Appliance Instructions


Spacers are small elastics that fit snugly between certain teeth to move them slightly so bands can be placed around them later. Once they are placed and the teeth begin to move, you may experience some discomfort for the first few days. To help alleviate the discomfort, we recommend taking Advil or Tylenol.

If you have spacers, it is important to remember:

  • Avoid sticky foods because they could pull spacers out
  • Do not floss where spacers are placed as flossing will pull them out

If you lose a spacer:

  • If it is 3 days or more until your next visit – your spacers need replacing. Please call our office for an appointment.
  • If it is 2 days or less until your next visit – no additional office visit is necessary.

Please check all of your spacers 3 days before your next visit. If you are missing one, you will need to make an appointment so we can replace them. Spacers can fall out on their own if enough space has already been created.

Rapid Expanders

The rapid expander is activated by turning a screw in the center, with a special key we provide, gradual outward pressure is placed on the left and right halves of the upper jaw. We recommend turning your expander twice a day for 10-14 days.

Instructions for Turning Your RPE

    • It is important to turn your RPE as instructed
    • To turn the RPE, it is best to lay on a flat surface where there is good lighting
    • Insert the key in the hole at the front and push it all the way back until the next hole appears.
    • Follow the arrow indicating the direction you should turn.
    • The next hole must appear in order for the RPE to work properly the next time you turn it.
    • When you can see the new hole, remove the key.


Headgear must be worn a certain number of hours per day as directed by Dr. Johnson. Please wear your headgear while you are sleeping and at times when you are not physically active. Headgear should never be worn while playing sports and should be removed while eating or brushing your teeth.

Some patients develop sores on the chin or forehead from wear. If this happens, we recommend using mole skin or a cotton cloth to keep the appliance from rubbing.

The key to success with your headgear appliance is consistency. We have found that the more you wear your headgear, the faster it will work.

Rubber Bands

Rubber bands are a vital part of treatment and are contingent upon patient compliance. They are worn at all times – 24 hours a day, 7 days a week – with the exception of eating, brushing your teeth, and playing musical instruments. Rubber bands should be changed at least once a day. You should always carry extra rubber bands with you in the event one breaks. It is important to wear them consistently or treatment may be delayed.

Soreness can develop when you start wearing rubber bands – but should go away in 3-5 days. If you run out of your rubber bands, please call our office, or stop by during normal business hours and we will supply you with more.

Retainer Wear and Care

The best way to keep your beautiful smile is by wearing your retainers as prescribed – typically 12-14 hours each day. Please follow these care instructions for your retainers.

      • Wear your retainer as instructed by Dr. Johnson
      • Take your retainer out when eating and immediately put it in the retainer case! (The majority of retainers are lost in school lunchrooms or restaurants when they are set on trays or in napkins and thrown away by accident.
      • Clean your retainer thoroughly with a toothbrush, toothpaste and room temperature water twice a day. Brushing your retainer is the best method to remove plaque and eliminate odors. A denture cleaner tab will help keep your retainer clean and fresh when used every week or two weeks.
      • When retainers are not in your mouth they should ALWAYS be in a retainer case. They can easily be lost and pets love to chew on them!
      • Keep retainers away from hot water, hot car dashboards, and the washing machine and dishwasher as heat will damage your retainer. Do not place your retainer in the microwave oven.
      • Please treat your retainer with care – it is breakable! If your retainer is lost or broken, please call us immediately.
      • If you have any questions or concerns about your retainer, or your retainer needs adjusting, please call us. Do not try to adjust it as you may cause damage.
      • It is important to bring your retainer to your appointments so it can be checked.


Congratulations on completing orthodontic treatment! However, just because you no longer have to come into our office for visits, it is important that you continue to wear your retainer at night indefinitely. This will ensure continued success for all of the hard work you have put into your orthodontic treatment.

Please contact our office as soon as possible for an appointment if you lose or break your retainer.