1. A quick (five minutes) visit to put spaces between the teeth that will have crowns later fitted on them.
2. About 1 week later, we see you for a half-hour visit to fit crowns around the teeth and take an impression of your teeth while the crowns are on. We will then remove the crowns and replace the spacers.
3. About 1 week later, another half-hour visit is scheduled to put in the expander and give you instructions.
The Williams Appliance allows Dr Van Vuuren to correct the lower arch and regain any arch length lost during the mixed dentition. This allows the orthodontic finish in the permanent dentition to be more simplistic and stable. One major advantage of the Williams Appliance is that it is totally fixed, which in turn allows Dr Van Vuuren complete control of the treatment. In addition, the appliance is well tolerated by the patient, and easy to keep clean. The various components of the Williams appliance include:
Crowns: One of the major advantages of the Williams appliance is that it is a totally fixed orthopaedic-orthodontic device. The appliance is secured by banding it to either the deciduous second molars or the permanent first molars.
Expansion Spring: The expander is fitted with a self-activating spring screw. It does not require you to manually adjust it. Dr Van Vuuren will review the rate of expansion at each adjustment appointment.
Lingual Arch Wire: A lingual (behind the lower teeth) arch wire is inserted into lingual tubes. When the appliance is placed the arch wire is automatically activated against the lingual surface of the lower anterior teeth. As the arch is developed, the lingual arch wire begins to align the incisors. If at any stage the lingual arch comes out of the tube and is causing annoyance or discomfort, either place it back in the tube, or if you are unable to do that you may gently remove the wire with a pair of tweezers or something similar.
Advantages of the Williams Appliance:
1. Being fixed, it lessens the potential for loss or damage, as well as the need for constant repair during the treatment period.
2. It is composed of heavy-duty materials, yet is comfortable for the patient to wear.
3. Use of the fixed spring expansion mechanism allows a predictable expansion force.
4. Patient and parent acceptance has been excellent.
Instructions for Lower Williams Appliance
Once Dr Van Vuuren has fit your Williams Appliance carefully, it becomes your responsibility to follow these instructions conscientiously. Please feel free to call our office at any time if you have any questions.
1. If unusual discomfort from your appliance is noticed, please call our office immediately. Do not hesitate, as treatment time can be prolonged if the discomfort becomes serious. Soft white wax can be supplied by Dr Van Vuuren upon your request and can be applied over the areas of irritation to help reduce soft tissue irritation to the cheeks and tongue, especially during the first week or so.
2. Special care must be taken to eliminate certain foods from the diet as they may bend the wires or loosen the appliance. Repair appointments will prolong treatment time. Avoid these foods:
ice cubes, whole carrots or hard apples, tacos, Doritos, hard popcorn or other hard, crunchy snack foods.
• STICKY FOODS:
sticky candy, roll-ups, fantails, minties, caramels and all types of gum.
all foods that are high in sugar content. Try to limit between meal snacks.
3. Brush thoroughly after each meal. Brush around the gum line as well as your teeth. If you fail to get teeth thoroughly clean and do not exercise the gums, the gums swell and make it more difficult to maintain good oral hygiene. Continued neglect of these areas may result in bad breath, white marks on the teeth or even tooth decay. Always clean your appliance when you clean your teeth. You can do this by using a toothbrush OR ask us about RETAINER BRITE, a special cleaning agent that Dr Van Vuuren can supply to help to keep your plates in great condition.
4. Do not play with the appliance with your tongue, because it may loosen the fit. Do not pick at the wires with your fingers, or bite on pencils or pens.
5. There may be an initial difficulty in speech, which should disappear in a day or two. We recommend that you practice reading out loud for fifteen-minute intervals several times a day until normal speech has returned.
6. Remember, all patients with appliances are ordinarily seen on a 6–12-week basis for re-evaluation of the bite and fit of the appliance. If you have not been seen for 3 months, please call for an appointment.