Separators

Separators (Spacers) are small rubber rings or metal springs that are placed between the teeth to slightly separate them. Over a few days the spacers gently move certain teeth apart to allow for band placement on your next visit. Rubber separators may feel like there is food stuck in your teeth and metal springs may rock and feel loose. Please follow these instructions: Avoid playing with them and do not floss in those areas. AVOID EATING STICKY OR CHEWY FOODS, SUCH AS GUM, CARAMEL, TAFFY, JELLY BEANS, NOW AND LATERS, SKITTLES, STARBURSTS, ETC(Of course, all of the foods to avoid cannot be named, so please exercise caution when selecting your snacks and meals.) Occasionally, spacers fall out when adequate space is available. If this occurs the day before your appointment, it is not necessary to replace them. However, if this occurs sooner, please call us to replace them. You may experience some discomfort or a feeling of tightness that may persist for a couple of days. Non-prescription pain remedies are recommended to alleviate any discomfort.

Separators
Separators (Spacers) are small rubber rings or metal springs that are placed between the teeth to slightly separate them. Over a few days the spacers gently move certain teeth apart to allow for band placement on your next visit. Rubber separators may feel like there is food stuck in your teeth and metal springs may rock and feel loose. Please follow these instructions: Avoid playing with them and do not floss in those areas. AVOID EATING STICKY OR CHEWY FOODS, SUCH AS GUM, CARAMEL, TAFFY, JELLY BEANS, NOW AND LATERS, SKITTLES, STARBURSTS, ETC(Of course, all of the foods to avoid cannot be named, so please exercise caution when selecting your snacks and meals.) Occasionally, spacers fall out when adequate space is available. If this occurs the day before your appointment, it is not necessary to replace them. However, if this occurs sooner, please call us to replace them. You may experience some discomfort or a feeling of tightness that may persist for a couple of days. Non-prescription pain remedies are recommended to alleviate any discomfort.

If you have any questions or concerns, please feel free to call our office. Kensington Orthodontic Specialists: (248)-684-6833 ____spacers have been placed. Please count them daily.

If you have any questions or concerns, please feel free to call our office. Kensington Orthodontic Specialists: (248)-684-6833 ____spacers have been placed. Please count them daily.

Rapid Palatal Expanders

A Rapid Palatal Expander (RPE) is used to expand or widen the upper jaw in cases where the jaw is too narrow and/or there is excessive crowding. The upper jaw forms as two bones that fuse after puberty. In young patients, we are able to use an RPE to separate the two bones. The appliance is cemented in place using bands on two or four teeth, using acrylic or incorporated into another appliance (i.e. Distalizing Appliance, MARA or Facemask). The appliance is turned daily (or every other day) either by the patient or a parent as instructed (usually at the same time, either in the morning or evening). The key is inserted in the hole and then pushed all the way to the back of the throat. This will bring the next keyhole into view. After a full turn is complete, release the key straight down. Pulling the key back out of the mouth while still in the keyhole will undo the turn and the next keyhole disappears. If you miss a day of turning, do NOT try to make up for the missed turn by doubling the next day. Instead, keep track of the number of turns completed and inform us of any missed turns at your next visit. If an appointment is missed, please discontinue turning the RPE until you are seen at the rescheduled appointment. Temporarily, a gap between the two front teeth may develop. It will close partially by itself and then fully with the braces. After the palate has been widened, the RPE will stay in place for a minimum of 4-6 months to allow new bone to form. During this waiting time, braces will be placed on the teeth to begin straightening them. You may experience mild difficulty in speech, soreness/sensitivity, excessive saliva and pressure marks on the tongue. Your tongue and mouth will adapt and return to normal in time. Non-prescription pain remedies are recommended to alleviate any discomfort. Cleaning Instructions: Brush at least three times daily Rinse vigorously with water to flush out the food that gets caught between the RPE and the roof of the mouth (a WaterPik is a useful tool to clean this area of the RPE) Use a fluoride rinse (Colgate Phos-Flur) daily Do NOT play with the RPE Avoid sticky or chewy foods, especially gum! If the RPE becomes loose, please call our office immediately! (248)-684-6833

