One of the most common problems orthodontists are asked to treat is the discrepancy that occurs when the upper teeth protrude beyond the lower. Ordinarily when we see a patient with the upper teeth protruding, we tend to think that the upper jaw and teeth are too far forward. More often than not, this condition is due to a small lower jaw that is further back than it should be. The Herbst appliance is very effective in correcting large overbites due to small lower jaws in patients that are growing.
With these patients, Dr. Henry would like to encourage the lower jaw to catch up in growth, and appliances like the Herbst help this to happen. The Herbst appliance is used to enhance the growth of the lower jaw in a forward direction, while at the same time applying pressure to the upper jaw in a backwards direction.
A tube and rod work together, similar to a shock absorber, to connect upper and lower jaws. This does not interfere with opening and closing the mouth. Side-to-side movement is somewhat restricted. The Herbst appliance is cemented on the back molars and in place and active 24 hours a day. It is generally worn full time for about 12 months. Additional treatment with standard fixed appliances (braces) will be needed after Herbst therapy.
At first, your mouth will feel unusually full and speaking will be awkward. But if you practice reading aloud, your ordinary speech will return quickly. You may also notice more saliva than normal, but this will decrease as you become accustomed to the appliance.
Even though the Herbst appliance prevents the lower jaw from moving backward, opening and closing movement still occur easily and patients do not have any problems learning to chew their food with their lower jaw in this new position.
Your Herbst appliance will be checked and adjusted by Dr. Henry. If sometimes between appointments you develop some sore areas on the inside of your cheeks, please do not try to adjust the appliance yourself. Call for an appointment and let Dr. Henry make the necessary adjustments.
Hints for your Herbst appliance
You may notice some tenderness in the muscles of your cheeks and jaw area. Take Tylenol or Ibuprofen as needed (unless allergic).
You may find chewing difficult at first. Cut food into small pieces and chew more carefully. Remember, in the first week let your knife and fork do most of the chewing for you. Sticky or hard foods such as gum, caramel, taffy, etc. are not allowed while the Herbst is in your mouth.
The inside of your cheeks may be slightly irritated by the Herbst appliance until these areas have built up calluses. You may apply wax to the Herbst if it causes any irritation during the first week. Use warm salt water rinses two times a day for a few days to help condition your mouth to the Herbst (dissolve one teaspoon of salt in a glass of warm water). It is also best to sleep on your back as pressure on the cheeks can cause irritation.
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 Dr. Henry so that he can repair the appliance as soon as possible to keep from delaying treatment.