What are headgear braces? Types and dos & don'ts during the treatment

Dani Dinkel

Written by Dani Dinkel RDH

Headgear is a dental appliance that is sometimes worn to correct misalignment of the teeth. While it seems like headgear should be a thing of the past, it is very much an active part of orthodontic treatment in 2021.

There are several types of headgear used to treat a variety of alignment problems. If your orthodontist recommends headgear for treatment, you should understand what kind of headgear you’ll be wearing, what condition it is correcting, and some dos and don’ts while in treatment.

Basic parts of headgear

Ceramic braces

Picture by Authority Dental under CC 2.0 license

There are several parts used in headgear, depending on what type of headgear is used and what condition it is being used to correct.

Head cap

This piece rests on your head and acts as an anchor for the rest of the pieces.

Fitting straps

There are several types of fitting straps based on the type of headgear. For instance, high-pull headgear utilizes several straps that wrap around the back of the head. Cervical headgear just has one strap that attaches the head cap and extends down the back of the neck.

Elastic bands

These anchor the parts of the headgear to the teeth.

Facebow

This piece is U-shaped that attaches to the teeth, head cap, and straps.

Chin cup / forehead pad / mouth yoke

These pieces are used to correct and underbite. The chin cup attaches to the forehead pad and is used to anchor the appliance. In this situation, a head cap would not be necessary.

Braces

Sometimes the headgear is attached to braces on the teeth to help with the correction process.

When is headgear necessary?

Headgear is only necessary when any form of malocclusion cannot be correct with braces alone. Headgear proves a solid anchor for more serious movement of the teeth. One of the most common reasons to need headgear is when the posterior teeth need to be moved forward.

Orthodontic headgear types

There are three types of headgear. The one used depends on what condition needs to be changed.

Cervical pull

Cervical pull headgear is used to treat an overbite. An overbite occurs when the maxillary anterior teeth overlap the mandibular anterior teeth. (A small overbite is healthy, but the maxillary teeth should only overlap the mandibular teeth by about a third of the length of the teeth.) A cervical pull headgear keeps the upper jaw in place and shifts the lower jaw forward.

A cervical pull headgear appliance has a U-shaped wire that attaches to bands that are placed on the molars to a strap that wraps around the back of the neck.

High pull

High pull headgear is also used to treat an overbite. The appliance is very similar to the cervical pull option, but instead of the strap going behind the neck, it is placed behind the head.

Reverse pull (facemask)

A reverse pull headgear appliance, also referred to as facemask headgear, is used to correct an underbite. It works by gently pulling the upper jaw forward until it is correctly aligned with the lower jaw.

A reverse pull appliance uses a forehead pad and chin cup and attaches the two to a vertical frame. The frame is connected to braces on the teeth by elastics or wires.

Dos and don'ts while wearing headgear

There are a few things you’ll need to know if you have headgear. Your orthodontist will give you specific instructions for your case, but there are some dos and don'ts that apply to everyone.

Wearing the appliance

In most cases, you will need to wear the headgear for 12 hours each day. Most people prefer to wear it while sleeping and then for a few hours either before or after bed. If you miss one night, you must make up the lost time the following day. Not doing this can cause you to start over at square one! It is common to use headgear for 1-2 years.

Eating and drinking with your appliance

You will not be able to eat or drink when your appliance is on, which is why most people choose to wear it when sleeping. You’ll also need to take it out when you brush and floss your teeth.

Sleeping with your appliance

It may be difficult to adjust to sleeping while wearing your appliance. It is recommended that you sleep on your back and find a comfortable pillow that complements your headgear.

Orthodontic headgear side effects

Like other forms of orthodontics, there will likely be some soreness and discomfort when you first start wearing headgear. Your orthodontist will recommend over-the-counter pain medications and a softer diet for the first week or two. After that, your soreness should dissipate.

Otherwise, there are no side effects associated with headgear. If you experience pain, call your orthodontist.

FAQ

How much does headgear cost?

Headgear is usually considered part of comprehensive orthodontic treatment, so the cost is factored into the rest of the treatment. The cost of orthodontic treatment is based on severity and length of treatment.

Does headgear hurt?

Headgear may cause some discomfort and soreness initially, but that should go away after wearing the appliance for a few days. Otherwise, headgear is not painful.

How long do you have to wear headgear?

In most cases, headgear is worn 12 hours each day. The length of time you’ll need to wear it depends on the severity of your case. Most individuals continue wearing headgear for 1-2 years.

How to clean headgear?

Any parts of the appliance that go inside your mouth must be rinsed with water each day. You may also need to lightly brush the appliance with your toothbrush and toothpaste. The metal parts can be cleaned with antibacterial soap. Any of the fabric pieces, like the straps, don’t need to be washed frequently. If they do require cleaning, you can use soap and water.

Are there any alternatives to headgear braces?

If headgear is needed for treatment, there is no alternative. In severe cases of malocclusion, headgear must be worn or orthodontic treatment will not be as effective.

References

  1. Effectiveness of early orthopaedic treatment with headgear: a systematic review and meta-analysis - Oxford Academic
  2. by 4.0 Effects of cervical headgear appliance: a systematic review - Scielo
  3. Patient cooperation in wearing orthodontic headgear - ScienceDirect