Orthodontic headgear is the last thing that most orthodontic patients wish to endure as part of treatment. Orthodontists understand the burden of wearing headgear and try to resolve issues without the use of headgear whenever possible. However, orthodontic headgear is necessary in some cases to help patients achieve straight teeth and properly aligned jaws.
Orthodontic headgear is an appliance that is worn over the head that attaches to a device inside of the mouth. Headgear applies more force to the jaws than is possible with braces or other devices alone. The headgear is generally attached to a device called a facebow, which is attached directly to the braces. The headgear is attached to the head by straps and metal arches. The headgear exerts force that is transferred to the facebow, which is then transferred to the braces to allow more movement of the teeth and jaws than would be possible without the headgear.
If the alignment issue stems from an underbite, a facemask may be needed to assist with correction. A facemask is worn mostly outside of the mouth, with a part inside of the mouth that exerts force to pull the upper jaw forward. A headgear facemask typically consists of two pads and a vertical frame. One pad rests on the chin, one on the forehead, with the frame connecting the two. Elastics and wires connect the frame to the braces inside of the mouth. A headgear facemask is sometimes called reverse headgear.
Headgear is used in cases of extreme underbite or overbite, where more force is required than what can be achieved with orthodontic appliances that are only applied inside of the mouth. Headgear is typically used with patients that are still developing to help guide the jaws into a more desirable position. However, headgear may also be used for adults that need help with tooth spacing and bite alignment following tooth extractions.
Depending on the type of headgear and the severity of the problem, headgear may be worn between 12 and 16 hours a day. If headgear is worn at night, patients must be consistent with wearing the headgear or the results can be reversed very quickly. Patients must carefully handle, maintain, and clean the headgear in order to achieve the desired results.
Headgear exerts significant pressure, so improperly removing or attaching the headgear can be dangerous. Patients should also beware of doing extreme physical activities while wearing headgear, as it can become dangerous. While wearing headgear may take getting used to, the results can make the treatment worthwhile if all instructions are carefully followed.