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Health and Fitness

Lower Lingual Holding Arch and Nance Appliance: A Perfect Pair for Your Little One’s Smile

The lower lingual holding arch (LLHA) and Nance Appliance, both of which are used to treat an overbite in kids, can be used in conjunction with each other to improve the aesthetics of your child’s smile. Since both appliances aim to move the lower jaw back into place, it is easy to see how they can work together effectively to create a beautiful smile that will last them into adulthood. However, it is important to understand how each appliance works individually and why they are such an effective combination before using them in treatment plans.

Lower Lingual Holding Arch

The Lingual portion of these appliances refers to their placement on or along a tooth, like an orthodontic retainer. The first part of treatment involves using two bite-turbos on your child’s upper arch—one on each side of his front teeth, at either end of his top canine. While your child wears these turbos, we’ll take impressions and get design plans going for her LLA appliance.

This type of device is designed to hold down her lower front teeth, allowing them to move forward into place as she grows. We can then remove her bite-turbos and begin wearing just one turbo on each side of her mouth, holding down only one set of teeth at a time. This allows us to push those remaining lower front teeth forward in stages until they’re in perfect alignment with all other permanent adult teeth in your child’s mouth.

The Nance Appliance

This appliance is used to move teeth in cases where a child has an open bite, which causes them to protrude their lower front teeth. The device can be fabricated by your orthodontist and is generally made of metal wire. It works similarly to how a retainer works, except that it allows you child to eat without having to remove it.

For example, if your child wears his or her retainer during meals, take out after eating and then reinsert prior going to bed, they can wear their nance appliance while eating without having to worry about removing it. If you’re considering using a lower lingual holding arch (or nance appliance) but have questions about how it’ll work with other appliances such as braces or retainers—ask your dentist!

How Does the Lower Lingual Holding Arch Work?

Most kids begin to lose their primary teeth around age 6 or 7, although there are some children who start earlier. By age 11, almost all children have lost their baby teeth. The first step in replacing a lost primary tooth is using a lower lingual holding arch (LLHA). This appliance will hold your child’s wisdom tooth until he or she is ready to get his or her permanent adult tooth.

It prevents shifting of gums, which can lead to problems with eruption of a permanent tooth in that area later on. Once your dentist has placed an LLHA, you will be instructed to remove it periodically so it doesn’t grow into your child’s palate. How Does the Nance Appliance Work?:

As your child’s permanent teeth come in, they may shift out of place. When that happens, your dentist may recommend getting a dental device called a nance appliance. Similar to an LLHA, it is used to stabilize loose upper front teeth by preventing them from moving forward while they continue to erupt toward their final position.


What are some common questions people have about the LLA?

An LLA is a removable appliance designed to correct class II malocclusions in growing children. That said, there are some things that parents should know before getting their child fitted with an LLA. For starters, it’s important to have realistic expectations about how quickly an appliance will straighten your child’s teeth.

If your child is in his or her early teens, braces may be a better option. An LLA can move teeth relatively quickly at first but has a tendency to slow down as treatment progresses. Also, keep in mind that using an LLA too long can actually cause more crowding later on—so ask your orthodontist about removing it once any serious bite problems have been corrected.


What are some things parents should know when getting an LLA?

The Lingual Lowering Appliance (LLA) is a dental appliance that provides anterior guidance to help make room for teeth that are erupting into a crowded mouth. When your child has baby teeth remaining, but permanent teeth pushing their way in, a lower lingual holding arch or nance appliance may be recommended by your dentist.

Most children will benefit from LLA treatment as it lowers a crossbite as permanent teeth erupt into an overcrowded mouth. The bite turbos on either side of your child’s archwire will protect emerging adult canines from damage while clearing space for them to emerge. While you should consult with your dentist before making any dental decisions, ask if they think an LLA is right for your little one’s smile!


How do I know if my child would benefit from the appliance?

This appliance is used when there is an existing problem with a patient’s bite. The most common scenarios are: a deep overbite, crossbite, open bite, or too much space between their upper front teeth (diastema).

When working with your dentist to determine if an appliance is right for your child, he will examine their bite at different stages of their mouth development to see if it can be fixed using orthodontic treatment. If not, then our goal is to fix any dental problems that may cause structural issues in their jaw as they continue to grow so that they have room in their jaw to accommodate healthy teeth. Orthodontic appliances are commonly used on children because they work well with baby and adult teeth.

Where can I find an orthodontist to place my child’s LLA?

Congratulations on finding your way to our website! Finding an orthodontist to place your child’s LLA can be a challenge. Don’t worry, we are here to help you find one that is right for you. Check out our Find a Dentist section to learn more about how we can assist in making sure you find someone close to home. If you would rather not wait, please visit our office locator page. You may be able to find an orthodontist who offers these appliances by searching near a major city in your area.

If you can’t find a dentist that provides these appliances near you, you may want to check with local dental schools. An advantage of visiting a school is they are always training new students in orthodontics and many participate in continuing education courses through local universities.

Many of them also serve low-income populations and will provide more affordable services. While some do have specialty practices that serve children, we still recommend verifying what type of patient population they see on their website or via phone call if you intend to schedule an appointment for your child or infant. You may need to consider another option if that isn’t a possibility where you live.


How does insurance work with appliances?

So why do we call them orthodontic appliances? After all, don’t braces do it all? The short answer is no. While braces are indeed an orthodontic appliance, they can’t fix every issue that comes with crooked teeth.

For example, some adult patients with crossbites may require a lower lingual holding arch (LLHA) to correct their bite if traditional treatment using braces isn’t enough. Using such an appliance alongside braces is usually sufficient in treating complex issues like crossbites or open bites; however, some patients need more than two or three years of traditional treatment with fixed or removable appliances before they’re ready for something like an LLHA. Why is that?

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