Ortho Appliances - Headgear

As implied by the name, orthodontic headgear is a dental appliance which is typically attached to the patient's head with a strap which goes around the patient’s head or neck. Using the appliance, a force is transferred to the mouth/jaw of the patient.

Headgear is often used to correct bite in addition to supporting proper jaw alignment and development. Headgear is usually recommended for children when their jaw bones are still growing.

Unlike with braces and other orthodontic appliances, headgear is worn partially outside of the mouth. An orthodontist may encourage the use of headgear for a patient with a bite which is severely out of alignment.

The device transfers the force to the teeth via a facebow or J hooks to the patient's braces or a palatal expander which aids in the correction of more severe bite problems.

Need for treatment and concurrent corrections

The most common use for headgear is for correcting anteroposterior discrepancies. The headgear is attached to the braces through metal hooks or a facebow. Straps or a head cap are used to anchor the headgear to the back of the head and/or the neck.

Elastic bands work by applying pressure to the bow or hooks. The goal is to slow or prevent the upper jaw from growing which helps to prevent or correct an overjet.

Other variations of headgear work to reverse an overjets. This occurs when the top jaw is not forward enough. Similar to a facemask, it attached to braces and encourages forward growth of the upper jaw.

Headgear can also be used to create additional space for future teeth to come in. In these cases, the headgear is attached to the molars and helps to pull the molars back in the mouth. This opens up space for the front teeth to be moved back through the use of braces and bands. Numerous appliances and accessories are used in addition to headgear. This can include power chains, coil springs, twin blocks, plates or retainers, facemasks, a headgear helmet, lip bumpers, palate expanders, elastics, bionaters, hybrid twinblocks, positioner retainers and jasper jumpers. Many patients wear a combination of these appliances throughout their treatment plan.

Forms of headgear treatment

Headgear should be worn between 12-23 hours each day in order to be effective in the correction of an overbite. The headgear is typically required to be worn over 12-18 months depending on patient specific factors including how severe the overbite is, frequency of wear and the patient’s growth stage. The amount of prescribed daily wear time is typically between 14 and 16 hours each day.

Orthodontic headgear typically consists of three different components:

1. Facebow: The facebow or J-Hooks is fitted with a metal arch on the headgear tubes and attached to the rear upper and lower molars. The facebow then extends out of the mouth and around the patient’s face. J-Hooks vary as they hook into the patient’s mouth and attach directly to the brace.
2. Head cap: the second component is the head cap. This component typically consists of one or more straps that fit around the patient’s head. This is then attached using elastic bands or springs to the facebow. Additional straps and attachments are used as needed to provide comfort and maintain safety.
3. Attachment: the attachment is third and final component. It typically consists of rubber bands, elastics, or springs and joins the facebow or J-Hooks and the head cap together. It provides the force needed to move the upper teeth and jaw backwards.