The Herbst Appliance is a non-removable functional appliance which effectively corrects skeletal Class II malocclusions. The Herbst design utilizes a buccal rod and tube assembly to encourage the patient’s jaw to function in a forward advanced position. The tube and rods extend from the maxillary first molar area down to the mandibular first bicuspid region.
The Super Screw expander is used in situations that require a larger degree of arch development but a physically smaller screw is desired. A 12mm or 16mm screw can be requested. A special adjustment wrench is used with each appliance.
Sometimes a patient’s upper jaw needs to be enlarged. In such cases, Dr. Epps may widen the upper jaw with a Palate Divider or RPE. This device spreads the halves of the upper jaw apart. New bone then fills in between the two halves and the upper jaw remains permanently wider. The device has a center screw that must be turned with a key. The key is inserted into the key hole in the center screw and then gently pushed toward the back of the mouth one notch. How often you turn the key will depend on the patient’s specific case.
The first noticeable effect of the divider is that the front teeth begin to separate. This is a sign that the appliance is working properly. The space will close naturally when the key turning is stopped.
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, please 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.
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.
Dr. Epps prefers to correct tongue thrusting by giving patients a tongue thrusting appliance. This appliance, similar to a mouthguard, is usually worn at night. Other times, a more permanent appliance is prescribed and can be only be adjusted by Dr. Epps.