Throughout your treatment, we will instruct you on how to wear the specific orthodontic appliance necessary for your treatment. Please feel free to call us if you have any questions or concerns. For your convenience, instructions for wearing each orthodontic appliance are provided below in chronological order. Depending on your treatment, you may not need some of the following appliances.

Spacers (Separators)

The first step in your orthodontic treatment is to obtain separation by placing spacers in between your teeth. During the next few days, you may experience some discomfort as the teeth begin their initial movements. Generally, discomfort is mild and subsides within a couple of days. Common pain relievers, such as Advil, can be taken if needed.

The spacers generally stay in place until your banding appointment. In the coming weeks, please call us for replacement evaluation if any of your spacers come out sooner than the day before your banding appointment.

To minimize losing spacers, please:

• Avoid sticky foods (for example: candy and gum) that could pull the separator out of place.

• Avoid flossing the areas that have spacers.
• Brush gently around the spacers.
• Keep the spacers in place even if they feel loose.

We will make every effort to ensure you are comfortable. Please call us with any questions you may have.

Download Spacer Information

Removable Expander

The removable expander will be worn for several months to widen your upper or lower jaw. The expander must be adjusted to be effective:

• Please adjust the screw ONCE every week.

Following these guidelines will ensure effective treatment:

• Wear the expander 14 hours a day after school, starting the very first day.

• Every morning, take the expander out and brush it in cold water. Never use hot water. Be sure to place the expander back in its case and store it in a safe drawer in your bathroom.
• Bring your expander to every appointment so that we can check it and make the necessary adjustments.
• Never leave your expander outside its case. This is a very common way of losing it.
• Please call us as soon as you can if your expander no longer fits or is lost. Your teeth can move quickly. If you wait too long, we may not be able to adjust your expander.

Download Removable Expander Information

Palatal Expander

The Palatal Expander will be worn for several months to widen your upper jaw. The expander must be adjusted to be effective:

*Please adjust the screw on your UPPER expander ONCE every OTHER day for 27 days.

*Please adjust the screw on your LOWER expander ONCE every OTHER day for 27 days.

The best time for the adjustment is first thing in the morning or right after dinner. This way, you will have time to get used to the tightness before you begin the day’s activities or before you go to sleep. Please call us if you have difficulty adjusting your expander.

While wearing your expander you may notice:

• Extra space between your upper front teeth. This is temporary and the space will close within a few weeks.
• Speech and swallowing difficulties. These difficulties are also temporary and should improve within a few days. Reading out loud will help improve your speech.
• Sore areas on the cheeks and tongue during the first few days. Please use the wax we provided to smooth the surface of the expander.

Following these guidelines will ensure effective treatment:

• Brush and floss your teeth and the expander frequently.
• To prevent breakage, avoid sticky or hard foods (for example: candy, gum, hard crusts, apples, carrots, popcorn, etc.).
• Adjust the expander very gently and remove the key after the adjustment to stop the hole from moving.
• If the expander loosens on one side: Push it back up and call us to set up an appointment.
• If the expander loosens on both sides: Take it out and bring it to your next appointment.

Please call us if you have any questions or concerns.

Download Palatial Expander Information

Headgear

Headgear corrects an “overbite” or an “under bite” by creating a pushing or pulling action, respectively, to guide the growth of the teeth and jaws. Headgear is effective when the upper and lower jaws are growing. This growth generally slows down around the age of 12 or 13, and mitigates the desired correction achieved by a headgear.

How to wear the headgear:

It is important to wear your headgear every day for 14 hours, most of it while sleeping. By not wearing your headgear consistently every day, you could compromise your orthodontic treatment. We recommend you wear the headgear as follows:

• Two hours after school, for a few days until it feels comfortable.
• Four hours after school, for a few days until it feels comfortable.
• Overnight wear for the next 5 days.
• Finally, 14 hours a day — four hours after school and about 10 hours during sleep time.

The hours the headgear should be worn are cumulative. Therefore, if you did not wear it as much during the week, try to make up the hours by wearing it more on the weekend.

