Orthodontists often use various fixed appliances to guide tooth development and alignment, particularly in children and adolescents. A lingual arch represents one such appliance, consisting of a wire that connects to bands on molar teeth. This wire rests along the inside, or lingual side, of the lower front teeth. It serves a specific role in managing space within the dental arch.
Purpose and Function of a Lingual Arch
The primary purpose of a lingual arch is to act as a space maintainer. It is relevant when a primary molar is lost prematurely before its permanent successor erupts. The arch prevents the permanent molars positioned behind the gap from drifting forward into the empty space. This forward movement, known as mesial migration, could otherwise block the path for the permanent premolars to emerge, leading to crowding.
The appliance also helps in preserving “leeway space.” This refers to the extra space available in the dental arch when larger primary molars are replaced by smaller permanent premolars. Maintaining this space allows for tooth positioning adjustments as the permanent dentition establishes itself. Beyond space maintenance, a lingual arch can also function as an anchor. This support can be useful during other orthodontic movements, preventing unwanted shifting of molars.
The Fitting and Placement Procedure
The process of placing a lingual arch begins with the placement of orthodontic separators. These small elastic or metal rings are inserted between the molars for a few days to create a gap. This temporary space allows for the precise fitting of metal bands around the molar teeth.
Once the separators have created sufficient space, an impression or a digital scan of the patient’s teeth is taken. This model of the dental arch is then sent to a specialized dental laboratory. There, a custom lingual arch is fabricated, ensuring the wire precisely follows the contour of the patient’s lower arch.
At a subsequent appointment, the custom-made appliance is fitted. The metal bands are cemented onto the molars, while the connecting wire is positioned to rest passively against the inner surfaces of the lower front teeth. The wire should not exert active pressure, but simply maintain its position.
Daily Life and Maintenance
Living with a lingual arch requires consistent attention to oral hygiene. Patients must thoroughly brush around the metal bands and under the connecting wire to prevent the buildup of plaque and food particles. Regular flossing is also recommended to clean between teeth and under the archwire. This cleaning helps prevent cavities and gum irritation.
Dietary adjustments are also important to avoid damaging the appliance. Patients are advised to steer clear of sticky foods like caramel or chewing gum, as these can pull on the bands or bend the wire. Hard foods such as nuts, hard candies, or ice should also be avoided, as they can dislodge bands or break the wire.
In the event that a band becomes loose or the wire breaks, contact the orthodontist promptly. A loose band can allow teeth to shift, compromising the appliance’s effectiveness. A broken wire can cause discomfort or irritate the tongue and soft tissues. Addressing these issues quickly helps ensure the treatment stays on track.