Headgear

Introduction,

Orthodontic headgear is a type of orthodontic appliance attached to dental braces or a maxillary removable appliance that aids in correcting some bite problems. Dental headgear was commonly used some time ago. However, its use has been tapered today because there are equally good and far more acceptable options available, but for some cases a headgear might still be the best option.
Wearing orthodontic headgear may seem like a big challenge — and nobody would deny that it takes some getting used to. But remember that you’re part of a team, which includes our office, your general dentist… and you! When everyone works together, it’s possible to achieve your goal: an attractive smile that you’ll have for your whole lifetime.

Orthodontic headgear is a type of orthodontic appliance attached to dental braces or a palatal expander that aids in correcting severe bite problems.

orthodontic headgear is kind of strange for most patients

It was often found that children experienced major difficulties in wearing their headgear. The issues involved were substantially social. Young patients, when confronted with the prospect of wearing headgear, would be worried that it was like having a bit in their mouth.Wearing headgear is not much fun, but it may be essential for your treatment. Follow your orthodontist’s instruction exactly, and your treatment will be ended before you know it. The short-term sacrifice you make now will be well worth your healthy, eye catching smile.

Indications

Sometimes, braces alone aren’t enough to move teeth into their proper position, or to correct problem with the bite or remedy troubled in the growth of the jaws. In those situations, your orthodontist may recommend the use of other appliances. Orthodontic headgear is the general term for an appliance, worn partly outside the mouth creating enough force to move the teeth properly and guide the growth of the face.
The most common indication of headgear is using to correct sagittal discrepancies. The headgear connects to the braces or a maxillary removable appliance via metal hooks or a facebow. Straps or a head cap support the headgear on the back of the head or neck. Its purpose is to slow or stop the growth of th eupper jaw, thereby preventing or correcting an excessive overjet.Headgear can also be used to make more space for crooked teeth to be aligned. In this instance the headgear is connected to the molars, via molar headgear bands and tubes, and aids in drawing these molars backwards in the mouth, providing space for the anterior teeth.

Timing

A key issue in using dental headgear is cooperation. The patient needs to provide excellent cooperation and ensure that the headgear is in place for the prescribed number of hours per day. These hours seldom number less than 16. A significant number of these hours can be accumulated while asleep, but there is daytime use also. Because each case is different, the amount of time you’ll need to wear your headgear will be determined by your orthodontist.Whichever type of headgear you’re wearing, there are some important things you should know. Probably the most essential one is this: In order for it to be effective, you must carefully follow instructions about wearing your headgear — that means putting it on each day for the time specified. If you wear headgear at night and you miss one night, you must make up the time the following day — otherwise, everything you’ve accomplished in the previous seven days of wear could be wiped out!

Headgear is typically used in growing patients to orthopedically correct overjets by holding back the growth of the maxilla, allowing the mandible to catch up. Headgear needs to be worn approximately 10-14 hrs to be effective in orthopedic approach, usually anywhere from 6 -18 months depending on the severity of the malocclusion and how much a patient is growing.
Headgear is also used in adults, but for a different reason. A typical scenario is a case where some teeth are romved, and anterior teeth are being retracted. When extraction spaces are being closed, the teeth behind the extraction space tend to move forward and the teeth in front of the space move backward. In such situations, to maintain the anchorage, the orthodontist will not want the posterior teeth to come forward. The headgear serves to maintain the anchorage. Orthodontists will want those cases to wear the headgear as much as possible. Realistically for most adults this might only be 8-10 hrs a day, but the more the better. In other words, for dental approaches, the best scenario would be continous wear of headgear for 24 hrs a day. You may remove the headgear only when eating your meals or brushing your teeth.

Cervical pull headgear for dental approaches should be worn 24 hrs a day

Inner Bow of Headgear Attached to the Band Tube

How to Use

Fitting your headgear

First, find the large tubes that are connected to the bands on your posterior teeth.
Now you’ve found the tube on one side of your mouth. Insert the inner wire of the face bow into the opening of the tube without pushing very hard.
Next, push the inner wire from the other side of the face bow into the opening of the contralateral tube, then pushing towards the back of your mouth to insert the wire into the tubes.
Once you’ve inserted both wires, you then should fit the neck pad as instructed by your orthodontist. Remember to hold the front of the face bow to make sure it doesn’t come out of the tubes while you do this. The neck strap should be adjusted just by your orthodontist.

