Herbst Appliance Orthodontics
While having your orthodontic consultation your orthodontist may advise you that you are a candidate for the herbst appliance. The herbst appliance helps treat the discrepancy between the when the upper jaw or teeth protrude beyond the lower jaw and teeth. This can be because the lower jaw is smaller and further back then it really should be. The herbst appliance helps correct large overbites to small lower jaws in growing adolescents. The herbst appliance encourages the lower jaw to in sense catch up in growth with the upper jaw. It allows the lower jaw to grow forward and apply pressure to the upper jaw to move backwards.
The herbst appliance is cemented to the back molars on the top and the bottom. It looks like stainless steel crowns but can be removed when the treatment is completed. There is a tube and a rod that is connected from the top to the bottom jaw. There are different types of herbst. Some may be used with a screw system and some may be just attached to the top back molar bands without the screws. You cannot remove these on your own. The herbst appliance is working 24 hours a day while in your mouth. It is normally placed in your mouth for about 9 to 12 months. When you are completed with the herbst appliance you will continue treatment with standard braces. The treatment after your herbst appliance depends on how much aligning of the teeth you still have. It could be another 12 months or longer. When you first get the appliance it will take some getting used to. It may seem hard to bite or eat and sometimes even speak correctly. Try reading out loud to yourself that day and night to get used to it. This should subside after about a week or two when you get used to it. You should not have an issue with chewing but it will seem different because you jaw is being forced to bite in a different pattern that you are used to. Don’t worry if you feel as if you cannot bite the appliance is doing its job and this is normal.
Herbst Appliance Problems
While the herbst is in you may develop some sore spots in your cheeks or inside your lips. You may want to ask your orthodontist for more dental wax in case you will need it. If a sore spot is present apply the wax over the appliance where it is rubbing causing irritation. They may even be able to place rubber tubing around the rods if needed. If this is the case proper oral hygiene is a must to keep those clean since it is a trap for food and bacteria. This should go away once you get used to the appliance. Your jaw may become sore and tender as well because of the movement of the jaw. Take Tylenol or Advil to help with the discomfort. You may also use a warm salt water rinse if you develop any sore spots in your mouth. Do this a few times a day to help in the healing process. Taking small bites or cutting your food up into small pieces can help as well.
In some cases a screw depending on the type of herbst used can come loose. This will dislodge the rod from the tube or both. You should call your office to be seen. If it is late at night it should be fine until the morning. It is rare but sometimes a piece may come uncemented allowing the appliance to become loose. Call again to be seen by your orthodontist. The process of removing the herbst appliance may take about an hour to hour and half. It does not hurt. You may feel a little bit of pressure when the orthodontist is removing the appliance from you molars but it is normally an easy procedure. The orthodontist may also bracket more of your teeth that day of the removal of herbst and change your wires. They may have you come back in a few weeks to do that as well. You should notice that your profile is different after you have the herbst removed. Later on in your treatment when you have just the braces on and no herbst appliance the orthodontist may have you wear dental elastics to do minor adjustments to your bite to complete your treatment.