Orthodontic Appliance Information

Herbst

What it does: The Herbst appliance is used to correct overbites. It does this by placing a forward force on the lower teeth and jaw and an opposite force on the upper teeth and jaws. It is a “fixed appliance” which means it stays in the mouth. Since it stays in the mouth, the results are very predictable.

What to expect: Typically, the biggest adjustment initially is eating while you are getting used to the Herbst. Most people report that this becomes much easier within the first two days. Approximately 25% of patients will get small sores on the cheeks as they are adjusting to the appliance. These will usually resolve within a couple of days. It may help to rinse with salt water if you experience these sores.

Upper Expander

What it does: The purpose of an upper expander is to widen the jaw. This is done by turning the expander with an expander key that you will receive. Typically the expander will be turned once a day for a prescribed number of days. The expander works by slowly moving apart the bones that form the palate. This is done so gradually that there is very little discomfort. Once the jaw has been widened to an ideal width, it will be left in place for some time while new bone fills in the gap to stabilize the correction.

What to expect: Since the expander is near the roof of the mouth, there will be an adjustment period getting used to eating, talking, and swallowing. Most patients make this adjustment very quickly, typically in one or two days. When the expander is turned, it won’t hurt. You will likely feel some tightness or pressure in the roof of the mouth for a minute or two, but this will dissipate quickly.

Lower Expander

What it does: The purpose of the lower expander is to create additional space for the teeth. This is done by exerting a gentle outward force on the teeth. The expander typically will be turned only twice a week for a prescribed number of days.

What to expect: The lower expander is removable. It is important that it is worn at all times except when eating or brushing. When it’s not in the mouth it should only be in the retainer case that you will be provided. It is a relatively comfortable appliance and will have little or no effect on speech.

Headgear

What it does: Headgear is used to correct bite problems. It utilizes a pulling action to guide the growth of the face and jaws to reduce an “overbite” (or “underbite” in the case of reverse headgear).

What to expect: It is best to wear your headgear as follows: 2-3 hours the first day, 4-5 hours the next day, 5-6 hours the following day. By the 4th day you may begin to wear it while sleeping in order to attain the required 12 hours of wear in each 24-hour period. Tender teeth are normal in the first few days of headgear wear. This will diminish quickly as you continue to wear the headgear consistently.