Orthodontic Appliances: What We Use and Why

Elastics help correct the relationship between your upper and lower teeth — fixing bite issues that braces alone cannot fully address. They are one of the most important parts of your treatment. The more consistently you wear them exactly as Dr. Bettagere directs, the faster your treatment will progress and the better your final result will be. Skipping elastics is one of the most common reasons treatment takes longer than planned.

The Forsus device is a spring-loaded appliance that works as an alternative to headgear. It works continuously — including while you sleep — to guide jaw growth in adolescents, reduce excessive overbites, and improve overall bite fit. In many cases, the Forsus device can prevent the need for jaw surgery later in life, making it one of the most valuable tools available for growing patients with significant overbites.

Headgear is used to correct overbites (upper teeth protruding) or underbites (lower teeth protruding) by guiding jaw growth during key developmental stages. While it may look unusual, headgear is a highly effective tool for patients whose jaws are still actively growing. An important note: headgear is always worn at home — never to school or work — which makes it much less disruptive to daily life than many patients initially fear.

The Herbst appliance is a fixed device that gently encourages the lower jaw forward and the upper molars backward — correcting overbite and improving bite function. It is most effective in younger, growing patients and is typically worn for 12 to 15 months. Unlike headgear, the Herbst appliance is fixed in place and works 24 hours a day, with no reliance on patient compliance for wearing it.

A palatal expander gently widens the upper jaw by applying consistent, light pressure to the upper molars over time. Dr. Bettagere will show you exactly how and when to make small adjustments at home — it takes just a few seconds each day. Once the desired width is achieved, the expander stays in place for several months to allow the bone to fully solidify and prevent the jaw from narrowing again. Expanders are most effective in younger patients while the palate is still developing.

Positioners are used at the very end of orthodontic treatment to make final, fine-tuned tooth adjustments and ensure your bite settles perfectly into place. With full cooperation, most patients only need to wear their positioner for four to eight weeks — a small commitment at the finish line for a beautifully polished result.

Retainers are one of the most important parts of your entire orthodontic journey — they hold your teeth in their new positions after treatment is complete, protecting everything you have worked for. We offer both removable and fixed retainer options depending on what is best for your specific case. Dr. Bettagere will give you clear, detailed instructions on how to care for your retainer and how long to wear it. Following those instructions is the single most important thing you can do to protect the long-term results of your treatment.

Separators (also called spacers) are small rubber rings temporarily placed between specific back teeth to create just enough space for orthodontic bands at your next appointment. They are removed before the bands are placed. While wearing separators, avoid sticky foods, toothpicks, and flossing near the spacers — this will help keep them in place until your next visit.

The MARA is a fixed appliance that corrects overbite by repositioning the lower jaw forward and the upper molars backward — similar in purpose to the Herbst appliance. It is most effective in younger, growing patients and is typically worn for 12 to 15 months. In some cases, Dr. Bettagere may recommend a Forsus Spring or Carriere Distalizer as an alternative, depending on your individual treatment needs and what will produce the best outcome for your case.

The Twin Block is a two-piece removable appliance — one piece for the upper arch, one for the lower — that works together to advance the lower jaw position and correct overbite. It is worn full time, including during meals, but can be removed for easy cleaning. Many patients find it more comfortable than other jaw-repositioning appliances because of its smooth acrylic construction and minimal wiring. It is particularly effective in growing patients when used during the right developmental window.