To keep your orthodontic headgear working as it’s programmed, it’s important that you follow our instructions about care and hygiene. It’s normal to feel some discomfort as you’re getting used to wearing it. Fortunately, if you wear orthodontic headgear regularly, the discomfort usually goes away in a few days. Your orthodontist may recommend an over-the-counter analgesic like Ibuprofen, and/or a soft diet, to help you adapt.
It’s also important that you learn how to put headgear on and take it off correctly and safely. To prevent accidents, don’t wear your headgear while running, swimming or playing contact sports. Remember to bring it with you every time you have an appointment at our office.

Soreness of teeth when chewing or when the teeth touch is usual. Adults typically feel the soreness 12 to 24 hours later but younger patients tend to react earlier

Soreness of teeth when chewing, or when the teeth touch, is usual. Adults typically feel the soreness 12-24 hours later, but younger patients tend to react earlier, (e.g., 2-6 hours).
Typically, soreness from the headgear and elastics will disappear after a few days, but it may continue for as long as a couple of weeks. Very few patients complain of having painful teeth essentially the whole time. Once the soreness is gone, it is not uncommon for soreness to flare up again, involving a few teeth. Then the soreness fades again. Soreness tends to leapfrog among different teeth at different times as a result of tooth movement.
The important key to the fastest relief of tenderness is to keep the wear headgear/elastics even though the teeth are a little painful. If you stop wearing the headgear or elastics, your teeth will feel better temporarily, but as soon as you resume wearing your headgear, the symptoms will reappear all over again.
Occasionally, you may also a little looseness in the first molars. This is normal, and it signals that the appliance is working correctly. However, if you feel unusual pain, find that the anchor band on your first molar (the one the headgear inserts to) has come loose, or notice that the headgear seems not to fit properly, it could show a problem. In that case, contact our office right away.

Removing your headgear

First, remove the neck pad by holding the front of the face bow, then gently removing the hook on the neck strap to release the force. Then you can slide the other side of the strap off the bow.
Next, grasp the bow where the inner and outer wires meet on one side of the mouth, pull it forwards gently until the bow releases from the tube, then let it go. Remove the wire on the other side the same way. If you feel any resistance, don’t pull harder, try pulling from a different angle.
Always remove your headgear exactly as your orthodontist showed you. If you’re not careful when taking it off, you could injure your cheeks, lips, face or even your eyes.
Never try to remove your headgear until the straps have been disconnected.
Never try to firm your headgear over your face.
Never allow anyone to grab your headgear, or to pull on it. Your friend or family members who don’t wear a headgear may not understand the danger that can be involved.

Types of Headgear

There are several different types of orthodontic headgear, each designed to work best in a specific situation. We will design a treatment program to address your individual needs, and select the most appropriate type of headgear; we will also instruct you on its use and care.

Cervical Pull Headgear

One common type of headgear is called the cervical pull type. This appliance has a U- shaped wire that attaches to the bands on your back teeth, and a strap that is worn behind your neck. This appliance is used to decline growth of the maxilla and facilitate growth of the mandible. This maneuver is typically recommended for growth modification of cases with mandibular deficiency during their growth period.
Moreover, cervical pull headgear can be beneficial in distalizing maxillary molars. This procedure may help orthodontist to provide required space to alleviate crowding of anterior teeth or reduce an excessive overjet. Sometimes, this kind of headgear serves as an anchorage to keep posterior teeth while anterior teeth are being retracted.

High Pull Headgear

A similar device is the high-pull headgear, which also has a wire connecting to the teeth, plus a strap that goes behind and over the head. This style of headgear is typically used to keep the maxilla not to grow more vertically. For instance, it may work in cases with gummy smile appearance during growth of the maxilla.

Straight Pull Headgear

The direction of force in this type of headgear is between high pull and cervical pull ones. It’s not so common due to its complexity. However, it may be recommended for those cases that orthodontist is going to distalize upper molars as much possible as bodily.