Active Plate (single retainer)

The removable brace for the jaw was first made public by Charles Nord in 1929 and was later improved by A.M. Schwarz. It consists of a plastic body, fixtures made from wire and active components such as springs and screws. It is nearly always only used at night because of the inevitable speech impediment that it causes. As a result of this, it doesn’t shift the teeth in a reliable way meaning that 30%-50% of all treatments actually end in failure. Even if the active plate was worn for the required 16 hours, it would almost certainly not succeed in moving, lengthening or shortening the teeth. Furthermore, it would only twist the teeth with certain restrictions – and then only in the case of the incisors but not the posterior teeth. Yet all these different manipulations of the teeth are quite easy to achieve using a fixed brace.

Upper jaw plate with closed screw

Upper jaw plate with open screw

With fixed devices every treatment procedure can be carried out more quickly and easily and it is also more comfortable for the patients. Even ‘stretching’ of the upper jaw, as show in the above diagram, is usually only an unwanted tilting of the posterior teeth. To achieve any real skeletal widening of the upper jaw it would be necessary to use a fixed Upper Palatal Expander. However, the use of an active plate requires very little knowledge and hardly any skill on the part of the doctor. This is the reason why therapists like using active plates so much, added to the fact that they can also make more profit using a removable appliance. However the enthusiasm of young patients for these devices only lasts for about 1-2 months. After that, the plate is normally relegated to the trouser pocket. So it is a good thing that, after using the ‘little plate’, a second phase of treatment involving a fixed brace is also usually scheduled. Although it would actually be more ethical just to do away with the active plate altogether because it is basically nothing more than an outdated brace that should not really be used any more.

Y-Plate with screws for the upper jaw

Y-plate with the screws undone

Just a little bit more? Two particularly nice types of active upper-jaw plates.

Given this background, there is no longer any justification for using active plates. Yet, although it runs counter to all the scientific knowledge in Germany, these kinds of braces are still frequently used for children and adolescents. And our young patients have to suffer because of this contradiction, not to mention the health insurance companies who pay out a lot of money for unnecessary procedures.

Lower jaw plate

Diagram of a particularly nice, if somewhat Baroquely-ornate lower jaw plate – how are children supposed to deal with their everyday life with this thing in their mouths?

In spite of the fact that most of today’s active plates are manufactured in lots of pretty colours, or if you like, can even be printed with the logo of your favourite football club, etc, it doesn’t alter the fact that the active plate is simply not an appropriate appliance for orthodontic treatment today.

…and this is what it looks like when two plates are worn at the same time: is this really child-friendly

Making them nice and brightly coloured like these does not make them any more efficient