similarly to retainers.
Adjusting to a Space Maintainer
- Mild discomfort or soreness may occur after placement but usually fades within a few days.
- Speech and swallowing may feel different at first—reading aloud and sipping water through a straw can help with adjustment.
- Eating: Avoid sticky foods (like gum and chewy candy) and hard items (like nuts or ice) to prevent damage.
Cleaning and Care
It’s important to brush around the appliance carefully and rinse the mouth after meals. A Waterpik can help clean areas around the space maintainer where food might get trapped. Good oral hygiene helps prevent gum irritation and keeps the appliance functioning properly.
Have Questions About Orthodontic Appliances?
Every patient’s treatment is different, and our orthodontists will walk through what each appliance does and how to care for it. Whether it’s an expander, space maintainer, or another device, our goal is to make the process clear and comfortable for both kids and parents.
Schedule a complimentary orthodontic consultation to see if your child may benefit from one of these appliances.