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Herbst Appliance Directions
Why the Herbst?
The most common problem presented to the orthodontist is the lower teeth being set back relative to the top teeth. In most cases, it is
the result of the lower jaw being set back relative to the top jaw. The Herbst appliance corrects this. In the past the headgear was the
most common method for this. However the headgear was a passive appliance that prevented the top jaw from continuing to outgrow
the lower jaw. It was dependent on growth and patient compliance.
The Herbst appliance is more active. While it has the same “headgear effect” of holding the top jaw from continuing to outgrow the
bottom jaw, it also pushes the bottom jaw forward, helping it to grow and “catch up.” The growth center of the bottom jaw is near the
joint area and the Herbst appliance works to “remodel” this area. Additionally, the Herbst appliance is a great “tooth mover” to help the
lower teeth move forward. The appliance is cemented in place, so it cannot be removed by the patient and does not rely on their
compliance.
By utilizing the Herbst appliance while your child is growing, we can maximize their growth potential and eliminate the need for a jaw
advancement surgery to fix their bite. The purpose of correcting their bite is not for cosmetics. It is important to have a proper bite
where the teeth work as they are intended to prevent future problems and breakdown of the teeth and jaw muscles. Positive changes to
their jaw line and soft tissue profile will be noticed.
How will it feel?
It will feel like a mouthful at first! But, within the first week, the patient will get used to it and it should not be uncomfortable. It may
irritate the inside of your child’s cheek at first, but soon the tissue will toughen up, and the appliance will not be a problem. Please
report any prolonged cheek or tongue irritation. Because we utilize the “telescoping” Herbst, the arms are shorter and less bulky, so it
will be easier to get used to. Additionally, the telescoping feature allows for better side-to-side movement of the jaw so there are fewer
jaw limitations.
What about eating?
You may hear your child say “I cannot eat with this in my mouth.” This is not true – they just can’t eat like they used to because we
have adjusted their bite so that some teeth will not touch initially. You may want to stay with a soft diet for the first few days to help
your child get used to it and reduce any frustration. Very soon, they should be back to a normal orthodontic diet.
What is the best way to get used to it?
It will be natural for your child’s tongue and mouth to be curious to this new appliance. This is normal, but try to encourage them NOT
to play with it with their fingers or tongue. Encourage them to allow it to work and not fight it! Don’t try to force the jaw where it’s
difficult to go.
What problems may arise while wearing a herbst Appliance?
There are two problems which may arise from the Herbst appliance. The first is ulcer formation on the inside of the cheek. We have
found this to be attributed almost exclusively to sucking on the appliance arms. Because they are telescoping, the arms will pinch the
cheek if they are sucked on. the problem has been virtually eliminated by having the patient not suck on the arms in the early weeks.
The second problem is the appliance becoming loose or uncemented from the teeth. Your child should be able to open wide enough to
eat anything large or yawn when sleepy. But, if they “pop” the appliance by popping their jaw, it will become loose as the muscles are
much stronger than the orthodontic glue! It should not happen with proper care and attention and following the appropriate orthodontic
diet. If an arm or screw comes off the appliance, PLEASE don’t throw It away or loose it. They are costly and may incur a charge on
your account.
How long will the Herbst be worn?
Normally the appliance is worn for a minimum of 12-18 months during jaw growth.
Report the following immediately to the office:
Bands that become loose. Irritations that don’t improve within 10-14 days. Any breakage.
Should you have any questions or concerns, please call.
909-793-2603
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Paulson Orthodontics
219 Cajon St. Redlands, Ca 92373 •
www.PaulsonOrtho.com