Procedures & Appliances

IPR (Interproximal Reduction)

To achieve the best possible result from orthodontic treatment, the teeth must sometimes be reshaped. Interproximal Reduction, known as IPR, is a quick and easy procedure that changes the size or shape of the teeth. The tooth enamel is slightly reduced to create space between the teeth. This allows the orthodontic treatment to be successful in producing the best possible smile.

This is a safe procedure, and research has shown that IPR does not increase decay on the affected surfaces, nor does it increase tooth sensitivity. In fact, research shows that when IPR is necessary, it gives the teeth greater stability once orthodontic treatment is complete.

Benefits of IPR

IPR is a good choice for patients who have:

  • Teeth that don’t lay next to each other in with an ideal fit due to their shape
  • Crowded teeth

IPR reduces a micro amount of enamel that does not harm the teeth. It’s an easy, painless procedure that doesn’t require anesthesia. It’s especially beneficial to patients who have crowded teeth and plan to use Invisalign® for treatment, because it creates just the right amount of space for the aligners to fit properly and comfortably.

Bleach Instructions
  • Always keep bleach solution refrigerated and remove 30 minutes prior to using.
  • Make sure your custom tray is clean from previous use. Never use hot water when cleaning your tray because it can cause permanent damage. The best way to clean bleach out of your trays is to use q-tips and room temperature water.
  • Apply a minimal bead sized amount of bleach to the front surface of each tooth pocket of the tray that you will be whitening. The bead is applied in the middle of each tooth pocket only on the front surface. Applying excessive gel, or adding gel to the back surface of the teeth will only waste your gel while not improving results.
  • Gently insert the loaded custom tray into your mouth and seal completely on your teeth.
  • Use a finger to gently press against the front surface of your teeth to adapt the tray.
  • Run a finger along your gum line just under the custom tray to remove any bleaching gel that may have squeezed out during the previous steps, which can help limit sensitivity.
  • Keep the tray on for 30 – 60 minutes. Wearing it longer can cause harm and has no additional benefit.
  • Remove and clean your custom trays.
  • Use bleach up to five consecutive days until you have reached your desired results.
Herbst Appliance

The Herbst appliance is an advanced functional device that is used to correct a lower jaw deficiency and/or protrusion of the upper teeth. If left untreated, these issues can threaten the long-term health of your teeth, gums, and jaw, and may even require surgical correction. This appliance is an alternative solution to traditional headgear, and has additional benefits:

  • Compliance: Headgear has to be worn for a specific number of hours each day in order to be truly effective. This can be difficult to keep track of; however, the Herbst appliance is fastened directly to your teeth, so you can be confident that it is working as intended.
  • Aesthetics: Headgear is generally bulky and has to be strapped to the back of the head or neck. The Herbst is a much more inconspicuous appliance because it is only visible when you speak or open your mouth.

The Herbst appliance consists of crowns cemented over your back teeth like a thimble. The crowns have rods and tubes (hinges) attached to them that hold your lower jaw forward, which moves the teeth and stimulates growth. The rods and tubes can be adjusted throughout treatment to position your jaw and move your teeth as needed.

Adjusting to Your Herbst

During your first week, you will experience soreness in your jaw as your muscles, teeth, and joints adjust to the new position. You may take over-the-counter pain medication as needed for the soreness. Eating softer foods in the first week, such as smoothies, yogurt, and potatoes, will help with muscle soreness and help you get comfortable with the appliance. After about a week, you should be back to eating like normal.


You will need to continue to brush your teeth at least twice a day. Aside from brushing your teeth, you will also need to brush around the metal crowns, rods, and tubes. Continue to floss your teeth, as well as in between the metal structure of your Herbst and your teeth.


If anything on your Herbst breaks, becomes unglued, or bends, contact us right away, as you will have to come to our office to have it repaired.

Carriere Motion Class II Correction Appliance

What is the Motion Appliance?

Utilizing the latest in advanced orthodontic technology, the Motion Appliance ensures a fast, effective, and aesthetic first phase treatment. Plus, by jumpstarting your orthodontic care with the Motion Appliance, your overall treatment time is reduced, which means less time in braces.

Normal treatment time for the appliance is 3 to 6 months, but it can differ depending on your orthodontic case. When the desired movement is reached, your orthodontist will remove the appliance and will place your braces or aligners to complete your orthodontic care.

Benefits for You!

