Facemask (Reverse Pull Headgear) Poway, CA

A reverse pull headgear is an orthopedic appliance used to stimulate the growth of the upper jaw forward, and to restrict or maintain the lower jaw in place. A typical patient needing the reverse pull headgear presents with an underbite, where lower anterior teeth are biting in front of the upper anterior teeth.

The appliance is comprised of forehead and chin pads, connected by a stainless-steel framework. The headgear force is applied via elastics to the expander that has been previously placed inside the patient’s mouth.

An expander is an essential part of headgear therapy for skeletal class III malocclusion (underbite). It helps coordinate the size and shape of the upper jaw to the lower jaw, and facilitates its forward movement.

However, it is important to note that not every patient with an underbite (anterior crossbite) needs a headgear. Most underbites can be resolved with a short course of partial braces.

Initial Placement

A maxillary palatal expander needs to be in place before the headgear portion can be delivered. Therefore, initial placement requires three different appointments over a period of 10-14 days.

  • The first appointment takes no longer than 5 minutes and can be done at the same time as the consultation appointment if desired. Separators or small rubber bands are placed between the back teeth. They are used to make space between those teeth, and allow for the band fitting at the second appointment. It is important to avoid flossing the areas with the separators.
  • The second appointment consists of band fitting around the upper molar (back) teeth, and taking the mold of the upper arch. The mold is used to customize the appliance for each individual patient.
  • The third appointment is the delivery appointment. The expander is ready to be cemented in the patient’s mouth. It is also time to educate the patient or parent on how to activate the expander at home and connect the headgear part to it.

Activations and Treatment Time

Factors influencing treatment time include patient compliance and the pretreatment severity of the underbite. Most patient’s use a protraction headgear anywhere between 3-9 months.

Headgear is activated when the patient connects the headgear to the expander with the elastics. In pre-adolescent patients, the appliance is used at night during sleeping hours only, 10-12 hours of use per day is ideal.

Helpful Tips for Your Headgear

As with most appliances, an adjustment period of a week to two is necessary. During that time, the patient may experience slight soreness as teeth are beginning to move. Standard pain medication can help alleviate the initial discomfort, but is not necessary thereafter.

As most of the growth happens during the evening and overnight hours, the ideal time to wear headgear is between 6-8PM and 6-8 AM. Using fresh elastics as much as possible can help treatment progress faster.

For any questions regarding facemasks and reverse pull headgear in Poway, California, please call Align Orthodontics at 858-487-0173 and speak with our orthodontist, Dr. Mirna Nguyen.