Rapid Palatal Expanders

A Rapid Palatal Expander (RPE) is used to expand or widen the upper jaw in cases where the jaw is too narrow and/or there is excessive crowding. The upper jaw forms as two bones that fuse after puberty. In young patients, we are able to use an RPE to separate the two bones. The appliance is cemented in place using bands on two or four teeth, using acrylic or incorporated into another appliance (i.e. Distalizing Appliance, MARA or Facemask). The appliance is turned daily (or every other day) either by the patient or a parent as instructed (usually at the same time, either in the morning or evening). The key is inserted in the hole and then pushed all the way to the back of the throat. This will bring the next keyhole into view. After a full turn is complete, release the key straight down. Pulling the key back out of the mouth while still in the keyhole will undo the turn and the next keyhole disappears. If you miss a day of turning, do NOT try to make up for the missed turn by doubling the next day. Instead, keep track of the number of turns completed and inform us of any missed turns at your next visit. If an appointment is missed, please discontinue turning the RPE until you are seen at the rescheduled appointment. Temporarily, a gap between the two front teeth may develop. It will close partially by itself and then fully with the braces. After the palate has been widened, the RPE will stay in place for a minimum of 4-6 months to allow new bone to form. During this waiting time, braces will be placed on the teeth to begin straightening them. You may experience mild difficulty in speech, soreness/sensitivity, excessive saliva and pressure marks on the tongue. Your tongue and mouth will adapt and return to normal in time. Non-prescription pain remedies are recommended to alleviate any discomfort. Cleaning Instructions: Brush at least three times daily Rinse vigorously with water to flush out the food that gets caught between the RPE and the roof of the mouth (a WaterPik is a useful tool to clean this area of the RPE) Use a fluoride rinse (Colgate Phos-Flur) daily Do NOT play with the RPE Avoid sticky or chewy foods, especially gum! If the RPE becomes loose, please call our office immediately! (248)-684-6833

Distalizer
The Distalizing Appliance is fixed in place and is activated by the orthodontist to begin orthodontic movement of the upper molars in a backward direction. The appliance is cemented in place using bands on the molars and bands on the premolars or wires on their top surfaces. This appliance may also have a rapid palatal expander incorporated into its design. If so, the appliance is turned daily either by the patient or a parent as instructed (usually at the same time, either in the morning or evening, once every day). Instructions for Expander Portion: The key is inserted in the hole and then pushed all the way to the back of the throat. This will bring the next keyhole into view. After a full turn is complete, release the key straight down. Pulling the key back out of the mouth while still in the keyhole will undo the turn and the next keyhole disappears. If you miss a day of turning, do NOT try to make up for the missed turn by doubling the next day. Instead, keep track of the number of turns completed and inform us of any missed turns at your next visit. Temporarily, a gap between the two front teeth may develop. It will close partially by itself and then fully with the braces. If an appointment is missed, please discontinue turning the RPE until you are seen at the rescheduled appointment. On average, the appliance remains in the mouth for 8-12 months. During this time, braces will be placed on the teeth to begin straightening them. You may experience mild difficulty in speech, soreness/sensitivity, excessive saliva and pressure marks on the tongue. Your tongue and mouth will adapt and return to normal in time. Non-prescription pain remedies are recommended to alleviate any discomfort. Cleaning Instructions: Brush at least three times daily Rinse vigorously with water to flush out the food that gets caught between the appliance and the roof of the mouth (a WaterPik is a useful tool to clean this area) Use a fluoride rinse (Colgate Phos-Flur) daily Do NOT play with the appliance Avoid sticky or chewy foods, especially gum!

