First phase appliances

A First Phase generally refers to a course of orthodontic treatment undertaken before the normal braces period. This might involve the use of various space-holding, expanding or growth-modifying devices.

Upper and lower lingual arches are cemented to the permanent first molars at the back. They simply hold the space from front to back while waiting for various permanent adult teeth to erupt.

Quad Helices and Rapid Palatal Expanders are commonly-used fixed expansion devices.

All these devices are constructed specially for each patient. We first fit orthodontic anchor bands to the first molars. Impressions are then taken over those bands. The bands are removed from the mouth and placed in the impression. Stone models are then made of the mouth and teeth - with the bands in place. The particular device is then formed to the mouth or palate shape - then soldered onto the bands. A week or so later, the completed appliance is inserted and cemented in the patient's mouth. A full set of instructions for use and care is given to the patient and family.

Removal functional appliances (Activators) are commonly used in our office to try to reduce the severity of so-called Class II occlusions - where all the upper teeth are too far forward for the lowers, or vice versa. Impressions of the upper and lower teeth and wax records of the new bite are sent from our office to the laboratory. The completed appliance is sent back to us for insertion into the patient's mouth and adjustment for treatment effect. Our patients generally only wear these functional appliances at home behind closed doors (including sleeping).

Various Headgears - to pull the upper teeth and jaw upwards, backwards or forwards, as necessary, are still used in a few cases. If considered for use in a particular case, recommended wearing will only occur behind closed doors at home (including sleeping).

Removable plates with active springs may be used to simply push one or two upper teeth out over their lower opponents to correct a cross-bite. Generally, these appliances are worn full-time (including eating) for only a few weeks.