We ask that you record the number of hours you wear your headgear. To download the tracking sheet, click here.

If the headgear is attached to a retainer:

• Wear the retainer 14 hours a day after school, starting the very first day. In addition, wear your headgear for increasingly longer periods as described above.
• Every morning, take the retainers out and brush them in cold water. Never use hot water. Be sure to place the retainers back in their case and store them in a safe drawer in your bathroom.

Remember:

• Bring your headgear to every appointment so that we can check it and make the necessary adjustments. The headgear is a very delicate instrument and is individually fitted and adjusted. You should not make any adjustments to your headgear. Please call us if you feel it does not fit properly.
• It is normal to experience tenderness the first few days. Don’t be discouraged because the tenderness will diminish as your teeth adjust to the new pressure. Call us if you continue to have discomfort.
• Do not play with your headgear or allow others to snap or pull it. Mistreatment of your headgear could result in harm to you or someone else. Always remove the strap before pulling the bow out from your teeth.
• Do not wear your headgear when running, swimming, or playing any contact sports.

It is important that you follow all these instructions. You’ll be done with your treatment sooner than you think! Please feel free to call us if you have any questions or concerns.

Download Headgear Information

Elastics (Rubber Bands)

One of the most important phases of your orthodontic treatment is when you are wearing your elastics. Elastics move your teeth and jaws into the desired position and create a proper bite by applying a small but continuous amount of pressure on the teeth and jaws. We recommend that you wear your elastics all the time, except when eating or brushing your teeth. Consistent wear of your elastics during the day and night will minimize your treatment time. Replace your elastics with new ones at least four times a day.

Please note the following guidelines:

• Poor or inconsistent wear of your elastics will prolong your orthodontic treatment. This is because the force that moves your teeth in the proper position is applied through your elastics. Failure to wear the elastics as directed, in many cases, will make your treatment goals impossible to achieve.
• Wear your elastics as instructed and your treatment time will be shorter. Dr. Rafati will occasionally change how you wear your elastics.
• Our goal is to maintain your progress. So, if you cannot wear your elastics as directed or you run out of elastics, don’t wait for your next appointment. Please call us as soon as you can.
• Minor discomfort and sore teeth are expected during the time you are getting used to the elastics. However, consistent wear of the elastics will diminish it significantly.

Download Elastics Information

Retainers

When your braces are removed, the teeth inside the bone are very loose; thus, they can easily move. Therefore, it is very important to wear your retainers as directed. Otherwise, your teeth will reposition themselves, and we will not be able to move them back in the proper position with retainers.

Your treatment fee will cover one set of retainers for the upper and lower teeth, which should last you a lifetime. We will follow up with you for two years to make sure your teeth are stable and steady, and that you got into the habit of wearing your retainers as recommended.

Please protect the time, effort, and money you have invested during your orthodontic treatment by complying with the following instructions:

• Wear your retainers for 14 hours a day for the first six months. If you attend school, wear them after school and at bedtime. Adults need to wear the retainers full time for the first year, except while eating and brushing. After the first year, they can cut back on the number of hours of wear until they wear them only at bedtime.

• Your teeth move throughout your life. Therefore, to maintain the best results you achieved, wear your retainers only at night after the first six months.
• Every morning, take the retainers out and brush them in cold water. Never use hot water. Be sure to place the retainers back in their case and store them in a safe drawer in your bathroom.
• Children attending school should never take their retainers to school. However, adults can take them to work and wear them at work.
• Never leave your retainers outside their case. This is a very common way of losing them. Never wrap them in a paper towel.
• Please call Rafati Orthodontics as soon as you can if you lose your retainer. Your teeth can move quickly; and if you wait too long, the retainers cannot move them back to their original position.

• If retainers are lost or broken, the fee to replace them is $200 per retainer. This fee includes an appointment to take a new impression, the lab fee to make your retainer, and the appointment to deliver your retainer.

Download Retainer Information