In Depth: What is a Herbst Appliance?
One of the most common problems presented to an orthodontist is the upper teeth being further forward relative to the lower teeth. In most cases, this is the result of the lower jaw being set back relative to the upper jaw, as opposed to the upper jaw being too far out. What can we do to help this?
How does it work?
The Herbst appliance is comprised of custom fabricated surgical-grade stainless steel frameworks cemented to the first permanent molars in all four corners of the patient’s mouth. These frameworks are connected by telescoping mechanisms that aid in modifying the Class II malocclusion by exerting an upward/backward force on the upper jaw and a forward force on the lower jaw. These types of appliances work comfortably with a patient’s inherent growth to affect the desired changes.
When the Herbst has been fitted to the patient, it stops the lower jaw from falling backwards and promotes healthy bone growth in the lower jaw so its able to catch up with the upper jaw, and therefore meet for a nice natural bite.
The Herbst appliance replaces the old-fashioned headgear and it can prevent surgery and or extractions in some patients.
Why do we use this appliance?
By using a Herbst appliance whilst you’re still growing, we can maximize the growth potential and eliminate the need for jaw advancement surgery to fix the bite later in life.
Although positive aesthetic changes to the jaw line and face will occur, the purpose of correcting their bite is not just for cosmetics. It is important to have a proper bite where the teeth can work efficiently to aid in digestion and avoid future issues with the teeth and jaw muscles.
How does it feel?
It will feel like a mouthful at first! But within the first 14 days you should adapt to the Herbst appliance and it should not be too uncomfortable. It may irritate the inside of the patiets cheek at first too, but soon the tissue will toughen up and the Herbst appliance will not be a problem.
We utilise the “telescoping” Herbst; the arms are shorter and less bulky, so it is easier to adapt to. Additionally, the telescoping feature allows for better side-to-side movement of the jaw. This reduces jaw limitations.
How long do patients need to wear this appliance?
Approximately 9 months.
How do I eat with the Herbst?
The bite will be different and some teeth will not touch initially. We recommend a soft diet for the first 7 days. This will allow for a transitional period whilst you adapt to your new chewing style.
Frustration whilst first wearing a Herbst appliance is normal, but stick with it! After a few weeks the patient should be back to a normal orthodontic diet.