One of the most common problems orthodontists are asked to treat is the discrepancy that occurs when the upper teeth protrude far beyond the lower. In the vast majority of cases, this condition is caused by the lower jaw that has not grown sufficiently. At Align Orthodontics, Dr. Mirna Nguyen offers the Herbst appliance to help correct this issue.

Functional appliances are used to redirect and stimulate the growth in patients with moderate to severe jaw growth discrepancy. The Herbst appliance is the most popular of the fixed functional appliances available for that use. It consists of custom fabricated upper and lower frameworks connected by telescoping mechanisms that apply forward force on the lower jaw, stimulating its growth; and upward and backward force on the upper jaw, holding it in place. The upper framework can incorporate a palatal expander in cases where the upper jaw is also narrow. Both frameworks are cemented in place and active around the clock. Hence, the Herbst appliance is a fixed, non-removable appliance.

As the Herbst is working with the patient’s inherent growth to affect the desired changes, it is important that the appliance stays in place for 9-12 months.

After the Herbst therapy, braces or Invisalign® treatment will be needed to align individual teeth and detail the bite. During that time, continuing bite treatment with elastics is essential to the ultimate success of treatment.

Initial Placement

The first week to two after the initial placement of the appliance, the inside of your cheeks and tongue may be slightly irritated. You may also experience some tenderness in the muscles of your cheeks and jaws.

Over the counter pain medicine may help with the initial discomfort, and wax or gooshy goo have proven to be useful against soft tissue irritation.

Chewing and speaking may also be difficult and awkward at first. Cutting food into smaller pieces and avoiding sticky or hard foods will help you eat more comfortably and avoid breakage of the appliance.

Practice reading aloud and your ordinary speech will return quickly. More you speak and practice, faster the speech will normalize.

You may also notice more saliva than normal, but this will decrease as you become accustomed to the appliance.

Activations

Your Herbst appliance will be checked and activated every 8 weeks. Gradual activations will amount to the desired correction.

Hygiene

Patients are encouraged to clean the appliance with the toothbrush and toothpaste used for routine oral care. Use of a Waterpik may help rinse out bigger food particles that may get wedged between the teeth and the Herbst components.

Helpful Tips for Your Herbst Appliance

If the rod slides out of the tube while opening, open wide again and guide the rod back into the tube as you close.

If the screw or crown comes loose, SAVE ALL PIECES and call our office immediately.

Even though opening and closing your mouth can still be done easily, side-to-side movement is somewhat restricted due to the rigidity of the components. Such movement should be kept to a minimum, as it may loosen the components.

Have questions about the Herbst appliance in Poway, California? Call 858-487-0173 to speak to our orthodontist and team.