Distalizer
The Distalizing Appliance is fixed in place and is activated by the orthodontist to begin orthodontic movement of the upper molars in a backward direction. The appliance is cemented in place using bands on the molars and bands on the premolars or wires on their top surfaces. This appliance may also have a rapid palatal expander incorporated into its design. If so, the appliance is turned daily either by the patient or a parent as instructed (usually at the same time, either in the morning or evening, once every day). Instructions for Expander Portion: The key is inserted in the hole and then pushed all the way to the back of the throat. This will bring the next keyhole into view. After a full turn is complete, release the key straight down. Pulling the key back out of the mouth while still in the keyhole will undo the turn and the next keyhole disappears. If you miss a day of turning, do NOT try to make up for the missed turn by doubling the next day. Instead, keep track of the number of turns completed and inform us of any missed turns at your next visit. Temporarily, a gap between the two front teeth may develop. It will close partially by itself and then fully with the braces. If an appointment is missed, please discontinue turning the RPE until you are seen at the rescheduled appointment. On average, the appliance remains in the mouth for 8-12 months. During this time, braces will be placed on the teeth to begin straightening them. You may experience mild difficulty in speech, soreness/sensitivity, excessive saliva and pressure marks on the tongue. Your tongue and mouth will adapt and return to normal in time. Non-prescription pain remedies are recommended to alleviate any discomfort. Cleaning Instructions: Brush at least three times daily Rinse vigorously with water to flush out the food that gets caught between the appliance and the roof of the mouth (a WaterPik is a useful tool to clean this area) Use a fluoride rinse (Colgate Phos-Flur) daily Do NOT play with the appliance Avoid sticky or chewy foods, especially gum!

If the appliance becomes loose, call our office immediately! (248)-684-6833

If the appliance becomes loose, call our office immediately! (248)-684-6833

MARA
The Mandibular Anterior Repositioning Appliance (MARA) is cemented on the first molars and has an upper portion and a lower portion. The upper portion guides the lower portion to bite more forward and in turn, stimulate growth. Unfortunately, since growth is a necessity for the appliance to achieve a more harmonious occlusion, the results depend highly upon favorable growth and response to treatment. Usually the appliance is used as an alternative approach to future orthognathic surgical correction. The upper portion may also have an expander incorporated into its design. If so, the appliance is turned daily either by the patient or a parent as instructed (usually at the same time, either in the morning or evening, once every day). The orthodontist will activate the MARA. Depending upon the severity of the correction, the appliance will be maintained between 8-12 months. Instructions for Expander Portion: The key is inserted in the hole and then pushed all the way to the back of the throat. This will bring the next keyhole into view. After a full turn is complete, release the key straight down. Pulling the key back out of the mouth while still in the keyhole will undo the turn and the next keyhole disappears. If you miss a day of turning, do NOT try to make up for the missed turn by doubling the next day. Instead, keep track of the number of turns completed and inform us of any missed turns at your next visit. Temporarily, a gap between the two front teeth may develop. It will close partially by itself and then fully with the braces. If an appointment is missed, please discontinue turning until you are seen at the rescheduled appointment. You may experience mild difficulty in speech, sensitivity, excessive saliva, muscle soreness and pressure marks on the tongue. Your tongue and mouth will adapt and return to normal in time. Non-prescription pain remedies are recommended to alleviate any discomfort. Cleaning Instructions: Brush at least three times daily Rinse vigorously with water to flush out the food that gets caught between the appliance and the roof of the mouth (a WaterPik is a useful tool to clean this area) Use a fluoride rinse (Colgate Phos-Flur) daily Do NOT play with the appliance Avoid sticky or chewy foods, especially gum! If the appliance becomes loose, call our office immediately! (248)-684-6833

