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Auxiliary Appliances

Correcting Your Jaw And Bite

For many orthodontic patients, braces, Invisalign®, or another similar treatment option are enough to both straighten their teeth and correct any jaw and bite misalignment. However, some patients require additional auxiliary appliances to correct bite issues. If your orthodontist determines that you need an auxiliary appliance, she will carefully explain her rationale, how the appliance works and what to expect.

Importance Of An Aligned Bite

When most people think of orthodontics, they think of straightening teeth. However, orthodontists like Dr. Pompei aim to both straighten teeth and align your bite so that the top and lower jaw fit together properly. An aligned bite is important for several reasons:

  • Less pressure on your joints: An uneven bite can put excessive pressure on your temporomandibular joint (TMJ). Over time, this can lead to chronic jaw pain and TMJ disorders

  • Better brushing and flossing: An aligned bite makes it easier to brush and floss properly, reducing the risk of cavities, tooth decay and gum disease

  • Even distribution of pressure on the teeth: When the jaw is misaligned and the teeth are crowded, you may experience wear and excessive pressure on certain teeth. With an aligned bite, pressure is more evenly distributed among all of the teeth

  • Facial symmetry: Having an aligned bite also has aesthetic benefits! When the top and bottom jaw fit together, it results in a more symmetrical face shape

Types Of Auxiliary Appliances

The type of auxiliary appliance that your orthodontist will recommend depends on your specific treatment needs. Some of the most common auxiliary appliances here at High Line Orthodontics are:

Used to correct front teeth overbites by leveling the lower arch, this helps prevent the upper teeth from overlapping the lower teeth. Though removable, Dr. Pompei will most likely instruct patients to wear their bite plate throughout the day—including while eating. Patients should only remove the bite plate to clean it.

Palatal expanders help widen a narrow upper palate. Dr. Pompei makes incremental adjustments to the expander, which slowly expands the upper jaw while putting pressure on the molars. Once the jaw has been sufficiently widened, patients will continue to wear their expander for a set amount of time in order to retain the new shape of the jaw.



Sometimes, permanent teeth erupt incorrectly—sideways or in the wrong place entirely. The distalizer helps move molars into the correct position. It works by attaching a space maintainer to the bottom tooth and attaching it to the distalizer on the top tooth.

Elastics are colored bands worn on braces that help close spaces between teeth. Not all patients with braces will need to wear elastics during their treatment. Those that do will begin to wear elastics several months into their treatment. It is important to wear elastics exactly as instructed to ensure effectiveness and prevent more time in braces.

Thumbsucking and tongue thrusting—placing the tongue in the incorrect position while swallowing—can push the teeth out of alignment. Patients who engage in these behaviors may benefit from a tongue crib. These metal appliances are attached to the back molars and fitted to the top of the mouth. A small metal caging that sits at the front of the teeth helps discourage the habit.

Used on patients with braces and overbites, a spring is attached to the upper back molar and a push rod is attached to the bottom teeth. The push rod part of the appliance slides and retracts, helping the bottom teeth move forward and the top teeth back.

Known as TADS, these durable, tiny screws are surgically implanted in the patient’s jawbone. They solve a variety of orthodontic problems such as bite alignment problems, overeruption of teeth and space issues. Using an elastic or spring, the jaw and teeth are gradually pulled into the desired position. At the end of treatment, the screws are easily and painlessly removed.

Habit breakers discourage various oral habits that can harm the teeth and jaw. Like tongue cribs, habit breakers are placed in the upper arch and attached to the back molars. The front part of the appliance will vary based on the habit it targets—for example, a lip bumper will prevent front lip biting while a cage will stop the thumb from touching the teeth. Some habit breakers even include a roller at the front of the teeth, offering a fun alternative activity for the tongue.

Headgear is an orthodontic treatment option for children with severe bite problems and can help prevent jaw surgery further on. The exact configuration of headgear depends on the patient’s needs, but all headgear is held in place on the head with a strap. Headgear can also be used in combination with braces. Because of the uncomfortable nature of headgear, we only recommend this when absolutely necessary.

When children lose a molar too early, the surrounding teeth can shift significantly. Space maintainers—also called spacers—hold open a spot for the future permanent tooth to erupt properly. When the permanent tooth is ready to come through, Dr. Pompei will remove the space maintainer.

While some of these auxiliary appliances are removable, such as a bite plate or elastics, other appliances like a distalizer or an expander, are temporarily fixed. No matter the appliance type, Dr. Pompei will ensure that you understand how to properly wear and care for your appliance for best results.

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