Using a Pendex Appliance


In modern orthodontics, there are plenty of devices and appliances which treat numerous orthodontic issues. Among the many common orthodontic tools is also the Pendex appliance. While not used as often as other orthodontic tools, like braces, the Pendex appliance shows excellent results in patients. By managing Type II malocclusions and fixing the bite, this appliance is much more useful than you think.

Also, know that the Pendex appliance is worn less than other orthodontic tools but still gives amazing results in return. What is more, the appliance is available for treatments in both children and adults.

Below, let’s learn more on the importance, uses, and maintenance of a Pendex appliance.

What is a Pendex Appliance?

A Pendex appliance is a fixed orthodontic device used to expand the jaw, thus fixing a series of issues. It works based on an expansion screw and springs which push the top teeth backward. With this, it allows a correction of the upper jaw and proper alignment of the teeth.

The appliance also manages other issues like teeth crowding, upper teeth flaring. Finally, Pendex appliance is used in both children and is often suggested following an unsuccessful headgear treatment.

What is the Pendex Appliance Composed of?

A traditional Pendex appliance is built of several elements. First, the device has a plastic press button which goes to the roof of the mouth. Second, there are wires which have the job of pulling the upper molars back.

Along with the button, the Pendex appliance also has a keyhole. After you are given a key, you will have to turn the appliance daily. Don’t worry as your orthodontist will show you how to do it right and will give you the instructions necessary to do this at home.

When the appliance is turned, it widens the whole structure, which then expands the palate. All Pendex appliances are fixed and need extra care because of it.

How can I activate a Pendex Appliance?

You can activate the appliance by turning the key once a day over the course of four weeks.

Having in mind your particular issue, the number of turns can vary from one patient to another. After activating the Pendex appliance for four weeks, you will have to visit your orthodontist for additional adjustments.

How long do I have to wear my Pendex Appliance?

Depending on your case and the severity of your issue, you may wear the appliance for up to 8 months.

What should I know about the Pendex Appliance?

When undergoing a Pendex appliance treatment, there are several instructions to keep in mind.

These include:

Using the key which has a plastic blue handle.

Activate the device daily, or every night before bedtime. Push the key backward until the next hole in line appears.

Take the key out by pushing it down with your tongue.

In the activation process, the patient may face a certain pressure, especially around the nose. But, it is completely normal for the device to behave this way, as it means it works. Usually, all unfavorable symptoms go away and you can activate the appliance without feeling any discomfort.

How to keep my Pendex Appliance clean?

As the Pendex appliance is fixed, special oral care is necessary to practice. The best way to keep the appliance clean is to do daily salt water gargles and rinses. Salt water soothes are treated area and prevents bacteria and infections built-up. Also, keep in mind that you have to clean any food stuck around the appliance’s screw.

As you turn and activate your appliance daily, it is recommended to schedule regular visits with your orthodontist, too. The best time to schedule appointments during this period would be every two weeks. The reason this is so, is that your orthodontist needs to check and see if the appliance is working properly. With regular appointments, you are also likely to wear the appliance for a shorter period than anticipated.

In case you notice the Pendex Appliance is damaged or even loose, don’t hesitate to see your doctor for help. Once the device is able to move molars backward in their posterior position, your orthodontist will take it out.

What are the side-effects of wearing a Pendex appliance?

Although there are no great side-effects from wearing a Pendex appliance, patients can face some issues with it. Such issues include:

A pressure in the arch and jaw, as the top teeth are pulled back.

A discomfort in wearing the device, especially after you activate it. This side-effect goes away the more you activate it.

Noticing an initial space between the front teeth. This gap will likely open and close immediately after the teeth are pulled back in their place.

A pressure in the nose, as the upper jaw and teeth are affected in the treatment process.

General soreness in the mouth which goes away in 3-5 days post installing the appliance.

If you feel an atypical pain, don’t hesitate to ask for professional help. In some cases, the appliance may not be installed properly or needs to be readjusted. If you do feel pain, especially after activating the Pendex appliance, you can take a mild painkiller like ibuprofen.

Patients typically wear the Pendex appliance from six to eight months. In most cases, after taking out this appliance, the patient has to wear a fixed retainer appliance. This tool is also known as the Nance appliance. This retainer makes sure the top teeth stay back during the time of their ‘nesting.’

Together with the Pendex appliance, many adults and children can sometimes wear braces as an additional treatment. Of course, this all depends on each specific case and it will be up to your orthodontist to decide if you need it.


The importance you pay to your oral and orthodontic health matters. In children, all orthodontic issues are better solved at the earliest, so you avoid greater complications. Still, adults have to be wise and consider finding a suitable orthodontic treatment as well.

One of the best orthodontist near me is IVANOV Orthodontic Experts


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!

Tula Garcia

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.

Kimberly Martinez

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.

Laura Jimenez

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

Christina Jenkins

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.

Joshua Xavier

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!!!

James C. Murphy

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.

Ketty Platon

Supplemental Content

If you don’t have problems with the size of your jaws it is hard to understand how difficult it can be to deal with. There is no room for teeth to come through and when they do manage, they are not in the correct place. They will not look right and often you will not want to smile as it will let people see how crooked your teeth are. It can also be difficult to eat as when you bite, the teeth are not where the other set expects them to be. When there is a need for a space to be created in the mouth and distalize the upper molars, a Pendex appliance will be an ideal way to achieve it.

This unique piece of equipment is designed purely for this purpose and is a field leader when it comes to arch development. It is used to expand in different areas and as the name suggests there are three different parts. The great thing about this is that each area can be dealt with in isolation. If one part needs to be expanded a little more or less than the others, then that is what can be done. You have a universal appliance as this is going to help with the jaw expansion.


Each of the three points can also be altered to different sizes. This is a great device but neither it nor the orthodontist can work miracles. There has to be a lot of co-operation form the wearer and when advice is given it must be taken and followed. When the Pendex appliance is first fitted the orthodontist. He will explain what you must and must not do. The list will include:

  • The Pendex Appliance must be worn 24 hours a day.
  • It cannot be removed to eat and to clean it.
  • It will be best to brush after ever meal. When there is a family member nearby will be the ideal time to turn the screw.
  • Don’t brush too hard as the wires could get damaged.
  • Try not to eat foods that can stick to it. That will mean avoiding lots of candy, and also items such as nuts that are hard and could damage it.

You need to carefully follow the timetable when it comes to visiting your orthodontist. If you are in the position where you have to reschedule an appointment, this could prolong your orthodontic treatment because the teeth have shifted in the wrong position. When you have your regular visits at your orthodontic office, he will decide how much more turning needs to be done and how much distalization is needed of the upper molars – or if it is in the right position already. Each time the screw is turned there will be a little pressure felt. Speech may be a little slurred and the tongue will need to adjust to the Pendex appliance. If pain is felt even after pain medication, arrange to see the orthodontist to see what the problem is.


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IVANOV Orthodontic Experts
12866 Biscayne Blvd, North Miami, FL 33181

Call us at (786) 540-1919 to schedule a free orthodontic exam.


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