An orthodontic appliance is any device, fixed or removable, that moves teeth, guides jaw growth or holds a finished result in place. Braces and clear aligners are the best-known examples, but they are only part of the picture. At Straight Smiles in Kelowna, BC, Dr. James Scramstad also uses palatal expanders, space maintainers, elastics and retainers when a child’s growth, a bite problem or the end of treatment calls for them. Below is what each one does and who tends to need it.
What counts as an orthodontic appliance?
Appliances fall into two broad groups. Active appliances apply gentle, steady pressure to move teeth or change the shape of the upper jaw. Passive appliances hold teeth where they are, either to save space for a tooth that has not come in yet or to keep a newly straightened smile from drifting back.
Fixed vs. removable appliances
Fixed appliances stay in until the office removes them, so they work around the clock without anyone having to remember them. Removable ones come out for eating and cleaning, and they only work while they are being worn.
Which appliances do we use at Straight Smiles?
| Appliance | What it does | Fixed or removable | When it is typically used |
|---|---|---|---|
| Palatal expander | Gradually widens the upper jaw to make room for teeth and correct crossbites | Fixed | Most often ages 7 to 12, sometimes teens and adults |
| Space maintainer | Holds open the gap left by a baby tooth that was lost early | Depends on the case | Childhood, while permanent teeth are still coming in |
| Elastics | Small rubber bands that help the upper and lower teeth meet correctly | Removable by the patient | During braces or aligner treatment |
| Braces | Brackets and wires that move teeth into alignment | Fixed | Kids, teens and adults |
| Clear aligners | A series of custom trays that shift teeth in stages | Removable | Kids, teens and adults |
| Retainers | Hold teeth in their new positions after treatment | Clear removable or bonded fixed wire | After braces or aligners |
How does a palatal expander work?
A palatal expander is a small, custom appliance that fits against the roof of the mouth. Its job is to widen the upper jaw (the palate) slowly and in a controlled way. Adjustments are usually made at home with a special key. Most expansion takes just a few months, followed by a retention period that lets the new width settle.
Expansion works best while the bones of the upper jaw are still developing, which is why it is most common between ages 7 and 12. Some teens and adults can benefit too, with the right treatment approach. An expander may be recommended when a child has crowded or overlapping teeth, a narrow or high-arched palate, a crossbite or underbite, or mouth breathing and other airway issues.
Expansion and airway health
Because a wider upper jaw can also open the nasal passages, expansion is part of our airway-focused care. When airway space is a concern, CBCT 3D imaging helps us see it clearly before we plan treatment.
When does a child need a space maintainer?
Baby teeth do more than help a child chew. Each one holds a place in the arch for the permanent tooth growing underneath it. When baby teeth are lost too early, crowding can follow, and early loss of primary teeth is also one of the causes of crossbites.
A space maintainer is a simple appliance that keeps that gap open until the permanent tooth is ready to come in. It is one of the reasons Dr. Scramstad recommends a first orthodontic evaluation by age 7, when the mix of baby teeth and emerging adult teeth makes problems like this easier to catch before they become more complex.
What do elastics do during braces or aligner treatment?
Elastics are small rubber bands that hook onto braces (or onto attachments with aligners) and connect the upper and lower teeth. They add a gentle pull that helps correct how the teeth come together, such as an overbite, an underbite or certain crossbites. Dr. Scramstad may combine elastics with braces or clear aligners so that many bite problems can be corrected without corrective jaw surgery. Dr. Scramstad will explain how and when to wear them.
How do appliances fit into early (Phase One) treatment?
Many appliances are used during the first stage of two-phase treatment, which usually begins between ages 7 and 10 while a child still has a mix of baby and permanent teeth. During Phase One, a child may use an expander, partial braces or early aligners, depending on what the exam shows. The goals are to guide jaw growth, create space for permanent teeth and correct bite problems early.
Catching skeletal bite problems early
Some bite problems are skeletal, meaning the jaws themselves are growing at different rates. An underbite is a common example. Diagnosing it early matters, because using appliances to advance the bottom teeth in childhood can often avoid the need for surgery later in life. After Phase One there is a resting period while the remaining permanent teeth come in and growth is monitored, then Phase Two refines alignment with braces or clear aligners. That timing-first approach runs through all of our orthodontic treatment for kids.
Which type of retainer will I wear after treatment?
Every patient who finishes braces or clear aligners moves into retention. Teeth naturally want to drift back toward their old positions, and a retainer is what keeps a straight smile straight. Straight Smiles offers two kinds.
Removable vs. fixed retainers
For removable retention, Dr. Scramstad uses clear Essix-type retainers because they are more aesthetic and more comfortable than the older plastic-and-wire style, and they are easier to clean. The other option is a fixed retainer, a small wire fitted to the back surfaces of the teeth to hold them in their new position, which only an orthodontic provider can remove.
Each patient is different, so Dr. Scramstad gives you a customized retainer prescription once your braces or aligners come off. Retainers are usually worn full-time at first, then moved to nighttime wear to preserve your smile. If a retainer is lost, call as soon as possible, because without it your teeth can start to relapse.
How do we plan appliance treatment in Kelowna?
Choosing the right appliance starts with good records. At our Kelowna office, Dr. Scramstad uses iTero 3D scanning in place of messy impressions and CBCT imaging for a detailed, three-dimensional view of the teeth, jaws and airway. From there he explains his diagnosis, the appliance (if any) he recommends, how long it is likely to be worn and what it will cost, with a written financial quote.
Dr. Scramstad is a General Practitioner dentist who offers orthodontics only, continuing the family practice his father, Dr. Don Scramstad, started in Kelowna in 1981. Treatment is provided without specialist fees, and we direct bill insurance and help you work out what your plan covers. Learn more about Dr. Scramstad and the technology we use.
Frequently asked questions about orthodontic appliances
Does every child seen at age 7 need an appliance?
No. Not every child requires early intervention, and many children will not need braces right away. An evaluation around age 7 helps Dr. Scramstad spot issues such as crossbites or crowding early and decide whether two-phase treatment would help or whether to keep monitoring growth.
Can adults use orthodontic appliances?
Yes. Braces, clear aligners, elastics and retainers all work for adults. Expansion works best while the jaw is still growing, though some teens and adults also benefit. Your exam will show what is realistic for you.
What happens if a removable appliance gets lost or broken?
Contact the office promptly. With aligners, depending on your treatment stage, we may advise you to wear your previous set, move to the next set or order a replacement. A lost retainer should be replaced as soon as possible so your teeth do not relapse.
Can I see whether my child needs an appliance without coming in first?
You can start with a virtual consultation by sending photos of your child’s smile, so Dr. Scramstad can share initial thoughts before you visit.
Book an appliance consultation in Kelowna
If you have noticed crowding, a crossbite, early lost baby teeth or a bite that does not look quite right, an exam is the simplest way to find out whether an appliance would help. Request a consultation with Dr. Scramstad, or call or text our new patient line at (778) 946-6325.