Orthodontic Appliances

Herbst Bite Jumping Appliance | Thumb Sucking Habit Appliance | Nance Appliance | Retainers | Pendulum Appliance | RPE – Rapid Palatal Expander

Herbst Bite Jumping Appliance

The Herbst Appliance was developed to correct misalignments of the upper and lower jaws and teeth.

This orthopedic bite jumping appliance is used prior to full braces while growth is still occurring. It corrects the bite by promoting growth of the lower jaw and shifting of the teeth. It is an effective alternative to headgear.

Once the Herbst has corrected the bite (usually taking about 12 months), braces straighten the teeth and finalize the bite correction.

Benefits of the Herbst Appliance Include:

  • In place and working 24 hours a day
  • Creation of space for the permanent teeth
  • Bite correction without surgery
  • Shorter time in full braces

Thumb Sucking Habit Appliance

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, 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.

Nance Appliance


A Nance appliance can be used in several different ways, depending on what the patient's needs are. The appliance can be used to rotate molars or just to hold the molars in place. It is most commonly used to keep the upper molars from drifting forward. It can also be used to slightly expand or rotate the upper molars. Generally, little or no discomfort is felt from this appliance. However, if soreness does occur, this may be relieved with whatever over-the-counter medication you would normally take for your pain.

The Nance fits across the roof of the mouth. Bands are placed on the two back molars on the upper arch, one on each side. A wire connects the insides of the bands. There will also be a piece of acrylic (plastic) in the center of the wire, which fits against the roof of the mouth. The fun part is that the patient will get to choose the color of the acrylic!

How to Clean

You will brush your teeth the way you would normally brush. However, make sure you brush the roof of your mouth thoroughly. In addition to brushing, floss can be used under the appliance. A Water Pik also can be helpful. If swelling occurs around the acrylic, use a warm salt-water rinse (2 teaspoon of salt in 8 oz. of warm water four times a day) to reduce the swelling.

Please feel free to ask any questions you may have or make any suggestions or comments.


Congratulations! Your active orthodontic treatment is complete, and we are beginning the retention phase of your treatment.

The purpose of this retention phase is to give your teeth the support they must have to remain in their new position until the bone has adapted. Understand that some minor movement (relapse) is expected.

We are sure that you have many questions regarding your new appliance. Here are some tips that we hope will answer some of those questions.

When do I wear my removable appliance?

Twenty-four hours per day (except when eating, swimming or contact sports), until our doctors tell you differently. This means all day, every day. Initially, you may produce more saliva and have difficulty swallowing and talking. This will go away as soon as you get used to the appliance. The lower retainer normally remains in place until the patient's wisdom teeth (third molars) have either been removed or are in the mouth as functional units.

When and how do I clean my appliance?

Be sure to remove your appliance to clean it every time you brush your teeth. Brush the plastic part of your appliance with toothpaste and warm water only. Brush the appliance before going to sleep.

What happens if I lose or break my appliance?

The best possible place for your appliance is in your mouth.

  • Never leave it out where an animal can chew it up.
  • Never put it in your pocket and sit on it.
  • Never wrap it up in a napkin while eating. You may forget and then throw it away.
  • Never leave it around baby brothers or sisters.
  • Always keep it in your mouth.
  • Always put it in the retainer case when removing it for eating, swimming and contact sports.

All appliances are made for us in a special orthodontic laboratory. If you lose or break your appliance, there is an additional charge to repair it or make a new one. Please bring in the broken retainer, as parts may be able to be used.

The active retention phase of your orthodontic treatment will last approximately 12 months. During this time, our doctors will be monitoring your retainer wear and the final positioning of your teeth. Our doctors will then release you from our active care; however, we will always be here for you should any problems or concerns arise. Be sure to notify our office if your retainers are lost, broken or not fitting properly. Arrangements will be made to see you as soon as possible.

It has been a pleasure having you as part of our family of patients, and we hope we have been of service to you and your family. With continued cooperation during this important and final phase of orthodontics, you will have a stable result, a solid bite, a pleasant smile and good dental health forever.

*Remember: always bring your retainer with you to your appointments!



A pendulum appliance is used to achieve optimum molar relationship with little or no effort required by the patient. With proper occlusion of the molars, we may have a more functional and effective bite. The pendulum appliance is also used to make space for incoming teeth. In many cases, a patient does not have enough room for all of their teeth, so space must be made. This appliance is a very active appliance and must be checked by our doctors every 2-3 weeks. Movement occurs quickly so be sure to keep your appointments.

How to Take care of your New Appliance

You will brush your teeth the way you normally brush. However, make sure you brush the roof of your mouth thoroughly. In addition, a Water Pik can be helpful. If swelling occurs, use a warm salt-water rinse (2 teaspoon of salt in 8 oz. of warm water four times per day) to reduce the swelling. You need to avoid eating hard and sticky, soft and chewy candy and foods. You will receive a list of foods not to eat. It is called our "Food for Thought" list. DO NOT eat anything on this list as it may break your appliance!

RPE – Rapid Palatal Expander

Congratulations! The appliance you have received today is called a Rapid Palatal Expander. We hope all of your questions have been answered concerning your new appliance. However, we would like you to take this information home so that you and/or your parents may use this as a reference.

Our doctors will instruct you on how often to turn your appliance. This is done with the key, which we have provided you with today. Be sure to keep it in a safe place. Your RPE cannot be turned without your key. We recommend you turn your appliance at night before bed. You may feel some discomfort on the roof of your mouth or across the bridge of your nose after turning your appliance. This is normal and should only last 20-30 minutes.

After a few weeks, you may notice a space open between your two front teeth. This is OK, as it tells our doctors that your appliance is working. Don't worry; we will close your space later in your treatment. During the active turning of your appliance, our doctors will want to check your teeth about once every 2-3 weeks. Once the appliance has done its job, we will leave it in for about 4-6 months and continue to monitor you every 8-10 weeks.

As far as eating is concerned, we suggest you cut your food into small pieces until you get used to chewing with your appliance. It is going to feel strange having something in the roof of your mouth. It may be a little different to swallow at first, but usually after 2-3 days, it will feel pretty normal! Remember to stay away from sticky, chewy foods. Also stay clear of nuts and popcorn. They have a tendency to get lodged under your appliance. Please read our "Food for Thought."

Be sure to notify the office if you have any difficulty with your new RPE. An arrangement will be made to see you ASAP.

If you have any further questions, please feel free to call us. We are here to serve you. Good Luck!

Fravel Brewer Orthodontics

  • Fravel Brewer Orthodontics - 1291 Blackwood Ave., Ocoee, FL 34761 Phone: (407) 656-0001 Fax: (407) 656-5290

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