Bite turbos have many purposes. The main ones including:

• Disarticulating the bite

• Allowing open coil spring to make space if needed (through disarticulation, if the bite is locked in, the space would not be able to open.)

• Keep the patient from biting on brackets and breaking them off

• Intruding the posterior teeth - in cases with TAD's

• Allow the teeth to move more freely with elastics

1. Before placing the bite tubos, make sure you have confirmed with the Doctor or your clinical lead where they will be placed. In most standard cases the bite turbos will be placed on the occlusal surface of the lower 6's.

No matter where the bite turbo will be placed, the way it should be prepared is the same.

2. Start by isolating the area. Cheek retractors are not neccesary to place them, you can simply take a large cotton roll and place it lingual to help retract the tongue.

3. Once the area is isolated, dry the surface for 6 seconds.

4. Using a one step (L-pop) scrub the surface for 8 seconds. Make sure to get the whole surface where any of the glue may touch.

5. After scrubbing, dry the surface for another 6 seconds. DO NOT RINSE!!

6. Once the surface is completely dry, take a microbrush with a light layer of ortho solo only and apply a small amount of glue being used for the turbo. Make sure the glue is a flat biting surface, you do not want it round, sharp, etc. that can cause the jaws discomfort instead of relief.

7. Once both sides are on, remove the cotton and allow the patient to rinse. The taste from the L-pop is not the best ;)

Before the patient leaves, make sure they are even!! The patient does not know what they are suppose to feel like and it is all very uncomfortable for the first time so be the patients advocate. Make sure they are flat and smooth. Use articulating paper to make sure that both sides are being contacted as even as possible. Sometimes it is hard for the patient to fully bite laying down so make sure to sit them up and have them bite a couple of times to make sure before they leave.

8. Make sure the patient knows that the bite turbos are a temporary solution and not permanent!! They are not comfortable and will take a couple of days to get use to, but we will take them off as soon as treatment allows us to. Make sure to educate the patient on why they are there, for example, if patient has a deep bite and the bite turbos are keeping patient from biting off brackets, explain why it is important if one comes off and how the patient should be checking daily to ensure they are always there and not hitting on any brackets. If a turbo does come off, the patient needs to be careful until they come in to get it fixed so they do not bite any of their brackets off in the meantime. This is especially important for patients that grind and clench their teeth at night because they tend to wear through the turbos a lot faster and may need them built up on a more regular basis.