This is a full time wear appliance. The only time you take it out is to brush your teeth and to turn it. You must turn it once a day on Mondays, Wednesdays and Fridays. If you forget a turn and a whole day has gone by, do not turn it until your next scheduled day. You must brush after every time you eat. Make sure you brush your tongue, gums and teeth. The roof of your mouth and gums under your lower appliance must each be brushed for 60 seconds. You must then put more toothpaste on your brush and scrub the top and bottom of the appliance. If the gums under your appliance start to look red and puffy and bleed easily, it means they are not getting brushed enough. Try to stay away from sticky,sugary foods. Any food that sticks to your appliance and cannot be brushed off with your toothbrush is too sticky and if left on your appliance will bathe your teeth with sugar for days, eventually causing cavities that otherwise would not have occurred. Do not play with your appliance by flipping it on and off of your teeth. This will eventually crack the plastic or break the metal clasps if you have them. If the clasps break, do not take the appliance out. If you break one or both clasps, the appliance will stay in place by suction like a denture even without the clasps. In fact, we used to make these appliances without clasps, but found that it was easier for our patients to get used to wearing them with the clasps. You may need a soft diet including soup, eggs, yogurt, applesauce, cottage cheese, ice cream, Jell-O, pudding, milkshakes, peanut butter sandwiches without the crust, mashed potatoes, etc. It takes three days of chewing with the appliance in to get the back teeth to come together enough so you can chew regular food. If you want to try eating regular food immediately, cut it into small pieces. If you cannot eat it, do not take the appliance out. Ten minutes of chewing against your back teeth without the appliance in will put your teeth back up into their original position and you will have to go back to a softer diet for three days to get them back down so you can chew with the appliance in again. If you lose or break your appliance to the point that it cannot be worn, it is not an emergency, but call the office as soon as possible. To allow time for the dental arch to stop constricting, we will have to wait one week from the time the expander was last worn to take an impression for a new one.