Orthodontic headgear

January 09, 2015

Functional and esthetic problems due to poor bite and crowded teeth are common concerns for parents. Often treatment is sought just for esthetic reasons, but severe malocclusion also poses a risk for the dental health, affects chewing and can be a factor for unclear speech. The aim in the orthodontic treatment is to shift the teeth into a position that is more beneficial in terms of functionality. In cases of jaw growth discrepancy the orthodontic treatment is aimed at modifying and navigating the jaw development.
A variety of dental appliances are used for treatment, depending on the extent and type of problem. The most commonly used are conventional braces, clear aligners, retainers, headgears e.t.c. As is obvious from the name itself, the orthodontic headgear is fitted over the head. It consists of three parts:

1. Facebow or j-hook: this is the part that goes inside the mouth and is attached to braces on the teeth. It delivers force to the jaws.
2. Head cap: this is the part that is fitted around the head and is used to anchor the appliance. It mainly consists of straps.
3. Attachments: this is the connection between the facebow and the head cap. It consists of elastics, springs and elastic bands. The necessary pressure is created through this component.

Purpose

A headgear is recommended when the aim is to correct jaw growth as well as controlling the movement of the teeth. It helps to treat pronounced overbite or underbite. In simple terms overbite is when the upper jaw protrudes beyond the lower jaw and underbite is when the lower jaw extends beyond the upper jaw. This appliance is normally advisable for children who are still growing as it works by modifying jaw growth.

Headgear types

The orthodontic headgear is classified according to different parameters. It may be categorized according to the type of attachment to the teeth:

1. facebow
2. j-hooks

It is also classified by the direction of the pull or force being applied:

1. Cervical pull
2. Straight pull
3. High pull (occipital or parietal)
4. Reverse pull or protraction headgear
5. Combination headgear
6. Interlandi
7. Chin cup - occipital or vertical

The orthodontic headgear is based on complex interaction between magnitude of force and direction. Different headgear designs exert force in a certain direction. The orthodontist selects headgear design that is most suitable for a given case. The success of the treatment depends on the correct selection of the headgear. It also dictates how long the patient will have to wear the headgear. Typically the child is expected to wear it for about 12 hours every day for about 12 months or more. Failure to comply or missing even one day can set back the treatment for a week.

What to expect from an orthodontic headgear appliance?

It is normal for the child to feel some discomfort in the beginning. However, it should clear out after a few days. Children are often concerned about being teased or ridiculed by friends, but it is important to remember that timely intervention with headgear prevents the need for an orthognathic surgery at a later age. The headgear should always be removed during sports and playtime to avoid injury.