MARA
The Mandibular Anterior Repositioning Appliance (MARA) is cemented on the first molars and has an upper portion and a lower portion. The upper portion guides the lower portion to bite more forward and in turn, stimulate growth. Unfortunately, since growth is a necessity for the appliance to achieve a more harmonious occlusion, the results depend highly upon favorable growth and response to treatment. Usually the appliance is used as an alternative approach to future orthognathic surgical correction. The upper portion may also have an expander incorporated into its design. If so, the appliance is turned daily either by the patient or a parent as instructed (usually at the same time, either in the morning or evening, once every day). The orthodontist will activate the MARA. Depending upon the severity of the correction, the appliance will be maintained between 8-12 months. Instructions for Expander Portion: The key is inserted in the hole and then pushed all the way to the back of the throat. This will bring the next keyhole into view. After a full turn is complete, release the key straight down. Pulling the key back out of the mouth while still in the keyhole will undo the turn and the next keyhole disappears. If you miss a day of turning, do NOT try to make up for the missed turn by doubling the next day. Instead, keep track of the number of turns completed and inform us of any missed turns at your next visit. Temporarily, a gap between the two front teeth may develop. It will close partially by itself and then fully with the braces. If an appointment is missed, please discontinue turning until you are seen at the rescheduled appointment. You may experience mild difficulty in speech, sensitivity, excessive saliva, muscle soreness and pressure marks on the tongue. Your tongue and mouth will adapt and return to normal in time. Non-prescription pain remedies are recommended to alleviate any discomfort. Cleaning Instructions: Brush at least three times daily Rinse vigorously with water to flush out the food that gets caught between the appliance and the roof of the mouth (a WaterPik is a useful tool to clean this area) Use a fluoride rinse (Colgate Phos-Flur) daily Do NOT play with the appliance Avoid sticky or chewy foods, especially gum! If the appliance becomes loose, call our office immediately! (248)-684-683

Facemask
The Facemask (Reverse Headgear) is used to attempt to improve an underbite. An underbite is characterized by the upper teeth/jaw being behind the lower teeth/jaw. Unfortunately, since growth is a necessity for the appliance to achieve a more harmonious occlusion, the results depend highly upon favorable growth and response to treatment. Usually the appliance is used as an alternative approach to future orthognathic surgical correction. The treatment of patients with this type of bite is one of the most complex and unpredictable types. Even following initial facemask therapy, outgrowing treatment with relapse of the underbite may occur. Depending upon the severity of the correction, the appliance will be maintained between 6-12 months. The facemask has a forehead pad and a chin pad that are connected by a metal rod and a metal crossbar that is attached to the metal rod. The elastics are placed on the hooks attached to the expander in your mouth (one elastic per hook) to the crossbar on the facemask. The facemask is held so the pads are against your forehead and chin. The elastics should be changed daily. The facemask should be worn at least 12-14 hours per day. This usually includes after school/dinner and during sleep hours. The more the appliance is worn, the quicker the results will be achieved. Not wearing the facemask for even one day may result in partial loss of correction. Consistent and routine wear is absolutely necessary for the facemask to be effective. There is an adjustment period before becoming comfortable with wearing the facemask while sleeping. The more time the facemask is worn before bedtime, the more easily you will be able to fall asleep. Care Instructions: Chin irritation ~ discontinue wear for 1-2 days to allow healing and use moisturizing lotions during the day (if persists, place a piece of silk material or baby powder on chin pad to maintain dryness) No rough housing, horseplay, fooling around when wearing the appliance; INJURY can result Do not leave within reach of pets; they can damage the appliance Keep track of how many hours the appliance is being worn Always bring the appliance with you to each appointment If the facemask becomes broken/lost, please call our office! (248)-684-6833

Facemask
The Facemask (Reverse Headgear) is used to attempt to improve an underbite. An underbite is characterized by the upper teeth/jaw being behind the lower teeth/jaw. Unfortunately, since growth is a necessity for the appliance to achieve a more harmonious occlusion, the results depend highly upon favorable growth and response to treatment. Usually the appliance is used as an alternative approach to future orthognathic surgical correction. The treatment of patients with this type of bite is one of the most complex and unpredictable types. Even following initial facemask therapy, outgrowing treatment with relapse of the underbite may occur. Depending upon the severity of the correction, the appliance will be maintained between 6-12 months. The facemask has a forehead pad and a chin pad that are connected by a metal rod and a metal crossbar that is attached to the metal rod. The elastics are placed on the hooks attached to the expander in your mouth (one elastic per hook) to the crossbar on the facemask. The facemask is held so the pads are against your forehead and chin. The elastics should be changed daily. The facemask should be worn at least 12-14 hours per day. This usually includes after school/dinner and during sleep hours. The more the appliance is worn, the quicker the results will be achieved. Not wearing the facemask for even one day may result in partial loss of correction. Consistent and routine wear is absolutely necessary for the facemask to be effective. There is an adjustment period before becoming comfortable with wearing the facemask while sleeping. The more time the facemask is worn before bedtime, the more easily you will be able to fall asleep. Care Instructions: Chin irritation ~ discontinue wear for 1-2 days to allow healing and use moisturizing lotions during the day (if persists, place a piece of silk material or baby powder on chin pad to maintain dryness) No rough housing, horseplay, fooling around when wearing the appliance; INJURY can result Do not leave within reach of pets; they can damage the appliance Keep track of how many hours the appliance is being worn Always bring the appliance with you to each appointment If the facemask becomes broken/lost, please call our office! (248)-684-6833