  • Shorter Treatment Time: The appliance is placed before your braces are put into place for faster movement of teeth and less time in braces.
  • Elastics Early On: Elastics are worn at the beginning of treatment when you are excited to start orthodontic treatment, rather than at the end when you are ready for your braces to come off.
  • Aesthetically Pleasing: Unique design makes the appliance hardly noticeable in your mouth.
  • Normal Speech: The quality of your speech is not affected unlike when wearing other traditional orthodontic appliances.
  • No Facial Appliance Needed: Avoid the bulky feeling from alternative solutions which are more invasive, such as headgear, and worn outside the mouth.
  • Sleek, Low-Profile Design: The low profile and smooth surface make it comfortable to wear; there is no poking of the lips/cheeks.
  • Good Oral Hygiene: The appliance is easy to clean, plus it is also easy to brush your teeth to keep your mouth free of debris, resulting in good oral hygiene.
Jaw Expander/Palatal Expander

When a child is suffering from a malocclusion, or a bad bite, early orthodontic treatment helps prevent more serious orthodontic issues from occurring in the future. One of the best ways to treat a malocclusion in a child is by using a palatal expander. Palatal expanders create more space in the mouth by gradually widening the upper jaw. Although this may sound scary, it’s really quite easy to do and to tolerate. The upper jaw actually develops as two separate halves that don’t completely fuse together until after puberty. Around this period of time, the two bones can gently be separated and stabilized over a period
of several months.

Why Use a Palatal Expander?

  • Crossbite: The upper jaw is too narrow to fit the lower jaw or the back top teeth are inside the lower jaw
  • Crowding: There is not enough room for permanent teeth and the upper jaw is too narrow
  • Impacted Teeth: A tooth has not yet come in and is being blocked by other teeth, and growing teeth are in the wrong position

How the Palatal Expander Works

The rapid palatal expander is custom-made to fit over most of the top teeth in the back of the mouth. The appliance consists of two halves connected in the middle with a screw. The screw is turned little by little each day to induce tension, which progressively moves the two palatal bones apart. On average, the RPE treatment takes 3-6 months to finish.

What to Expect During Treatment

It’s very common for your child to experience some minor side effects, like soreness and pressure. Your child may also speak and eat a little differently at first, and they may have a small gap between their front teeth – all of this is normal and is not a cause for alarm. However, if your child experiences any severe or long-lasting pain or discomfort, please feel free to call our office.

Temporary Anchorage Devices (TAD)

Temporary anchors are made of sterile, medical-grade titanium alloy and are fixed to the bone, specifically for the purpose of providing orthodontic anchorage. Orthodontics with TADs can:

  • Be used as an alternative to jaw surgery
  • Eliminate the need for headgear
  • Provide a more ideal finish
  • Prevent extra tooth movement when preparing for a bridge, crown, or implant without braces
  • Close some open bites without surgery
  • Achieve difficult orthodontic tooth movement

Installation of a TAD

After numbing the area with a topical anesthetic where the TAD is to be placed, gentle pressure is applied to insert the anchor through the gums and into the bond between your teeth. Some patients say they feel slight pressure for a short period of time afterward.

Removing a TAD

TADs are temporary and are typically removed after a few months when they are no longer needed to assist in tooth movement. The entire process of removing a TAD takes only a few seconds, and a topical numbing gel is usually applied around the area for the gentlest removal.

Post-Procedure Care

To keep the TAD clean, brush it twice a day. If the TAD causes irritation inside your cheek or lip, you may use wax over the top to protect the irritated area. TADs can sometimes become loose. In most cases, minor mobility is nothing to cause concern. However, if you feel your TAD has become excessively loose and causes discomfort, you should make an appointment to repair the loose TAD.

VPro+ Accelerated Orthodontics

Faster, more comfortable treatment in just 5 minutes

We are excited to offer VPro+ from Propel Orthodontics. VPro+, along with Dr. Hershey’s expertise, can be used during your orthodontics to reduce your overall treatment time and relieve any orthodontic discomfort. The device operates at a high frequency, delivering gentle vibrations to give you the best orthodontic treatment yet. And get this, you only have to use it for 5 minutes a day!

Good vibes, better treatment

High-frequency vibration, like the vibration delivered from the VPro+, improves orthodontic treatment both mechanically and biologically. This unique vibration profile can lead to many orthodontic benefits:

  • Reduced Treatment Time by up to 64%
  • Accelerated Tooth Movement
  • Reduced Discomfort
  • Improved Predictability
  • Optimal Aligner Seating
  • Assists in Retainer Wear

VPro+ Features

  • Quick 5 Minute Wear Time
  • Wireless Charging
  • Waterproof Vibration Device
  • Compact Travel Case
  • Patient Mobile App

VPro+ App

Enhance your orthodontic experience on all levels. Enjoy the user-friendly patient application, optimized to keep your treatment on track. All of the features you need. None that you don’t.

  • Track usage with daily and weekly views
  • Share results with your doctor
  • Locate device with the click of a button

Available on the Apple App Store and Google Play

Get Your Dream Smile, Fast!