A Herbst appliance is used to modify the growth of the upper jaw when it is too far forward in relation to the lower jaw, and it has a number of benefits for patients, including open airways and improving their appearance. The Herbst replaces headgear, which was hard for many patients and required a lot of parental coaxing. Wearing a Herbst can also help patients avoid having teeth extracted. It takes some getting used to, but is an excellent alternative to having teeth extracted or undergoing oral surgery.
The Herbst is a custom-made, surgical grade stainless steel appliance comprised of four caps cemented to the first permanent molar, one on each corner of the mouth. The top portion is an expander or in some cases, a looped wire that runs across the upper palate. The lower part of the Herbst consists of two hinged stainless steel frameworks with telescoping mechanisms that connect the upper and lower jaws on the outside of the teeth. For some patients, a thin stainless steel bar rests along the inner sides of the lower teeth for added stability.
The Herbst appliance is cemented to the first molars, so it’s always working to create precise and gentle movement at five points of the teeth and jaws to fix an overbite, where the upper jaw protrudes far over the lower jaw.
Here’s how the points of pressure create movement:
- The upper jaw is expanded by the upper bar, which widens the dental arch
- The top jaw is gently moved backwards
- The lower jaw is pressed forward
- The teeth located on the upper jaw move backwards
- The bottom teeth move backwards
Imagine an almost pointed V-shaped jaw. It’s narrow and there’s not a lot of room, so upper teeth are forced to stick out in awkward angles, creating an unpleasant profile and “buck teeth” that can interfere with speaking and eating.
The Herbst appliance gently and uniformly places pressure on the upper and lower jaws, moving the teeth into a wider, symmetrical, U-shaped arch. The facial profile is smoothed and properly proportioned, creating a beautiful wide smile. The entire face of the patient changes as the cheeks moves from pinched and narrow to smooth and wide.
How Long Do You Wear a Herbst Appliance?
The Herbst appliance is worn for around 12 months. That’s because the pressure is being applied gently, so the changes it creates are permanent.
Is it Hard to Wear a Herbst Appliance?
It does take some time to get used to wearing a Herbst appliance, just like any oral appliance. You might feel like your mouth is making more saliva, and the soft tissues of your mouth may be a little sore. A topical product helps with any irritation, as does using wax over the screws. Warm saltwater rinses a few times a day help and you should avoid hard foods or foods that are tough to chew. When the appliance is first installed, a diet of soft foods will be best for the first few days.
Over time, people get so used to the Herbst that they don’t really notice it. It may not feel that way the first day or so, but people do become accustomed to it, just as they get used to wearing braces or a palate expander.
What’s Good About the Herbst Appliance?
Once it’s in, the Herbst appliance does not have to come in and out of the mouth every day until treatment is completed. No one needs to know that you are wearing it. You can play sports, although we recommend that you always wear a custom-fit mouth guard.
Wearing the Herbst appliance increases airway volume as it moves the lower jaw forward. Small airway passages can create sleep apnea in children; the Herbst appliance serves to expand the palate as it moves the jaws.
You won’t have to think about the Herbst appliance, and once you are used to it, you won’t notice it. Parents don’t have to nag children about wearing their Herbst appliance, and that is easier for everyone.
The final results: a wider jawline and a more open airway to make a beautiful smile possible. Avoiding oral surgery or having teeth extracted is worth the time and effort involved with wearing a Herbst appliance.
There’s more information about the Herbst appliance here.
If you have any questions about your smile, or if your child has a large overbite, please call our office today at 631-427-8444 to learn how we can help.