Schwartz Appliance
The Schwarz Appliance is used on the lower teeth to broaden the arch. Although the appliance is removable, it should be worn at all times except when eating and brushing your teeth. During the active phase of wear, the appliance should be turned one time per week. Use the key provided to turn the screw in the direction indicated by the arrow on the appliance. The turn should be made with the appliance out of your mouth and then the appliance should be placed back into your mouth. You will be instructed when to stop turning the appliance and then it will be worn as a retainer. You may experience mild difficulty in speech, sensitivity, and excessive saliva. It may take one week or greater to adjust. Cleaning & Care Instructions: Brush or rinse with water every time you take them out. (After brushing your teeth, brush the appliance with the leftover toothpaste or soak them in an ultrasonic cleaner with a tablet for 5-10 minutes.) Store the appliance in the case provided; NEVER wrapped in a napkin or placed in your pocket. Do NOT use very hot water to clean them and do NOT leave them in a hot car; they will distort and no longer fit. Do NOT leave within reach of pets; they can damage the appliance Do NOT play with the appliance; use your fingers to place and remove; NOT your tongue. Always bring the appliance with you to each appointment. If the facemask becomes broken or lost, please call our office!

Schwartz Appliance
The Schwarz Appliance is used on the lower teeth to broaden the arch. Although the appliance is removable, it should be worn at all times except when eating and brushing your teeth. During the active phase of wear, the appliance should be turned one time per week. Use the key provided to turn the screw in the direction indicated by the arrow on the appliance. The turn should be made with the appliance out of your mouth and then the appliance should be placed back into your mouth. You will be instructed when to stop turning the appliance and then it will be worn as a retainer. You may experience mild difficulty in speech, sensitivity, and excessive saliva. It may take one week or greater to adjust. Cleaning & Care Instructions: Brush or rinse with water every time you take them out. (After brushing your teeth, brush the appliance with the leftover toothpaste or soak them in an ultrasonic cleaner with a tablet for 5-10 minutes.) Store the appliance in the case provided; NEVER wrapped in a napkin or placed in your pocket. Do NOT use very hot water to clean them and do NOT leave them in a hot car; they will distort and no longer fit. Do NOT leave within reach of pets; they can damage the appliance Do NOT play with the appliance; use your fingers to place and remove; NOT your tongue. Always bring the appliance with you to each appointment. If the facemask becomes broken or lost, please call our office!

Kensington Orthodontic Specialists (248)- 684-6833

Kensington Orthodontic Specialists (248)- 684-6833

Diet & Eating Habits

Braces (Brackets and Bands) are attached to your teeth with an adhesive that normally will withstand the forces of eating. A careful orthodontic patient can probably eat almost any food and do no damage to the appliances. However, certain foods may cause trouble. 1. HARD FOODS may do damage by bending the wires, loosening cement under the bands or breaking the brackets and tubes that are attached. 2. STICKY AND CHEWY FOODS damage appliances by bending wires and pulling brackets or bands loose. 3. FOODS HIGH IN SUGAR CONTENT should be avoided whenever possible. If you do indulge, brush your teeth immediately afterwards. If it is not convenient to brush, then always rinse vigorously with plain water. Hard Foods Hard Candy (Jolly Ranchers, Lollipops) Butter Fingers Peanut Brittle Granola Bars Ice cubes Pizza Crust Croutons Nuts Corn Chips (Doritos, Nachos, Fritos) Combos Hard Tacos Popcorn Sticky/Chewy Foods Gum Gummy Candy (Bears, Sour Patch Kids, Swedish Fish) Taffy Caramels Milk Duds Tootsie Rolls Starburst Now & Laters Licorice Skittles Fruit Roll-Ups Dried Fruits Beef Jerky Sweets Candy Ice Cream Cake Pie Cupcakes Presweetened Cereals Shakes/Malts Cookies Soda Pop (very acidic and high in sugar; limit to mealtimes)

