Lingual Arch Appliance and Its Uses

Home » Lingual Arch Appliance and Its Uses


Presently, there is an array of dental tools which keep your oral health in check. From braces to retainers and headgear, solutions exist for each particular case. Among many available treatments also includes a lingual arch appliance. But, what exactly is a lingual arch appliance and what is it used for?

Read all about it below.

Lower Lingual Holding Arch Appliance: Introduction

A lingual arch appliance is an orthodontic tool which amends the mandibular jaw and Class II malocclusions. This particular device is attached to two primary molars of both the upper arch and bottom arch. Today, the device is among the most popular and helps treat orthodontic issues of various sorts.

The appliance is placed on the side of your lower teeth. It also has a stainless steel wire for the holding arch which connects the molars in the palatal vault. This type of a lingual arch appliance is also known as ‘Transpalatal Arch.’ The tool first saw the light of day in 1972, thanks to Robert Goshgarian.

Transpalatal Arch

A transpalatal arch device falls in the group of lingual arch devices for the upper jaw. The main purpose of TPA devices is to maintain the ideal dental arch width and prevent molars tipping. With that, the device creates more space in the jaw. Many studies consider TPA treatment one a great space maintainer for teeth inside the oral cavity. As a most popular form of LLA, a TPA device manages the placement and movement of molars and makes sure no tooth ends in the wrongful place.

What is a Lingual Arch Appliance Used for?

A lingual arch appliance, or LLA, is used actively or passively. The appliance enables a greater tooth movement control, especially in its target areas. According to studies, lingual arch appliances have an even greater potential, although no sufficient evidence testifies to it. Other uses of LLA include:

  • Stabilizing and supporting the molars, thus avoiding possible side-effects.
  • Maintaining space in the jaw.
  • Preventing early loss of the second deciduous molar, and keeping other teeth in check once that happens.
  • Balancing the ‘Leeway space’. This space opens up within the arch, upon molar exfoliation and replacement by permanent molars.
  • In cases of mobile appliances, the tool can move the molars in the desired space.
  • Expanding or reducing the space between the intermolar, thus rotating the molars as well. This further helps reshape the arch.
  • Introducing anchorage for the first molars on each side of the arch. This use is among the most common and diagnosed in patients.
  • Playing the role of retainers and treating the mandibular arch continuously.
  • Opening omega loops in the lingual arch, thus preventing mandibular incisors outburst.

When is a Lingual Arch Appliance Used?

Typically, the appliance finds its use when there is an early baby teeth loss. In other cases, the tool is of the bottom teeth face overcrowding.

Depending on your particular diagnosis, the duration of wearing LLA varies. However, the orthodontist will remove the device as soon as permanent teeth appear. It also does not require additional extraction of permanent teeth, which makes the treatment less severe than others.


Awesome experience with Dr. Ivanov! He shows great passion in his work, and cares about his patients and their concerns. I had my braces for 1yr 11 months and now I’m wearing my retainers. It amazes me as I look at my before and after pics of how great he is. Very happy and well pleased with my results that I referred a colleague of mine. Special thanks to Dr. Ivanov and his team for the fabulous job done!

I took my son to Dr. Ivanov because he had a severe overbite. The doctor explained everything to me with patience and understanding. I noticed the improvements in no time. I thought my son would be in braces for 3-4 years. My son, under Dr Ivanov’s care, now has the straightest most beautiful teeth (in only 2 years)!. The shape of his face adjusted to the changes as well and he looks ‘Hollywood’ Ready’. I am very satisfied with the doctor’s work. His office staff is great as well. Dr. Ivanov is very professional and I highly recommend!

Amazing experience! I’ve had my braces for 6 month now and I’m impressed of how much my teeth have changed. No pain at all. Dr. Ivanov is such a sweet person and very professional, he knows what he’s doing and always cares for patients personal concerns. Highly recommended!

Dr . Ivanov is in one word AMAZING . I been under his care for a year and I got to say What a change!!! I cannot wait to see the final results . . He always answers all my questions, in every visit he will take the time to understand how my teeth are improving and always makes the right decision. The staff is awesome, I always feel right at home . I made the best choice when I decided to get my braces with Dr . Ivanov. There’s is no doubt he is the best ortho . Thank you Dr. Ivanov for the hard work and for being so amazing and helping me feel awesome with every month visit . Anyone who is looking for a good ortho and the best care , there’s no other , Dr. Ivanov is the man!!!

Dr. Ivanov, Amy, and Helen are great! Dr. Ivanov took his time to get to know me, understand my needs, and come up with a treatment plan within my expectations. He offered various treatment options, and Amy and Helen offered payment options. They answered multiple questions without hesitation and with patience. They are all very friendly and personable. Happy I got my braces with them today. P.S. They all worked very quickly to get my braces on as painless as possible. And it went better than expected.

