Orthodontic headgear

One topic that deserves mentioning is the role of headgear in orthodontic treatment. Orthodontic headgear has evolved as a necessary evil for some patients. While orthodontists try to avoid orthodontic headgear whenever possible, in some cases it is unavoidable. On the bright side there have been many design changes that have made headgear sleeker and less cumbersome. In reality orthodontic headgear is still the bane of most young orthodontic patients. Fortunately the ultimate cosmetic improvement to the teeth and bite is well worth the temporary discomfort.

What is orthodontic headgear?

Orthodontic headgear is an orthodontic appliance that is worn on the outside of the mouth. It applies unique forces to the developing jaw. Orthodontic headgear is attached to equipment within the mouth, such as a facebow. The facebow is connected to the braces themselves, usually to brackets, bands, and buccal tubes in the mouth. The headgear anchors to the head by thin metal arches and straps. These pieces transmit force to the facebow. The facebow subsequently transmits force to the growing upper jaw.

Alternatively if the orthodontic patient has a Class III malocclusion or an underbite, the top jaw may need to be pulled rather than pushed back. In cases of true underbite, a facemask is used. A headgear facemask is worn mostly outside of the mouth except for the part of the facemask that actually pulls on the upper jaw. A headgear facemask is sometimes referred to as reverse headgear. In contrast to a facebow which pulls the lower jaw back, a facemask pulls the lower jaw forward.

The purpose of orthodontic headgear

Headgear is used in orthodontic treatment to correct severe overbite or underbite in developing (young) orthodontic patients. The forces supplied by orthodontic headgear are greater than can be achieved by an orthodontic appliance housed completely within the mouth. While most orthodontists will attempt to correct malocclusion and move molars through another orthodontic appliance or appliances, headgear is still must be used for tough cases.

Some considerations about orthodontic headgear

Just as orthodontists try not to use headgear (either facebow or facemask) unless necessary, they also try to keep orthodontic treatment time to a minimum, Orthodontists realize that most orthodontic patients do not enjoy wearing orthodontic headgear. Studies have shown that treatment with most headgear can be limited to about 14 hours a day and still be effective (of course you must follow your orthodontist’s directions about specific treatment times). In most cases this means that children can wear the orthodontic headgear at home and to sleep but can leave it off during school hours.

It is also important to note that both types of headgear (facebow or facemask) are under significant amounts of tension. They can injure orthodontic patients and those around them if they are mishandled. Risk of injury is reduced by incorporating quick release pulls on orthodontic headgear for daytime hours and special headgear locks for use during sleep.


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