Diet & Eating Habits

Braces (Brackets and Bands) are attached to your teeth with an adhesive that normally will withstand the forces of eating. A careful orthodontic patient can probably eat almost any food and do no damage to the appliances. However, certain foods may cause trouble. 4. HARD FOODS may do damage by bending the wires, loosening cement under the bands or breaking the brackets and tubes that are attached. 5. STICKY AND CHEWY FOODS damage appliances by bending wires and pulling brackets or bands loose. 6. FOODS HIGH IN SUGAR CONTENT should be avoided whenever possible. If you do indulge, brush your teeth immediately afterwards. If it is not convenient to brush, then always rinse vigorously with plain water. Hard Foods Hard Candy (Jolly Ranchers, Lollipops) Butter Fingers Peanut Brittle Granola Bars Ice cubes Pizza Crust Croutons Nuts Corn Chips (Doritos, Nachos, Fritos) Combos Hard Tacos Popcorn Sticky/Chewy Foods Gum Gummy Candy (Bears, Sour Patch Kids, Swedish Fish) Taffy Caramels Milk Duds Tootsie Rolls Starburst Now & Laters Licorice Skittles Fruit Roll-Ups Dried Fruits Beef Jerky Sweets Candy Ice Cream Cake Pie Cupcakes Presweetened Cereals Shakes/Malts Cookies Soda Pop (very acidic and high in sugar; limit to mealtimes)

Do NOT bite directly into anything (i.e. carrots, apples, hard breads, meats, crackers/biscuits, corn-on-the-cob). Cut into small pieces and chew carefully on the back teeth. Avoid habits (i.e. nail biting, chewing on pencils, thumb/tongue sucking). Do NOT pick or play with your appliances. Take SMALL BITES and chew food carefully. Of course, as every food cannot be listed, this is only a guideline, so please use your best discretion and judgment. If you have any questions or concerns, please call us! (248)- 684-6833

Do NOT bite directly into anything (i.e. carrots, apples, hard breads, meats, crackers/biscuits, corn-on-the-cob). Cut into small pieces and chew carefully on the back teeth. Avoid habits (i.e. nail biting, chewing on pencils, thumb/tongue sucking). Do NOT pick or play with your appliances. Take SMALL BITES and chew food carefully. Of course, as every food cannot be listed, this is only a guideline, so please use your best discretion and judgment. If you have any questions or concerns, please call us! (248)- 684-6833

Retainers
Your teeth are like everything else about you and as you age, they are going to want to change. In order to maintain your orthodontic results as best as possible, you have been given retainers. Please follow these instructions: Immediately after orthodontic treatment, retainers should be worn 24 hours a day (full-time wear). They may be removed for eating, brushing, drinking liquids other than plain water, playing sports or an instrument. Remember to brush or rinse vigorously after eating prior to wearing them. After a period of full-time wear, you will be instructed to decrease wear to approximately 12 hours a day (i.e. night-time wear). Eventually, you will be instructed to wear the retainers at least a few nights of the week for lifetime. When you first begin wearing your retainers, you will have trouble speaking and notice an increase in saliva. You will adapt and return to normal in time. Do NOT flip the retainers with your tongue. The retainers will break. Always use finger pressure to seat and remove your retainers; biting them in place will result in breakage. Make sure to bring your retainers to all retainer check appointments. If you grind or clench your teeth, invisible retainers will not withstand these pressures and may eventually breakdown. Hawley retainers are typically recommended. (Also ask your dentist about a splint/nightguard to protect your teeth.) Retaining your orthodontic result is a lifetime commitment. We recommend that you wear your retainers at night indefinitely (i.e. forever!) for maximum stability. Please also refer to the Retainer Care and Cautions form included for further instructions. Phase I Early Treatment: If these retainers were given after the completion of the initial phase of treatment, as more adult/permanent teeth erupt, the retainers will NOT fit as well. They are temporarily holding your teeth in place until you are ready for Phase II treatment. You will be seen every 6-12 months after your braces are removed to monitor your growth and development. If any problems occur, please call us immediately. Waiting will cause relapse of the teeth. (248)-684-6833 Congratulations on completing your orthodontic treatment!

