Headgear | Herbst | Nance Appliance | Orthognathic Appliance | Frankel Appliance


Young boy with brown hair wearing headgear.Headgear

Headgear is often used to correct an excessive overjet. This is done by placing pressure against the upper teeth and jaw, which would hold the teeth in position or help move them into better positions. The severity of the problem determines the length of time headgear needs to be worn. The key to success with your headgear appliance is consistency. Headgear must be worn a certain number of hours per day, and if not, it must be made up the following day.

Headgear should never be worn while playing sports and should also be removed while eating or brushing your teeth.



A model of healthy teeth showing the Herbst applianceHerbst

One of the most common problems orthodontists treat is the discrepancy that occurs when the upper teeth protrude beyond the lower. Ordinarily, when we see a patient with the upper teeth protruding, we tend to think that the upper jaw and teeth are too far forward; but, more often than not, this condition is due to a small lower jaw that is further back than it should be. With these patients, we would like to encourage the lower jaw to catch up in growth, and appliances like the Herbst appliance help this happen.

Even though the Herbst appliance prevents the lower jaw from moving backward, opening and closing movement still occur easily, and patients do not have any problems learning to chew their food with their lower jaw in this new position.

As with all kinds of braces, patients with Herbst appliances need to be careful about what they eat. For instance, cold foods such as ice slushes, Popsicles and ice will freeze the cement and make the brace loosen. Sticky foods such as caramels, bubble gum and candy suckers will pull the brace away from the teeth. Hard foods like crisp vegetables and hard candies will bend and loosen the Herbst appliance, too. So stay away from these foods during your orthodontic treatment.

Your Herbst appliance will be checked and adjusted at your appointments. If, sometimes between appointments, you develop some sore areas on the inside of your cheeks, please do not try to adjust the appliance yourself. Call for an appointment so that the necessary adjustments can be made.



Plaster mold of bottom teeth demonstrating how the Nance attached to the back teeth.Nance Appliance

The Nance Appliance is used to prevent upper molars from rotating or moving forward after you’ve worn a headgear, a Wilson’s arch or any other appliance to move your molars back. Some patients wear the Nance Appliance while they are awaiting their bicuspids to grow into place.

The appliance is made of two bands that are cemented onto the first molars and a wire spans the roof of the mouth from one molar to the other. An acrylic pad or “button” covers the wire that touches the roof of your mouth directly behind your front teeth.

Patients should always brush around the bands daily. Do not eat sticky, chewy candy as it can loosen your appliance.



Orthognathic Appliance

An orthognathic appliance, or growth appliance, is used to correct discrepancies in the growth patterns of the jaws and/or cleft palate. There are a number of different growth appliances available to correct these problems. Certain appliances are designed to gently encourage the upper palate to expand allowing for more room for the permanent teeth to grow in, while others are designed to correct overbites that occur due to growth problems. Orthognathic (growth) appliances are designed to create more room for incoming permanent teeth, promote a better bite and/or enhance the facial profile. They are sometimes used for less complex cases that do not require orthognathic surgery.



Plaster mold of teeth with the Frankel appliance attached to the front.Frankel Appliance

The Frankel Appliance is a functional orthopedic appliance that is used to help create additional space for permanent teeth to erupt by expanding the arches. It stimulates growth of the lower jaw which will better align the upper and lower teeth. The Frankel can also be used to help with protrusion or overjet by retracting the upper teeth and creating a better bite.

Frankel Appliances are typically worn full-time for 18 – 24 months and possibly longer if the permanent teeth have not fully erupted.