Overview of Orthodontic Headgear
- Headgear is commonly used to correct the bite of the patient.
- The headgear attaches to the braces via metal hooks or a facebow.
- Straps or a head cap anchor the headgear to the back of the head or neck.
- Elastic bands are used to apply pressure to the bow or hooks.
- Other forms of headgear treat reverse overjets, encouraging forward growth of the upper jaw.
- Headgear needs to be worn between 12 and 23 hours each day to be effective.
- Orthodontic headgear consists of a facebow, head cap, and attachment components.
- The facebow is fitted with a metal arch onto headgear tubes attached to the molars.
- The headcap consists of straps fitting around the patient's head.
- The attachment component, such as rubber bands or elastics, joins the facebow and headcap to provide the force to move the upper teeth and jaw.
- Facemask or reverse-pull headgear is used to correct underbites.
- It pulls forward and assists the growth of the upper jaw.
- Facemasks or reverse-pull headgear needs to be worn between 12 and 23 hours per day.
- The appliance consists of a frame, chin cup, forehead pad, and mouth-yoke.
- The frame is adjusted to fit onto the patient's face and has hooks to attach elastics or springs into the patient's mouth.
- Headgear is typically worn for 12 to 18 months depending on the severity of the overbite.
- The prescribed daily wear time is between 14 and 16 hours a day.
- Soreness of teeth when chewing or touching is typical during headgear treatment.
- Younger patients tend to react sooner to soreness.
- Multiple appliances and accessories are used along with the headgear.
- Examples include power chains, coil springs, retainers, facemasks, lip bumpers, and palate expanders.
- These appliances work in combination with headgear to aid in treatment.
- Patients may wear a combination of these appliances at any given time.
- The use of these additional appliances depends on the specific needs of the patient.
Adverse Effects and Controversy
- Orthodontic headgear may flatten the face and prevent the chin from coming forward, pushing both the upper and lower jaw down and back, into the airway.
- It inhibits the natural growth of the jaws and can lead to a reduction in the SNA and ANB angles, which relate to the forward position of the maxilla and the mandible.
- Severe health symptoms, such as sleep apnea, breathing problems, and acute TMD, have been reported by formerly headgear-treated patients.
- Eye injuries have been reported, but can be minimized with the use of safety release straps and safety facebows.
- Teenagers prescribed orthodontic headgear often face social stigma and bullying due to wearing these appliances.
Decreased Usage and Alternative Methods
- The need for headgear in orthodontics and its application has somewhat decreased in recent years.
- Some orthodontists now use temporary implants (temporary anchorage devices) inside the patient's mouth to perform the same tooth movements.
- However, headgear is still widely used and remains a very effective appliance in orthodontics.
- Adults may sometimes be prescribed headgear, but this is less frequent than in younger patients.
- Soreness of teeth when chewing or when the teeth touch is typical, with adults experiencing soreness 12 to 24 hours later, and younger patients reacting sooner (e.g., 2 to 6 hours).
Safety Considerations and Solutions
- Eye injuries have been reported with orthodontic headgear, but the use of safety release straps and safety facebows can minimize these risks.
- Compliance with daytime wear of headgear can be difficult, leading to its mainly evening and sleep-time usage.
- The use of temporary implants as an alternative to headgear reduces the need for compliance and potential discomfort.
- The effectiveness of headgear as an appliance used by orthodontists today is still widely recognized.
- Social stigma and bullying are common challenges faced by teenagers prescribed orthodontic headgear.
Long-Term Effects on Airway and Facial Structure
- Orthodontic headgear can have long-term effects on the airway by inhibiting natural jaw growth and potentially reducing the size of a person's airway.
- It may flatten the face and prevent the forward position of the maxilla and mandible.
- Reduction in the SNA and ANB angles, which indicate the forward position of the jaws, can be observed in patients wearing headgear.
- These measurements are good indicators of the size of a person's airway.
- The controversy surrounding headgear intensified when formerly treated patients developed severe health symptoms, such as sleep apnea, breathing problems, and acute TMD.
This article needs more reliable medical references for verification or relies too heavily on primary sources. (April 2018) |  |
Orthodontic headgear is a type of orthodontic appliance typically attached to the patient's head with a strap or number of straps around the patient's head or neck. From this, a force is transferred to the mouth/jaw(s) of the subject.
Headgear is used to correct bite and support proper jaw alignment and growth. It is typically recommended for children whose jaw bones are still growing.
Unlike braces, headgear is worn partially outside of the mouth. An orthodontist may recommend headgear for a patient if their bite is more severely out of alignment. The device typically transfers the force to the teeth via a facebow or J hooks to the patient's dental braces or a palatal expander that aids in correcting more severe bite problems or is used in retention of the teeth and jaws of the patient.