Retainers
Your teeth are like everything else about you and as you age, they are going to want to change. In order to maintain your orthodontic results as best as possible, you have been given retainers. Please follow these instructions: Immediately after orthodontic treatment, retainers should be worn 24 hours a day (full-time wear). They may be removed for eating, brushing, drinking liquids other than plain water, playing sports or an instrument. Remember to brush or rinse vigorously after eating prior to wearing them. After a period of full-time wear, you will be instructed to decrease wear to approximately 12 hours a day (i.e. night-time wear). Eventually, you will be instructed to wear the retainers at least a few nights of the week for lifetime. When you first begin wearing your retainers, you will have trouble speaking and notice an increase in saliva. You will adapt and return to normal in time. Do NOT flip the retainers with your tongue. The r etainers will break. Always use finger pressure to seat and remove your retainers; biting them in place will result in breakage. Make sure to bring your retainers to all retainer check appointments. If you grind or clench your teeth, invisible retainers will not withstand these pressures and may eventually breakdown. Hawley retainers are typically recommended. (Also ask your dentist about a splint/nightguard to protect your teeth.) Retaining your orthodontic result is a lifetime commitment. We recommend that you wear your retainers at night indefinitely (i.e. forever!) for maximum stability. Please also refer to the Retainer Care and Cautions form included for further instructions. Phase I Early Treatment: If these retainers were given after the completion of the initial phase of treatment, as more adult/permanent teeth erupt, the retainers will NOT fit as well. They are temporarily holding your teeth in place until you are ready for Phase II treatment. You will be seen every 6-12 months after your braces are removed to monitor your growth and development. If any problems occur, please call us immediately. Waiting will cause relapse of the teeth. (248)-684-6833 Congratulations on completing your orthodontic treatment!

Habit Appliance
Habit (Tongue Crib) Appliance is used to eliminate and control thrusting/sucking habits of the tongue, thumb and/or finger. The appliance is cemented in place using bands on two teeth or may be incorporated into another appliance (i.e. RPE, MARA). The appliance attempts to direct the tongue behind the teeth and place it at the roof of the mouth during swallowing, which avoids thrusting the tongue against the teeth. This helps to eliminate the opening (lack of coupling) between the top and bottom teeth. The appliance may also be used to remind the patient to not suck their thumb or finger. You may experience mild difficulty in speech, soreness/sensitivity, excessive saliva and pressure marks on the tongue. Your tongue and mouth will adapt and return to normal in time. Non-prescription pain remedies are recommended to alleviate any discomfort. Since improper swallowing patterns are a subconscious action, it is very difficult to control. Therefore, the appliance may not be successful and limitations of correcting the malocclusion will occur. Sometimes the tongue is very strong and may cause the appliance to be imbedded in the tissue. If this occurs, the appliance will need removal and correcting the malocclusion will be limited. Cleaning Instructions: Brush at least three times daily Rinse vigorously with water to flush out the food that gets caught between the appliance and the roof of the mouth (a WaterPik is a useful tool to clean this area of the appliance) Use a fluoride rinse (Colgate Phos-Flur) daily Do NOT play with the appliance Avoid sticky or chewy foods, especially gum! If the habit appliance becomes loose, please call our office immediately!