Dr. Ivanov was amazing. When I first got my braces I was scared it was going to last 4yrs for my teeth to look better but it only lasted 2yrs and the results are beyond amazing. I’m really happy with everything and would absolutely recommend him to anyone. Thank you so much.

Dr. Ivanov was my orthodontist. I had a very difficult case, I had an opening in my front area when I closed my mouth. Most orthodontist that I went to said that this case would be impossible to do without surgical intervention. Dr. Pavel thought outside of the box and was able to straighten my teeth WITHOUT surgical intervention. I felt that I was in safe hands because after careful research I found that he graduated at the very top of his class. He was able to do a complex braces technique called the MEAW technique to straighten my teeth. He has restored my self confidence and smile. I highly recommended Dr. Ivanov, he will go out of his way to make sure that your treatment plan is well thought out and he will spend his time to evaluate your situation. He is the Best Orthodontist in the North Miami\Aventura area.

I’ve been visiting Ivanov since December 2015. I had crossbites, crowded teeth, and just all the works. Together with his professional and amazing staff I was able to slowly over the years fix my smile into something life-changing. I am internally grateful to him as well as his staff, especially his assistant and front desk. If you don’t come here then you’re just passing up a great opportunity to change your life for the better and meeting amazing people who will help every step of the way to getting you a better smile! Thanks again, Mr Ivanov.

Very good experience. The attention was great. The doctor is very punctual and they don’t make you wait, which for my busy schedule is super important. Also, the time the doctor told me I had to wear the braces was the exact time I needed and I was very happy with the results. Definitely recommend him.

Dr. Ivanov and his staff really feels like my second family here and they’re always looking out for the best of me. When I first came into the office, my teeth were quite messed up, but now only after a year, it feels surreal that the braces could fix them so well. I see myself smiling alot more and feeling much more confident to show my teeth than to just smirk like I used to. They give you good advice on how to take care of yourself and take the extra step to make sure you do. When I come here for my checkup, I never feel awkward or uncomfortable because they’ll welcome and talk to you as a friend as well as your dentist, something I feel good about when I think about it walking out and saying “See you next month!”

Dr. Ivanov was amazing. He was very understanding and took the time to explain, every step of the process for my daughters braces. I am proud to say with great care her braces were finally removed and the end result is the beautiful smile she now has. Thank you

Usually, when a professional says that the reason they do what they do is to see the end results and how happy it makes their patients, you have to take it with a grain of salt. However, with Dr. Ivanov, he doesn’t even have to tell you why he does what he does for you to know that it’s out of pure kindness and enjoyment in seeing a (perfect) smile in his patients. From the very first moment I met him for a consultation for orthodontic work, I knew I was in good hands. Dr. Ivanov is one of the most humblest, kindest, and caring individuals I’ve ever met in the professional field and I know that I’ll have that perfect smile in no time.

Ivan and his staff made my experience a smooth and convenient process. I am absolutely delighted and satisfied with the progress and how far my teeth has come. Ivan and his staff works effortlessly to ensure that my teeth are perfected beyond my expectations. If I had any other choice I would still choose Ivanov Orthodontic experts.

Very good service they took great care of me Helen is very very sweet and caring she walk me through everything ivanov was so welcoming and caring he is very passionate to his patients felt very comfortable the STAFF IS AMAZING THE PLACE IS CLEAN IM SO EXCITED TO START THIS JOURNEY WITH THEM ISABEL WAS VERY CARING WITH SHE EXPLAIN EVERYTHING VERY WELL I recommend Anyone to come here if you want fast and friendly service thank for the experience

My family and I are so happy with the results of Dr. Ivanov!!! So knowledgeable, kind and always available to answer questions. I am so happy we found him and his staff. I am looking forward to addressing my dental needs now that the family is on track!!! How many can say that about their dental experts. Way to go Dr. Ivanov!!!

Since day one, i’ve had positive and friendly energy with every staff member including your future orthodontist Dr. Ivanov. Dr. Ivanov have given every patient he’s recieved the optimum care and dedication to receive their dental goal. He will provide you the steps and information you need to make your journey a successful one. You’ll become so confident with your new smile at the end!! With the amount of time and work he has done with you, you’ll never doubt selecting Dr. Ivanov as your orthodontist.

He is awesome. You will start seeing changes quick in your smile. He shows passion in his work, he cares about you and your smiles. The office is very nice and great customer service. You will be in good hands if you choose to go with him.

Why Should I Use a Lingual Arch Appliance?

