Orthodontic Headgear: Does Your Child Need One?

Headgear is a nightmare for many children. And of course it is — what growing adolescent wants to walk around with a contraption on their head?

But the thing to remember is that headgear for braces are a short treatment compared to the rest of the child’s life. It will be like a blip on the timeline of their existence.

So does your child need braces headgear?

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What Is a Braces Headgear?

Braces headgear — also called orthodontic headgear — is a contraption worn on the head. They attach either with straps that go over the back of the head, or they fit like a hat over the entire head.

With headgear, the orthodontist can attach a number of different appliances, like J-hooks, elastic bands, retainers, and other things. Whatever the appliance, it will attach to the braces with hooks, allowing the orthodontist to control the growth of the jaw by adjusting the tension of the headgear.

Braces headgear is a piece of equipment worn on the head that attaches to a person’s braces, giving extra support and allowing for more extreme teeth and jaw movement.

What Is Orthodontic Headgear Used For?

The main thing braces headgear does is fix misaligned bites. The problem can be with the upper or lower jaw, but both can be corrected with headgear.

Some of the most common issues that call for headgear include:

  • “Buck teeth” or overjet: where the front teeth protrude over the bottom lip
  • Overbite: where the upper front teeth protrude over the front teeth
  • Underbite: where the lower front teeth protrude out in front of the upper teeth
  • Crossbite: where the upper and lower teeth don’t align properly

Any time the upper and lower jaw and teeth are not aligned, it’s called malocclusion. And all of the above issues fall into that category. Sometimes a patient can even have multiple of the issues listed above.

Headgear is used for patients with overjet (“buck teeth”), overbite, underbite, or crossbite.

Types Of Headgear

Generally speaking, there are two main types of headgear: one called a cervical and high-pull headgear and another called a reverse-pull facemask.

Cervical And High-Pull Headgear

The first type of headgear is actually two devices often used together and they are (you guessed it) a cervical headgear and a high-pull headgear.

This type is used to fix overjet and overbite, and it’s made up of a few pieces of equipment:

  • Head cap: held by a strap that goes behind your neck (aka the cervical strap) and other straps that go around the back of your head (aka high-pull straps)
  • J-hooks or facebow: J-hooks are two pieces of wire that run from the headgear to the braces, connected by hooks. A facebow is a piece that runs from the headgear to the molars.
  • Other appliances: there are other things involved, like rubber bands, spacers, springs, and coils that help keep the necessary tension to help move jaw and upper teeth backward over time.

Reverse-Pull Facemask

A reverse-pull facemask is meant to fix Class III malocclusions, pulling the lower jaw forward to help it grow in line with the upper jaw.

It’s made up three parts:

  • Facemask: this involves a forehead pad, chinup, and a metal frame that connect with each other. The whole thing is held in place with velcro straps around the forehead or with a head cap.
  • Mouth yoke: the frame of the facemask has a horizontal mouth yoke, which is where you can attach other appliances.
  • Other appliances: rubber bands run between the mouth yoke and your braces and help pull the upper jaw forward.
  • Palate expander: on newer devices, sometimes a palate expander is necessary. It would be connected to the mouth yoke.
The two main types of headgear are Cervical And High-Pull Headgear (for buck teeth and overbite) and Reverse-Pull Facemask (pulls the lower jaw forward).

What Does Headgear Do?

Headgear is mainly just for those who are growing, i.e. adolescents. With children between the ages of 13 and 18, the orthodontist will have to determine if the patient’s bones are still growing or not. There’s also a general difference between boys and girls — girls usually stop growing earlier than boys.

To figure this out, the orthodontist will probably get an X-ray to view the vertebrae, which will show if the patient is still growing or not. If the patient has stopped growing, headgear won’t useful, so it’s best to get your child into headgear earlier rather than later if it’s needed.

Whatever the issue is that requires you wear headgear, you can expect to wear it 12-14 hours each day. Most orthodontist will suggest you wear it at night, so you can put it on right after dinner and take it off when you wake up. However, if your case is very severe, you may need to wear it as many as 22 hours a day.

And the whole process usually lasts 1-2 years, depending on your case.

At the beginning of treatment, there will most likely be a period of adjustment where the patient is getting used to the headgear. To help the adaption process go smoothly, the orthodontist may recommend a gradual increase in the amount of time the headgear is worn. For example, the patient may wear the headgear for an hour on the first day, two hours the second day, and so on until they’re at 12-14 hours a day.

Obviously, you’ll remove the headgear before eating, but you should keep it on while drinking. You can use a straw for liquids if that’s easier. Your orthodontist will give detailed instructions on how to eat, drink, and generally maintain the headgear.

As is always the case with wearing braces, there will be some discomfort, especially while wearing headgear. The headgear is slowly shifting the alignment of the teeth and jaws, so it’s to be expected. Ibuprofen or acetaminophen can help lessen the pain, but if it becomes severe, contact your orthodontist or dentist for help.

The main thing to remember is consistency. Keep up with wearing the headgear on a regular basis and the treatment will go faster. It will help straighten your smile at a much quicker rate than if you slack off with the instructions.

Headgear provides additional support for those wearing braces and is used in more severe malocclusion cases.

Dental Headgear Cost

There’s not really a number we can point to and say, “This is how much wearing headgear will cost.” Each patient is different. And the overall cost is determined by the work being done, how difficult it is, and how long it will take, not so much the actual headgear.

Headgear Care & Maintenance

Each orthodontist may have slightly different instructions for cleaning and maintaining your headgear, so we’ll speak generally here.

You definitely still need to brush your teeth as you normally would. You’re still eating and drinking and bacteria can still grow in your mouth. However, the specifics of how to brush, the frequency of brushing, and other dos and don’ts will come from your orthodontist.

And it’s crucial that you follow every single direction to the letter, or else you could risk a failed treatment, or worse, a reversal of any aligning that has already been done.

Patients need to follow their orthodontist’s care and maintenance instructions very closely if they want a successful treatment.

Is Headgear Still Used?

Yes, orthodontists still use headgear on their patients (or else we wouldn’t have written this guide!).

If you or your child suffers from overjet, overbite, underbite, or crossbite, you could be a candidate for headgear. Now, that doesn’t mean that if you have one of these alignment problems that you’ll definitely need headgear. But it’s definitely a possibility, depending on your age, your orthodontist, and the severity of the case.

The benefits of headgear are clear, but what about side effects?

The most common side effects are pain, discomfort, and/or soreness. But these issues are easily remedied with over-the-counter pain medications.

As for safety, if you work with a reputable orthodontist, wearing headgear is perfectly safe and is a proven method for fixing severe bite problems.

Headgear is still used by many orthodontists and is perfectly safe for patients.

Summary

  • Braces headgear is a piece of equipment worn on the head that attaches to a person’s braces, giving extra support and allowing for more extreme teeth and jaw movement.
  • Headgear is used for patients with overjet (“buck teeth”), overbite, underbite, or crossbite.
  • The two main types of headgear are Cervical And High-Pull Headgear (for buck teeth and overbite) and Reverse-Pull Facemask (pulls the lower jaw forward).
  • Headgear provides additional support for those wearing braces and is used in more severe malocclusion cases.
  • Patients need to follow their orthodontist’s care and maintenance instructions very closely if they want a successful treatment.
  • Headgear is still used by many orthodontists and is perfectly safe for patients.

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