Is Headgear Dead?

Yes and no. While it may have a bad reputation and even be the cause of jokes in television or movies, headgear is still the gold standard for some types of orthodontic care. Fortunately, in other cases, some more modern approaches have supplanted the old-style appliances.

headgear    

WHAT IS HEADGEAR?

Traditional headgear is an orthodontic appliance that is worn inside or outside of the mouth to influence orthopedic (bony) change as opposed to just dental (teeth) change. When used properly, headgear influences the growth of the jaws. Because sometimes there are large discrepancies between the sizes of the upper and lower jaws that can contribute to problems like TMJ, it’s important to be able to control jaw position. Changing the relationship of the jaws with headgear can help eliminate the need for jaw surgery to correct the discrepancies. Jaw surgery should be avoided when possible. Not only is jaw surgery super expensive, but it is also a controlled fracture and resetting of the jaws, with major associated risks.

Traditionally, headgear has been used to treat two distinct discrepancies:

  1. When the lower jaw is small relative to the upper jaw (overbite).  Overbites can also be caused by a relatively large upper jaw, but this is uncommon.
  2. When the lower jaw is large relative to the upper jaw (underbite).  Underbites can also be caused by small upper jaws and combinations of small upper jaws and large lower jaws. 

FOR OVERBITES (CERVICAL PULL HEADGEAR)

Most of the time, when shown in movies or television, it is designed to treat overbites by restricting the growth of the upper jaw.  It is far more common that an overbite is the result of an underdeveloped lower jaw.  Fortunately, headgear for overbites is obsolete.  Modern appliances for overbites do not involve anything outside of the mouth; everything is inside the mouth and is extremely comfortable.  For a view of a modern appliance for overbites, watch this video: https://www.youtube.com/watch?v=k3T3Fl7b8FQ

FOR UNDERBITES Reverse Pull Headgear
(REVERSE PULL HEADGEAR / FACEMASK)

Reverse Pull Headgear or Facemask is still the gold standard for early treatment of underbites; therefore, I use the Reverse Pull Facemask to correct Class III malocclusions. The facemask uses the forehead and chin as leverage to pull the upper jaw forward, making the upper jaw “bigger.”  This is actually quite comfortable for patients, as you’ll see in the videos below.

Dr. Joosse explains the uses for these appliances:

 

WHAT TO EXPECT WITH REVERSE PULL HEADGEAR/FACEMASK

Basic tips for wearing headgear:

  • Follow your individualized instructions and consistently wear for the recommended time each day. The more it is worn, the more effective it will be.  Typically, the goal is 12 hours/day.
    • To accomplish 12 hours/day, we recommend wear begin immediately after dinner and continue until breakfast time. You should not attempt to eat/drink while wearing!
    • There is no such thing as wearing the appliance too much, as long as you remove it to eat, play sports, and clean.
  • Fast progress can be made at a young age, so starting early is the most efficient way to change a growing issue.
  • Very little discomfort is reported with consistent wear. The most common discomfort is irritation of the skin of the chin and this is typically solved with a combination of skin cream and finding the right surface for the headgear.  For example, some people cover the area where it contacts the chin with Moleskin or baby socks for added comfort.

 

Please contact Joosse Family Orthodontics at (757) 229-4181 today to schedule your complimentary orthodontic consultation. Contact us online, if you prefer, to find out what we can do to help you on your journey to a healthy, attractive, well-aligned smile.