Katie B., Prosperity, SC

Orthodontic Appliances

Moving your teeth to achieve a great smile and a comfortable bite can be achieved in a number of ways. There are many types of braces (and even alternatives such as clear aligners), but they each serve the same purpose. Since they all work the same way, your choice should be based on the appearance you desire.

The types of braces we offer at Pitner Orthodontics are:

  • Metal braces
  • Clear (Ceramic) braces
  • Hidden lingual braces – braces that are hidden because they are attached to the back of your teeth

In addition we also offer clear aligners (Invisalign) — a series of clear retainers that gradually move your teeth into their ideal position.

How do braces work?

A set of braces consists of two parts: 1) the brackets — which are the “handles” attached directly to the teeth and 2) the wires — which are positioned in the slot of a bracket and apply pressure to the teeth. Traditional metal brackets are made of special medical grade stainless steel or titanium, while clear (or tooth colored) brackets are made of ceramic. Lingual braces are made of metal and attached to the back side of the teeth (tongue side which is why we use the term “lingual”). The wires can be held into the bracket in a number of ways. They can be tied into place using a very small and soft wire, with a colorful elastic tie, or possibly with a small door that is a part of the bracket. Once the brackets are attached, they remain in place for the duration of treatment (unless a patient breaks them by eating hard or sticky food!). The wires and ties are changed throughout treatment.

If the brackets are the “handles,” the wires are what actually cause the teeth to move. The initial wires are most often made of a nickel titanium alloy. This alloy was developed by NASA for antennas on space satellites. When a rocket launches, antennas can’t protrude because they would burn away on takeoff. Instead the antennas are made of nickel titanium alloy with “shape memory.” This means the alloy “remembers” the shape it wants to have. So an antenna can be coiled up in a compartment, but after launch, the compartment opens and an antenna will immediately straighten out into its pre-determined shape. Here on earth, we use this amazing ability in orthodontics! We place a small nickel titanium wire into the brackets of very crowded teeth. The wire “remembers” how it wants to be shaped (i.e. straight) and puts pressure on the teeth as it works to straighten out. Pretty cool, right?! This means a consistent light pressure is applied to the teeth, making 21st century braces much more comfortable than braces of the past. Using the same approach, wires can be made of many different materials and shapes, allowing more and more precise control over the position of your teeth.

Sometimes we do need to use additional appliances beyond just braces. You can learn more about these below.

Forsus Appliance

We use the Forsus appliance to help move the upper molars back while moving the lower teeth and jaw forward. Composed of a spring coil rod, the appliance is used while a patient is currently wearing braces. It runs from the upper first molar band down to the lower archwire. This appliance remains in place for 4-6 months and efficiently corrects protrusive teeth or blocked out teeth with no effort required by the patient.

Example of an appliance used.

Palatal Expander

Attached to the upper molars by cemented bands, a Palatal Expander is an orthodontic device used to create a wider space in the upper jaw. It is typically used when the upper jaw is too narrow for the lower jaw or when the upper teeth are crowded or blocked out of the dental arch.

When patients are still growing, the connective tissue between the left and right halves of their upper jaw is highly responsive to expansion. Simply activating the expander by turning a screw in the center (using a special key we provide) places gradual outward pressure on the left and right halves of the upper jaw. This pressure causes an increased amount of bone to grow between the right and left halves of the jaw, ultimately resulting in an increased width. Another appliance called a Quad Helix works in a similar way, but does not require activation by a key.

Reverse Pull Headgear

A Reverse Pull headgear works to correct an underbite by bringing the upper teeth and jaw forward. Reverse pull headgear is only effective before age 10, so it is used for early interceptive treatment. The severity of the problem determines the length of time headgear needs to be worn. The key to success with your headgear appliance is consistency. Headgear must be worn a certain number of hours each day, and if not, the time must be made up the following day.


Headgear can be used to correct excessively protruding teeth, particularly for young children in early treatment. This is done by placing pressure against the upper teeth and jaw, which holds the teeth in position or helps move them into better positions.

Connect with Pitner Orthodontics Today!

Should you have a need for orthodontic treatment, schedule your free initial consultation and exam with Pitner Orthodontics today to learn the best smile correction option for you. We look forward to meeting you!

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