Elastics/Rubber Bands

Why are they used?

They add an extra force to the braces to help move the teeth. For example, if the upper teeth are too far forward and the lower teeth are too far back, rubber bands may be stretched from the upper front teeth to the lower back teeth.

When are they worn?

They are worn usually at all times except when brushing. Part time wear may be recommended; Dr. Backus will determine a schedule. It is important to be consistent; the elastics will not work as well if they are not in place each day.

When are they changed?

Elastics are replaced at least once each day or they will lose their snap. Be sure to pick up plenty at the office. A few days without them can cause a serious setback.

Are there different sizes?

There are many sizes, each designed for a specific purpose. Wear only the size provided.

What can be expected?

The teeth may become sore when elastics are first used. This soreness will be gone in a few days. The teeth may become loose; that is a normal reaction to the elastic force. Expect to see progress; look for it carefully.

Why are they important?

The patient must help with this part of treatment in a substantial way if there is to be progress. It requires hard work, even though elastics are not comfortable. If elastics are worn one day and left off the next, your teeth will set up resistance that will slow or even stop your progress…. And discomfort in your mouth will increase. If elastics are worn one week and left off one day, your teeth could shift back to their original position.

What is your responsibility at each appointment?

At each appointment, be sure that you have sufficient elastics to last until the next appointment. If you run out of elastics, call or phone immediately. Never wait until the next appointment. We will mail them to you if it is impossible to pick them up at the office. Always be sure you understand exactly where each elastic hooks in the mouth.

Orthopedic Correctors/Forsus Appliance

The Forsus appliance is used in order to help move the upper molars back while moving the lower arch 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.

You may notice some discomfort initially, so we recommend a soft food diet for the first few days after the appliance is placed. Regular anti-inflammatory medication may help with any pain, if needed. It is important to keep the appliance clean; you may do this by carefully brushing the coil and other metal pieces of the appliance. Also, we recommend that patients not open their mouths very wide, as the appliance may come apart.

If your Forsus appliance breaks, please contact our office immediately to schedule a repair appointment.

Palatal Expanders

This special appliance (attached with bands) widens the roof of your mouth by gently separating the elastic membrane in the center of your palate. Once the palate has been fully expanded, new bone tissue fills that space.

Why is this sometimes necessary?

  • To expand the upper jaw for a proper fit with the lower jaw.
  • To make room for crowded teeth.

How long will it take?

  • This usually takes about 2 to 4 weeks to achieve our expansion.
  • The appliance remains in place for about 6 to 8 months to allow new bone tissue to generate in your expanded jaw.

Will I feel it moving?

  • You may sense some initial pressure, causing a tingling or itch under your appliance.
  • A tingling sensation may occur on the bridge of your nose.
  • You will see a temporary space between your two front teeth. The space closes again naturally.

What should I do during the expansion period?

  • Use your toothbrush carefully around the special appliance.
  • Use Listerine to keep your mouth free of spoiled, irritating food particles.
  • Take Advil for any discomfort.

How is the appliance activated?

The appliance is activated once every day, either in the morning or evening, unless we direct you otherwise.

  • You or one of your parents must “activate” your appliance as instructed by Dr. Backus.
  • Insert the Key carefully into the hole in the middle front part of the appliance. (Fig.A)
  • Push the Key gently and steadily from the front toward the back of your mouth. Do not back up. Remember—push the key toward the throat. You automatically bring a new key hole forward by pushing the key as far back as possible. It will now be ready for the next activation. (Fig. B)

Responsibility as a Parent…

  • Activate the appliance
  • Closely follow the schedule and instructions given by Dr. Backus
  • Do not rush or delay the activation of the appliance
  • Be sure the appliance is carefully cleaned each time you brush


What does it do?

It helps correct an excessive overbite by placing pressure against the upper teeth and jaw to hold the teeth in position or help move them back into better positions. It can also be used as an “orthopedic” appliance, helping control the growth of the jaws by “holding” the upper jaw and allowing the lower jaw to grow forward. The pressure used and time worn depends upon the severity of the problem. Orthopedic changes take place over an extended time period while the patient is growing. To produce a successful treatment result, the headgear must be worn every night.


A device with two parts: a soft strap with springs or elastics attached to it and a metal part, called a facebow, that fits into the bands or onto the archwires. A headgear adds extra force to the braces as they move the teeth.

How does it work?

