Orthodontic Appliances in Las Vegas & Henderson
Braces move teeth. Appliances do the jobs braces cannot — guiding jaw growth, holding space, widening an arch, or interrupting a habit.
Some problems are not about the teeth
Braces are remarkably good at one thing: moving teeth within the jaws. What they cannot do is change how the jaws themselves relate to each other, widen an arch, hold a space open, or stop a thumb.
That is what appliances are for. Most are used in children and early teenagers, because most of them work by influencing growth — and growth is a resource with a deadline.
Almost every appliance on this page is prescribed for a specific, identifiable reason. If Dr. Beth recommends one, ask her what happens if you wait. A good answer names the problem and explains why the timing matters. That is a reasonable question and she will not mind you asking it.
The appliances, and what each one is for
Palatal expanders
For: a narrow upper jaw, posterior crossbite, severe crowding, and as part of underbite correction.
Widens the upper jaw by gently separating the midpalatal suture before it fuses in the mid-teens. We offer both the classic fixed expander and the removable Invisalign Palatal Expander.
Palatal expanders →Herbst appliance
For: a lower jaw set back relative to the upper — the skeletal cause of most significant overjet.
A fixed appliance with telescoping arms that holds the lower jaw in a forward position, encouraging it to develop that way during growth. Typically worn nine to twelve months, usually alongside or before braces. Because it is fixed, it does not depend on cooperation, which is why it often succeeds where elastics have not.
Overjet treatment →Headgear
For: controlling the position of upper molars and, in some cases, restraining upper jaw growth.
Used far less often than a generation ago, since other options now cover many of the same situations. Where it is genuinely the right tool it remains effective. Worn at home and overnight rather than to school — typically twelve to fourteen hours a day.
Reverse-pull face mask
For: skeletal underbite in a growing child, where the upper jaw is underdeveloped.
Combined with an expander, it applies forward traction to encourage the upper jaw ahead. Worn at home and overnight. This is the intervention that most often prevents an underbite becoming a surgical case later, and the window for it is roughly ages seven to ten.
Underbite treatment →Habit appliances
For: thumb and finger sucking, and tongue thrusting, that persist past the age they should have stopped.
A small fixed device that interrupts the habit — not as punishment, simply by removing the sensation that makes it satisfying. Most habits resolve within months. Where an open bite was caused by the habit, it frequently improves on its own once the habit stops.
Open bite treatment →Space maintainers
For: a baby tooth lost earlier than it should have been.
Holds the gap open so neighbouring teeth cannot drift into space the permanent tooth beneath still needs. Small, fixed, and cheap compared with the crowding or impaction it prevents.
Space maintainers →Elastics
For: correcting how the upper and lower arches meet, during braces or aligner treatment.
Small rubber bands hooked between upper and lower attachments. Simple, cheap and genuinely effective — and almost entirely dependent on being worn as instructed. Elastics are the part of treatment where compliance most visibly changes the timeline.
Temporary anchorage devices
For: movements that need a fixed point to push against.
Small titanium mini-screws placed in the bone under local anaesthetic, used as an anchor and removed afterwards. They allow tooth movements that were once impossible without surgery or headgear, and they are considerably less alarming in practice than they sound.
Living with an appliance
Broadly similar whichever one your child has, and the first fortnight is the hard part.
Speech feels wrong at first
Almost every appliance affects speech initially, and almost all of it resolves within one to two weeks. Reading aloud for ten minutes a day speeds it up measurably.
Soft food for a few days
Pressure and tenderness are normal for the first few days after fitting and after any adjustment. Soft food and children’s ibuprofen cover it.
Cleaning takes more effort
Fixed appliances trap food. A water flosser earns its cost here, and rinsing after meals should become automatic. Keep six-month dental cleanings without fail.
Avoid the same foods as braces
Hard, sticky and chewy things break appliances just as readily as brackets. Ice, caramel, taffy and hard sweets are the usual culprits.
Removable means worn
Headgear, face masks and removable expanders only work in the hours they are actually on. Wear time is the whole variable, and treatment stalls without it.
Call if something loosens
A loose band or cemented appliance needs re-fitting promptly. It is not applying force correctly, and trapped food underneath risks decay.
Orthodontic appliance FAQ
What is a Herbst appliance and what does it do?
A fixed appliance with telescoping arms that holds the lower jaw forward, encouraging it to develop in that position during growth. It is used where the lower jaw is set back relative to the upper, which is the skeletal cause of most significant overjet. Typically worn nine to twelve months. Being fixed, it does not rely on cooperation.
Is headgear still used?
Far less than a generation ago, because other approaches now cover many of the same situations. Where it is genuinely the right tool it remains effective. It is worn at home and overnight rather than to school, typically twelve to fourteen hours a day.
Do appliances hurt?
Expect pressure and tenderness for a few days after fitting and after adjustments, rather than pain. Soft food and over-the-counter pain relief handle it. Any sharp or persistent pain is not expected — call us if that happens.
Will my child be able to speak normally?
Not for the first week or two. Almost every appliance affects speech initially and almost all of it resolves as the tongue adapts. Reading aloud daily speeds up the adjustment noticeably. Children adapt considerably faster than adults expect.
Are appliances used instead of braces or as well?
Usually as well, and often before. Appliances address jaw relationships, arch width, space and habits — braces then align the individual teeth once those foundations are right. Some children need only an appliance and nothing further.
What are temporary anchorage devices?
Small titanium mini-screws placed in the bone under local anaesthetic, used as a fixed point to push or pull teeth against, then removed when no longer needed. They allow movements that once required headgear or surgery, and patients generally find them far less troublesome than they sound.
How do I know an appliance is genuinely necessary?
Ask what specifically gets worse if you wait. A good answer names the problem and explains why the growth window matters for it. A vague answer about getting ahead of things is not a clinical reason. You are also entitled to a second opinion, and we will provide your records if you want one.
Does insurance cover orthodontic appliances?
Usually they are covered under your orthodontic benefit rather than separately, and where treatment happens in phases, most plans apply a single lifetime maximum across both. We verify your specific plan before treatment starts and explain how the benefit is best used.
Find out whether anything is needed yet.
A free evaluation with Dr. Beth and a 3D scan — and a straight answer, including “not yet,” which is what most families hear.