Learn About Orthodontic Appliances

During your treatment at Clinebell & Anderson Orthodontics, our doctors may prescribe an orthodontic appliance as part of your plan to get you the best possible result. Read below to find out more about these helpful tools.

Types of Orthodontic Appliances

Palatal Expander

An expander is a device used to widen the upper jaw. It is used to correct narrow dental arches and crossbites and can provide additional space to help treat crowding in the upper arch.  It consists of a metal framework with a small screw that fits across the roof of the mouth. As the screw is turned, the expander gradually applies gentle pressure on the palate and upper jaw, causing it to separate and widen.

Our doctors prescribe expanders for children and teens. Adults are not able to be treated with expanders as the sutures in the upper jaw fuse in the late teens and skeletal change from the expander alone is no longer feasible.

Tongue Thrusting Appliance

Tongue thrusting occurs when a patient presses their tongue against the teeth during swallowing, speaking, or resting. If thrusting is consistent, this can cause flaring and spacing of the front teeth and/or an open bite and should be addressed.

A tongue thrust appliance, also knows as a tongue crib, is designed to address a tongue thrust habit. The appliance is glued to bands on the upper molars and provides a barrier to the tongue from pushing on the teeth. It can help train the tongue to adopt a proper position during swallowing and rest.


The Herbst appliance is used in conjunction with braces to correct severe overbites or protruding upper teeth. It consists of a metal tube and rod on each side of the mouth that connect to the upper and lower teeth. It repositions the lower jaw forward and encourages proper growth, thereby helping to improve the bite and jaw relationship.

In our office, a Herbst is usually worn for 9-12 months. The ideal time for this appliance to be used is during the patient’s peak growth period which is usually between 10-13 for girls and 11-14 for boys.

Reverse Pull Headgear

Reverse Pull Headgear, also known as facemask or protraction headgear, is used in our office as it is still the gold standard for treatment of young children with an underdeveloped upper jaw. It consists of a custom-fitted facemask worn on the forehead and chin that is connected to an intraoral appliance by elastics. The appliance pulls the upper jaw forward and is used to treat underbites in children. When worn successfully, this treatment can prevent the need for jaw surgery later in life.

For optimal skeletal change, this appliance is used on patients 7-10 years old, although it can be used on older patients in certain circumstances. Dr. Clinebell and Dr. Anderson do not ask patients to wear the reverse pull headgear to school or social events but do prescribe wear of 12 hours/day for the best results. Patients will usually wear this for 6-12 months depending on the severity of their upper jaw deficiency.

Space Maintainers

A space maintainer, also known as a nance or lower lingual holding arch, is a fixed retainer that is used to maintain space in the upper or lower arch. It consists of a wire that runs along the tongue side of your teeth and prevents the permanent molars from drifting forward, allowing our doctors to preserve space for the proper eruption of permanent teeth.

At Clinebell & Anderson Orthodontics, these appliances are commonly used after phase 1 orthodontic treatment. They are also prescribed when a patient has lost one or more baby teeth early, and we don’t want to lose the space while the permanent teeth are forming below.

Temporary Anchorage Devices (TADs)

A TAD is a mini orthodontic implant used to provide additional anchorage during tooth movement. It is a small screw-like device that Dr. Clinebell or Dr. Anderson insert into specific locations of the jawbone to serve as an anchor point, enabling them to achieve more precise tooth control and facilitate complex tooth movements.

Some of the ways our doctors use TADs are to correct gummy smiles, intrude molars for your dentist to restore missing teeth, and to close spaces for missing permanent teeth to prevent the need for implants or bridges later in life.

Fixed Anterior Bite Plate

An anterior bite plate is an appliance used to address severe deep bites. It is glued to bands on the upper molars and consists of acrylic positioned behind the upper front teeth. This acrylic prevents the patient from biting all the way down and resets their overbite, allowing eruption of the back teeth and correction of the problem. This appliance may be used with or without braces depending on the patient’s growth and dental development.

Thumb / Finger Habit Appliance

Thumb sucking that persists beyond the eruption of primary teeth can cause improper growth of the jaws, misalignment of the teeth, crossbites, and open bites. If the habit continues past age 6 when the permanent front teeth are starting to erupt, we recommend scheduling a consult with our doctors to discuss what should be done to break the habit and allow for proper growth and development of the permanent teeth and jaws.

A habit appliance may be prescribed by Dr. Clinebell or Dr. Anderson to stop thumb or finger-sucking habits. It is glued to bands on the upper molars and is designed to block the fingers or thumb and make the digit sucking less satisfying, serving as a reminder to break the habit. With patient and parent support, this appliance is extremely successful, and we have seen habits stopped within a week!