There are several benefits to wearing a lingual arch appliance as a treatment. Some of these include:

  • Active effect by wearing the tool 24 hours a day.
  • Easier removal and placement, as well as easy to clean and maintain.
  • Great for adjustments and targeting problematic areas in the arch.
  • Comfortable to wear, regardless of the ultimate objective.
  • No noticed side-effects while wearing it or erratic tongue movements.
  • Is usually worn on its own, but it can also be combined with related orthodontic treatments and treatments.
  • A partial or complete treatment, without having to amend the device’s dimensions in regards to the arch.
  • A lingual placing, making the device feel super pleasant and almost unnoticeable in the jaw.

Are There Any Side-Effects of Wearing a LLA?

Although minimal, there are a few side-effects which can occur due to wearing a LLA. Read the most common side-effects of wearing a lingual arch appliance or a TPA below.

  • Issues with adapting the lingual arch on the molars.
  • Cracking the lingual sheath, as it hasn’t been fixed in time.
  • Mucosa overgrowth, as a result of irregular appointments with your orthodontist.
  • Looseness in the lingual arch, due to tongue pressure.
  • Allergies, and especially to cobalt (found in the appliance’s wire). It is worth mentioning this side-effects is very rare in patients.

How to Use my Lingual Arch Appliance?

Be aware of the food you consume. That said, steer clear of sticky or chewy foods, like candy or gum. Also, keep the upper teeth bites moderate and avoid pulling food with your teeth.

How to Clean my Lingual Arch Appliance?

The best way to clean your appliance is by rinsing it with water. Make sure you rinse the tool after each meal so you avoid harmful bacteria built up. Proceed brushing and flossing your teeth as per regular, and maintain the bands hygiene optimal as well.

How Does LLA Work for Kids?

Lingual arch appliances are a lesser known orthodontic tool which helps your children overcome teeth and spacing issues. In fact, this appliance is recommended for children for several reasons. These are very comfortable and invisible to wear and can be taken out if necessary. In addition, lingual arch appliance does not cause as much gum irritation as harsher dental tools. Last but not least, children can easily maintain the LLA hygiene and rinse it themselves.  

What to Expect from Wearing a LLA?

Once the device is placed (a very short process), you might experience tongue oppression. However, this will only last a few days, after which your tongue and speech will return to normal. If you are feeling any additional pain or discomfort, don’t hesitate to call or visit your orthodontist.

Keeping the oral health in check is more than necessary for the proper teeth and jaw development. As all dental issues are best treated early, making an appointment with your orthodontist is highly recommended.

Supplemental Content

Having straight teeth is very important to everyone, but few are born with a perfect smile. Not only do they look better than misplaced teeth, but it is easier to eat and speak if they are in the right place. Most of the time we lose our baby teeth and then the adult ones start to come through quickly; but what happens when things don’t quite go to plan. We run the risk of the teeth we already have shifting or spreading out, not taking into account that others have to come through. It is then that a lingual arch appliance comes into use.

When there are molars that have to be kept in place, a lingual arch appliance will be called for. It does not matter if they are in the upper or lower dental arch, the appliance will be able to help. Depending on which one is to be treated, the placement will be a little different. It can work one of two ways.

  • If it is for the lower teeth it is the lower lingual arch and the archwire will be placed on the lingual side of the lower palate.
  • When it is the upper teeth, the molars will be connected by the archwire with it going through the palatal vault. When this happens, it is known as Transpalatal arch.

Very often the lower lingual arch appliance works as a space maintainer for teeth in the lower jaw. It will keep the molars in place. Both upper and lower appliances can be used to help the orthodontist carry out the work they need to do.

When a baby molar is lost before its time in the lower jaw, then a space maintainer will be needed. When it is set in, the permanent molars are not able to move forward and preventing further teeth coming through. It can also make sure that the Leeway space is kept. The Leeway space will be useful when the permanent premolars erupt.

When used correctly, it is possible to get a lingual arch appliance to move the molars in a way that they are needed to be moved. This is more likely to happen when they are removable, and they can be activated to increase or decrease the distance between molars. They also have the ability to rotate molars to help the job of the orthodontist who is working on the teeth. The reality is that the entire dental arch can be reshaped if there is a buccal archwire connected molars to the rest of the teeth.

It is important that the lingual arch appliances are made out of the correct material and to the correct standards. They will be made differently if they are for passive or active use. Stainless steel is the normal and correct material used when the arch is for passive use, whereas it will be good to use stainless steel with some beta-titanium properties for the wire when there is active use – i.e. there is an active use and the goal is to move the position of molars.

contact us

Contact Us

Welcome to Ivanov Orthodontic Experts! How can we help you get started?