By using your neck or head as an anchor, the strap or elastic bands produce a steady pressure that gradually aligns the protruding upper jaw and teeth with the lower jaw and teeth. The headgear can work by slowing the growth of the upper jaw, giving the lower jaw time to catch up.

How long will it be worn?

The headgear is usually worn a year or more to correct an excessive overbite. If it is being used to hold the back teeth in place, it will usually be worn for only a portion of the total treatment time.

How often should it be worn?

The more it is worn, the faster the teeth move. Dr. Backus will recommend the correct number of hours. Usually it is worn 12 to 14 hours each day. If it is not worn enough on one day, the time must be made up on the next day. Once headgear treatment is started, it must be adhered to continuously. THE KEY TO SUCCESS WITH YOUR HEADGEAR IS CONSISTENCY.

When is it not to be worn?

The headgear should never be worn during any active sport or activity such as swimming, soccer or dancing. It should be removed during meals and while brushing your teeth.

Taking care of it

Make sure to put the headgear in a place where it won’t be stepped on or lost. Brush it with a toothbrush to keep it clean and shiny. The strap can be washed in cold, soapy water.

Be careful! Always be very careful placing it or removing it because the wires can be dangerous. There will be clear instructions for this procedure. Note: Always remove the elastic force before removing the headgear from your mouth to prevent it from springing back and causing injury to the face or eyes.

If it hurts or breaks. Call the office to arrange an appointment to adjust or repair it. If it is lost or broken beyond repair, there may be a replacement charge.


Separators or spacers are small elastics that fit snugly between certain teeth to move them slightly so bands can be placed around them later. Separators can fall out on their own if enough space has already been created. To determine if it needs to be replaced, slip some dental floss between the teeth; if it gets stuck, that means the spacer hasn’t created enough room and needs to be replaced prior to your banding appointment.

Lingual Arch

A Lower Lingual Arch acts as a space maintainer to keep the molars from drifting forward, and prevent them from blocking the space where permanent teeth will eventually erupt. This appliance is commonly used in cases of premature loss of baby tooth or when the lower teeth of a growing child is slightly crowded and no permanent teeth are extracted to correct the problem.

You should expect soreness the first day or two, and it may hurt to chew. We recommend a soft diet initially. You may take Advil or Tylenol to relieve the pain. Avoid sticky or hard foods, and please monitor how many foods you eat that are high in sugar.

Brushing and flossing daily is very important. Be sure to clean around the bands that are connected to the molars and the wire on the tongue side. This will prevent the formation of cavities or infection of the gums.

The duration of wear varies. We will monitor the eruption of new teeth and make adjustments. Generally, the Lower Lingual Arch is removed following the eruption of all the permanent teeth.

Trans-Palatal Arch

The Trans-Palatal Arch is an orthodontic appliance used to maintain the upper jaw’s arch width and move molars into positions that wires alone can’t. The appliance is banded around the first molars on each side of the mouth, and a thin wire spans across the roof of the mouth.

Patients should be sure to brush their appliance daily. Also, avoid sticky, chewy or hard foods as these can get caught between the appliance and the roof of your mouth. These foods may also break your Trans-Palatal Arch.


One of the many important advances in orthodontics has been the development of temporary anchorage devices, or TADs. Made of a bio-compatible titanium alloy, TADs are miniscrew anchors which are inserted into specific places in the mouth to be used as a fixed point from which teeth can move. Before TADs, orthodontists who wanted to move some teeth while keeping others still or to achieve orthodontic movement in a mouth with missing teeth had to rely on headgear for their fixed point. But TADs now provide an option for that fixed point that is smaller, more discrete, and more efficient and requires significantly less work for the patient.

Temporary anchorage devices may not be recommended for everyone, and in fact, anchorage devices at all may not be needed in all cases. Contact us if you’d like to know more about TADs and how they can potentially prevent you from needing orthodontic headgear.

Disruptive Sleeping

Loud snorers may have a serious condition known as obstructive sleep apnea syndrome (OSAS). With this condition, air passages become blocked so greatly that no air can get through. This causes repeated awakenings throughout the night. OSAS can contribute or lead to many other conditions, such as high blood pressure, stroke, heart attack and depression, so it is important to be diagnosed by a medical professional if you experience any sleep-related symptoms.

Dr. Backus can treat OSAS utilizing orthodontic-related appliances, which can help open the airways during sleep.

Motion appliance (new to practice)