For many patients, the chief concern is a large "overbite' or "bucked teeth." If this is due to a lower jaw that is too far back, then Dr. Trentini might recommend using a Herbst appliance. In addition to moving the upper teeth back and the lower teeth forward, it can modifiy jaw growth so the lower jaw develops more forward than it would otherwise. This is not effective for adult patients who are no longer growing. Instead, surgery to advance the lower jaw would be the alternative.
A Herbst appliance is fixed to your child's molars. It includes a metal tube that connects the upper and lower jaw. By adjusting the tube, your orthodontist is able to control the jaw's position in relation to the upper teeth. A Herbst appliance is typically placed along with braces and is only used during the initial portion of treatment, about 9-12 months.
Herbst vs. Headgear
In the old days, a headgear was often the appliance of choice for correcting overbites, but Herbst appliances have largely replaced headgears for this purpose. They don't require a child's compliance, and they have the ability to affect both the upper and lower jaws/teeth, not just the upper. There are actually a number of appliances available now that work similarly, but we have found the Herbst appliance to be the most effective.
Adjusting to a Herbst Appliance
Muscle Tenderness – When your child first gets his or her Herbst appliance, there may be some overall muscle tenderness and soreness of the teeth. As your child's mouth adapts to the appliance, the soreness should fade.
Tissue Irritation – Because the Herbst appliance is metal, it may cause some slight tissue irritation, especially on the lower gums. It will take time for your child's mouth to adapt. Until it does, dental wax can help to ease the irritation.
Diet – Eating softer food will help with any muscle soreness, especially after the first week or two after getting the appliance. It is also important to eliminate sticky foods, like candy and gum, or hard, crunchy food, which can damage the appliance and lengthen treatment time.