How to Deliver KIYO Clear Expanders

Have patients try in aligners and then expanders, one at a time.
- Place the aligner on the front teeth and slowly push onto the rest of the teeth.
- The expander is placed in the mouth on top of the aligner. Make sure the orientation is correct. Push the expander straight upward for the upper arch (and straight downward for the lower arch) until it seats against the aligner.
If the expander is loose, use the key to turn it one quarter turn until it seats snugly against the aligner.
Show the patient the included “chewie” and instruct them how to use it to properly seat the aligner.
- Press down firmly with your fingers to seat aligner onto the teeth. Please be careful not to bite down too hard. If using a “Chewie”, use it only after the aligner has been seated onto all the teeth.

When both expanders are in, use articulating paper to check for interferences. The patient should not be biting on the expander.
- If adjustment is necessary to remove interferences, use a diamond burr.
Expanders should be turned once per week in the direction of the yellow arrow for the prescribed number of weeks.
Instruct the patient on how to advance the expander by demonstrating how to place the key in the hole and turn it one quarter turn (90 degrees) in the direction of the yellow arrow until the next hole appears. Be sure to turn it back after the demonstration. Ask the patient to do it and then turn it back.

Deliver the instruction card and explain which aligner stages require a turn of the expander screw.
Encourage patients to set a reminder in their phone to turn the expander on the same day and time each week for the number of turns as prescribed.
Patients must wear expanders until instructed otherwise, even after they are no longer activating them. Wearing the expander will hold the space while the bone remodels.
Expanders should be worn ten hours per night, even after the patient is no longer advancing the expanders.

Upper arch: Place your index finger on the rim of the inner part of your back teeth pull down to loosen one side. Using your right hand on the left back tooth OR your left hand on the right back tooth will make it easier to remove it. Use the opposite movement to loosen the other side.
Place the fingers of both hands on the front teeth on both sides and remove the entire mouthpiece.
Lower arch: Place your thumb or the thin part of the remover on the rim of the mouthpiece on the cheek side of the 2nd molar and push up.

Brush your aligners before and after wearing them to keep them clean and to protect your oral health from unwanted bacteria and food debris
Use a soft-bristled brush to prevent scratching your aligners
Use a mild, non-abrasive toothpaste (if desired) Do not use a toothpaste designed for dentures. These can be abrasive.
Always use cold water to rinse and clean your aligners and expanders.
Do not use HOT water – this may deform the aligner and compromise fit
At least once a week, use an over the-counter, effervescent aligner/denture cleaner.
You may soak your aligners daily (15 minutes) using a product designed for aligners or dentures.
Always keep your aligners in the case when not wearing them.