Fitting and Adjustment
The TRAINER¨ usually requires no adjustment. Have the child place it into the mouth themselves. Do not try to place it into the child's mouth yourself. Tell them to squeeze in the distal ends then place it into their mouth.
Ask them to check that it does not hurt anywhere. Usually it will not. Narrow mouths may require 2-3 mm off distal ends if they say it it too long or they cannot get their lips together.
Cut with scissors (soft) or trim with acrylic bur (hard) with straight handpiece anywhere that discomfort occurs.
If the tongue tag area hurts after night wear, deepen the v cuts either side of the tongue tag.
If there is too much bite opening, the anterior teeth do not come into the tooth guidance system. Trim 2-3mm off the distal ends to close the bite down and correct this. Trim back the upper labial bow if the child has an extreme class II or open bite. This will make it easier to the anterior teeth into the TRAINER¨ .
Children younger than 6 years without the first permanent molars can still use the TRAINER¨. Just cut 4-6 mm off the distal ends to compensate for the lack of the permanent molars.
Adjusting the upper labial bow
The upper labial bow can be removed to adjust the upper anterior incisor position. This is appropriate for class III correction where you want to get more anterior advancement past the lower anterior dentition.
Adjusting the lower labial bow
Removing the lower labial bow produces more of a lip bumper effect which allows for more arch length increase (if desired) and increased lower anterior advancement. This is more efficient in the harder TRAINER¨.
Edge to edge bite
As with all functional appliances the TRAINER¨ is made in an edge to edge position to ultimately achieve an ideal class I in incisor relationship. Occasionally the very compliant patient will achieve an edge to edge bite. This can be adjusted to allow a slight overjet by removing the upper labial bow as in above. A acrylic bur is the most suitable. The settling in period after the TRAINER¨ is removed tends to slightly increase the overjet and overbite. Therefore, it is ideal to have a minimal amount of both.
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Patent No. 5 259 762