Habit Appliance
Habit (Tongue Crib) Appliance is used to eliminate and control thrusting/sucking habits of the tongue, thumb and/or finger. The appliance is cemented in place using bands on two teeth or may be incorporated into another appliance (i.e. RPE, MARA). The appliance attempts to direct the tongue behind the teeth and place it at the roof of the mouth during swallowing, which avoids thrusting the tongue against the teeth. This helps to eliminate the opening (lack of coupling) between the top and bottom teeth. The appliance may also be used to remind the patient to not suck their thumb or finger. You may experience mild difficulty in speech, soreness/sensitivity, excessive saliva and pressure marks on the tongue. Your tongue and mouth will adapt and return to normal in time. Non-prescription pain remedies are recommended to alleviate any discomfort. Since improper swallowing patterns are a subconscious action, it is very difficult to control. Therefore, the appliance may not be successful and limitations of correcting the malocclusion will occur. Sometimes the tongue is very strong and may cause the appliance to be imbedded in the tissue. If this occurs, the appliance will need removal and correcting the malocclusion will be limited. Cleaning Instructions: Brush at least three times daily Rinse vigorously with water to flush out the food that gets caught between the appliance and the roof of the mouth (a WaterPik is a useful tool to clean this area of the appliance) Use a fluoride rinse (Colgate Phos-Flur) daily Do NOT play with the appliance Avoid sticky or chewy foods, especially gum! If the habit appliance becomes loose, please call our office immediately!

Kensington Orthodontic Specialists (248)-684-6833

Kensington Orthodontic Specialists (248)-684-6833

Elastics
Elastics (Rubber Bands) are used to generate a gentle but continuous force to help in the movement of individual teeth or in the alignment of one dental arch to the other. They are used to close spaces more efficiently and/or improve your bite. Teeth will move as desired when elastics are worn consistently and as instructed. When elastics are worn one day and left off the next, tooth movement does not continue and often no change takes place. Inconsistent elastic wear actually results in the bone and periodontal structures resisting movement. If you follow the instructions, you will get better and faster results in a more comfortable manner, and therefore, in turn results in a shorter period of time. There is often some initial discomfort when elastics are first worn, but this will disappear within a few days with consistent wear. Ibuprofen (Motrin) or Acetaminophen (Tylenol) can be taken to help ease the initial discomfort. Elastics lose their elasticity over time and should be changed a few times per day. Unless otherwise directed, your elastics should be worn 24 hours a day. The elastics should be removed to brush/floss your teeth, eating/drinking, and playing sports or an instrument. They should be replaced immediately following the activity. Please note that elastics are ALL-or-NOTHING: if you only wear them parttime (i.e. night time), they will do NOTHING. You should call the office if you are having trouble placing the elastics or you experience soreness in the jaw joint. Wearing the elastics improperly, will greatly affect your orthodontic results. If you run out of elastics, you can stop by the office to pick up some more or call us to mail them to you. Do NOT wait for your next visit; this can delay your treatment progress! (248)-684-6833 Type of Elastics: __________________________

Elastics
Elastics (Rubber Bands) are used to generate a gentle but continuous force to help in the movement of individual teeth or in the alignment of one dental arch to the other. They are used to close spaces more efficiently and/or improve your bite. Teeth will move as desired when elastics are worn consistently and as instructed. When elastics are worn one day and left off the next, tooth movement does not continue and often no change takes place. Inconsistent elastic wear actually results in the bone and periodontal structures resisting movement. If you follow the instructions, you will get better and faster results in a more comfortable manner, and therefore, in turn results in a shorter period of time. There is often some initial discomfort when elastics are first worn, but this will disappear within a few days with consistent wear. Ibuprofen (Motrin) or Acetaminophen (Tylenol) can be taken to help ease the initial discomfort. Elastics lose their elasticity over time and should be changed a few times per day. Unless otherwise directed, your elastics should be worn 24 hours a day. The elastics should be removed to brush/floss your teeth, eating/drinking, and playing sports or an instrument. They should be replaced immediately following the activity. Please note that elastics are ALL-or-NOTHING: if you only wear them parttime (i.e. night time), they will do NOTHING. You should call the office if you are having trouble placing the elastics or you experience soreness in the jaw joint. Wearing the elastics improperly, will greatly affect your orthodontic results. If you run out of elastics, you can stop by the office to pick up some more or call us to mail them to you. Do NOT wait for your next visit; this can delay your treatment progress! (248)-684-6833 Type of Elastics: __________________________