Upper Expansion Appliance

The upper expansion appliance is a removable plastic appliance that widens the upper jaw bone to create space for crowded teeth. It is worn 24/7 and is removed only for cleaning. Activation is done on a 5 to 7 day interval. Eating with it in is important to keep it seated and allow for full expansion of the upper jaw bones.

Care and Maintenance
The appliance should be cleaned with your toothbrush and toothpaste along with brushing your teeth. Occasional soaking in diluted mouthwash for thirty minutes will control any appliance odor. Constant removal and “flipping” it while in the mouth will result in breakage and looseness. Removing it and wrapping it in a napkin or putting in a pocket or backpack often leads to loss or breakage. The safest place for it is in your mouth.

Quad Helix

The Quad Helix is a wire appliance attached to the braces fitted on the upper molars. It expands the upper jaw to create space for crowding or to correct crossbites of the upper back teeth.

Care and Maintenance
The Quad Helix should be cleaned with your toothbrush and toothpaste everytime you brush. Playing with the Quad Helix with your tongue or fingers may result in breakage or loosening.

Lower Crozat Appliance

The lower Crozat appliance is a sturdy, metal expansion appliance used to create space and upright teeth. It is worn 24/7 and is only removed for cleaning. It is activated by Drs. Axelrode at each appointment.

Care and Maintenance
It is cleaned each time you brush your teeth using your toothbrush and toothpaste. The Crozat is very strong and tight fitting but can be bent, loosened or broken if constantly “flipped’ up and down by your tongue. This will result in a lack of expansion or the need for replacement if broken.

Twin Blocks Appliance

The Twin Blocks Appliance is a removable, plastic upper and lower appliance. It advances the lower jaw and teeth and inhibits upper jaw growth and tips the upper front teeth backward. It is worn 24/7 including eating with it in.

Care and Maintenance
The Twin Blocks are removed and cleaned with your toothbrush and toothpaste every time you brush your teeth. Occasional soaking the Twin Blocks in diluted mouthwash for 30 minutes will help reduce any odor. Removing the Twin Blocks and wrapping them in a napkin or placing them in pockets or backpacks often leads to loss or breakage.


Headgear is worn to put strong, backward pressure on the upper jawbone and teeth. This results in reducing the protrusion of the upper teeth by tipping the the front teeth back and inhibiting forward growth of the upper jaw. The metal facebow slides into tubes on the upper molar braces. Arms attached to the facebow extend outside the mouth along the cheeks and hook to springs attached to a padded neckpiece. Headgear is worn 12 to 14 hours per day in the evening and while sleeping.

Care and Maintenance
Headgear is worn while sleeping and during waking hours but not to school or during rigorous activities. The metal facebow can be cleaned with soap and water. The neckpiece can be washed after removing the spring parts.


Spacers or separators are small , thick elastics that are placed between the back teeth to create for the fitting of orthodontic bands.

Care and Maintenance
Care should be taken while brushing to avoid dislodging the spacers. Flossing should not be done on the teeth with spacers between them. Advil or Tylenol should be taken after placement of spacers to reduce the discomfort caused by them.

Forsus Appliance

The Forsus Appliance is a strong metal appliance that attaches to the upper molar braces and to the lower archwire near the lower canine teeth. It advances the lower jaw and tips the upper front teeth backward to correct the bite.

Care and Maintenance
The Forsus Appliance should be cleaned with your toothbrush and toothpaste everytime you brush. Care should be taken to avoid wide opening or extreme sideway movement of the lower jaw. Playing with it with your tongue or fingers may result in breakage or loosening.

Lingual Arch

The lingual arch is a heavy wire that fits behind the lower teeth and slides into sheaths on the tongue side of orhtodontic bands fitted on the lower molars. It is a space maintainer that saves space in the lower arch when the deciduous teeth are being lost.

Care and Maintenance
The lingual arch should be cleaned with your toothbrush and toothpaste each time you brush your teeth. Playing with it with your tongue or fingers could loosen or break the lingual arch.

For food guidelines, follow our instructions for patients with New Braces.


Elastics are worn to correct the bite relationship between the upper and lower teeth. They come in several different strengths and sizes. They are worn 24/7 and are changed at least daily. The size and direction required will be determined by Drs. Axelrode or to get the bite correction needed. Always carry a pack of elastics with you to replace lost, worn or broken elastics. They may be taken out to eat but should be replaced after eating. Also remember to sleep with the elastics in.

Care and Maintenance
Elastics should be removed to brush your teeth. Always replace them right after finishing eating. Always carry a pack with you to replace when needed. Part time wear will result in limited progress and unnecessary soreness that occurs when you startup wearing elastics.

If you have any questions about our services, please contact us today at (707) 643-2307 (Vallejo), (925) 376-2800 (Moraga), (510) 724-8855 (Pinole).