D-Gainer stands for Damon space re-gainer. It is a gentle way of re-gaining space and arch width as the first step of treatment in 9-11 year olds.
The D-Gainer is also known as a limited fixed appliance. Basically, it comprises of Damon orthodontic brackets placed only on permanent front teeth and permanent first molars. Initially, just the front teeth are aligned during the first couple of visits so that stronger wires can then be placed connecting the front teeth to the back teeth. Light nickel titanium springs are then placed on either side to gently expand the arch. These appliances are used primarily to create additional space to allow for the eruption of the permanent canines (eye) teeth when it is determined early that it won’t be possible for these teeth to fit into the dental arch.
The D-Gainer also gently widens the dental arch which also generates space. The appliance can be used in both arches or just the upper or lower arch. This system of treatment has been shown to produce more physiological acceptable forces and, in many cases, has replaced the use of palatal expanders. When deemed necessary, it is used as the first step to placing full Damon braces on the teeth. This approach is usually started in the 6-12 months preceding the eruption of the adult eye-teeth. This is often around 9 1/2 to 11 years of age. However, this has to be assessed in each individual case. D-Gainers would not be used when all of the teeth have already erupted and more commonly a full set of Damon braces would be chosen at that time.
With this in mind, Dr. Luis will normally plan for D-Gainer treatment if it appears that the ability for the canine teeth to eventually erupt into the arch is questionable and possible impaction of the canines will result. In many cases, it is fairly clear that if nothing is done, extractions will be required at a future time at the least, or worse, the permanent canines may become impacted and need surgical intervention to be brought into the arch with or without extractions of permanent bicuspids. The duration of this type of early treatment is normally 12 months.