The General Dentist’s Quick Guide to Interceptive Orthodontic Appliances

When you first begin offering orthodontic treatment in your practice, knowing what appliance to use for your young patients can be challenging. In most instances, you will have several viable options to select from. So how do you choose?

We put together this quick guide to help you better understand your options when it comes to selecting which orthodontic appliance is right for your patient. For each appliance, we’ve detailed who needs it, what it does, how it works, and how long it should be used for.

With this little bit of quick knowledge, you can be well on your way to providing quality orthodontic care in your practice!

1. Rapid Palatal Expander Banded (RPE)

WHO NEEDS IT: Children 15 years and younger with posterior crossbite

WHAT IT DOES: Upper arch expansion and posterior crossbite correction

HOW IT WORKS: Bands are fitted to the first molars. A key is used to unscrew the appliance in increments to cause expansion.

TREATMENT DURATION: 1 mm expansion every 4 days followed by a 3 month hold period

2. Trans-Palatal Arch (TPA)

WHO NEEDS IT: Patients with mild crossbite

WHAT IT DOES: Expands and/or maintains upper arch width

HOW IT WORKS: A wire attached to 2 bands that are fitted to the last molars holds the teeth in place.

TREATMENT DURATION: Ranges from a few months to a few years

3. Galella Tongue Habit Appliance

WHO NEEDS IT: Patients with tongue thrust and finger habits

WHAT IT DOES: Corrects position of the tongue to improve swallowing patterns, discourages thumb sucking

HOW IT WORKS: The rolling ball on the appliance helps the patient posture the tongue properly, and for those with thumb sucking habits, as it rolls it makes the thumb move and discourages this habit  

TREATMENT DURATION: 8 to 12 months

4. Bionator

WHO NEEDS IT: Class II growing patients

WHAT IT DOES: Corrects overbite during growth

HOW IT WORKS: Advances the lower dentition, some distalization of the upper dentition, and postures the mandible forward

TREATMENT DURATION: 1-2 years

5. Cervical Headgear

WHO NEEDS IT: Class II patients with large maxilla or small mandibles 

WHAT IT DOES: Corrects class II by restricting maxilla growth

HOW IT WORKS: The module generates force through the facebow to the molar teeth, allowing the mandible to continue growing forward, while the maxilla is restricted.

TREATMENT DURATION: 1 to 2 years

6. Reverse Pull Headgear

WHO NEEDS IT: Class III patient

WHAT IT DOES: Corrects anterior crossbite and class III

HOW IT WORKS: Protracts the maxillary teeth and in young patients it has been shown that it also moves the maxilla forward

TREATMENT DURATION: 1 year is the most common, but sometimes 2 years

7. Lower Lingual Arch (LLA)

WHO NEEDS IT: Patients with mild crowding on the lower, before the loss of the lower second primary molars as a space maintainer, after alignment of the lower incisors in mixed dentition

WHAT IT DOES: Maintains space, holds the lower incisor position.

HOW IT WORKS: Keeps the lower molars from drifting mesially taking away space on the arch

TREATMENT DURATION: 6 months to 2 years

We hope that you can now feel more confident when it comes to selecting the right orthodontic appliances for your young patients.

If you’d like to take your orthodontic knowledge a step further, we recommend you attend Orthodontics for Children. This 6-day class will give you more detail on how to use these appliances to immediately help your young patients that need them. You may also consider our Comprehensive Orthodontic Training Program which will teach you how to provide quality orthodontics to not only children, but patients of all ages. You can learn about this program here or on our partner’s website posortho.com.