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Fixed Appliances

Fixed Appliances

Band & Loop

band and loop

A Band & Loop is routinely used to hold space for a missing baby tooth until the permanent tooth can grow in.

Herbst Appliance

herbst appliance

In Class II malocclusions exhibiting severe overjet (“bucked tooth”) a Herbst appliance is designed to encourage the lower jaw to grow forward and catch up to upper jaw growth.

Lower Lingual Arch

lower lingual arch

A lower lingual arch is a space maintainer for the lower teeth. It maintains lower molar position. Molar bands are placed on the right and left molar connecting them using a wire that fits up against the inside of the lower teeth; this keeps the molars from migrating forward. By holding the molars in the correct position the space needed for the permanent cuspid and bicuspid is protected allowing them to erupt correctly. This is used when baby teeth are lost early, or when lower teeth are slightly crowded in a growing child and you want to avoid removing any permanent teeth to correct the crowding.



The Nance appliance maintains the position of the maxillary molars similar to the lower lingual arch. The appliance has a small plastic button on the palate to provide stability.

Palatal Expander

palatal expander

A palatal expansion appliance is a dental appliance which is placed in the roof of the mouth to widen the upper dental arch. Sometimes this appliance is called a RPE. This appliance is activated by making a series of turns of the adjustment screw – each turn widens the appliance ¼ of a millimeter – four (4) turns equal one (1) millimeter. After measuring the amount of expansion needed to correct the crossbite, Dr. West gives the parent instructions on how many days they will be making adjustments, usually at the pace of one (1) turn [¼ millimeter] per day.

A temporary space may develop between the upper two front teeth. This will slowly go away. Once the desired expansion has been achieved, the appliance is worn for several months to prevent relapse to the constricted state. With time the bone of the maxilla fills in and the palate returns to normal except that the upper dental arch it is wider.

Quad Helix

quad helix

This appliance provides continual, gradual pressure in as many as four directions, to move molars, expand or contract arches, or assists in eliminating finger or thumb sucking habits. It is known as a quad helix because it has 4 helical loops which allow for periodic adjustments by Dr. West.

Bi Helix

bi helix

An appliance used to expand the lower arch without interfering with tongue posture or movement.

Lower Lip Bumper

A lower lip bumper is an appliance which is used to relieve crowding in the lower arch prior to the eruption of the second permanent molars. The lower first molars are banded and special attachments on the bands allow the appliance to be placed. The appliance is worn 24/7. The anterior bow of the appliance sits just inside the mouth behind the lip. The lips then exerts a constant pressure on the appliance with the goal of moving the first molars backwards and opening space to relieve lower crowding. As needed, the lip bumper can be removed by Dr. West and adjusted to continue moving the molar teeth to acquire the space needed for orthodontic correction.


Although not used as often as it once was, headgear is an effective auxiliary appliance used to move upper posterior teeth backwards. Although there are several uses of headgear, a major indication for its use is to move the entire upper arch posteriorly to correct severe Class II malocclusions when the upper arch is diagnosed to be too far forward. Another use is to move teeth posteriorly to open space lost due to premature loss of primary teeth. If the eruption of permanent teeth is impeded due to space lost, headgear might be used to re-open lost space to allow the eruption of the blocked out tooth.