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The Herbst is a growth modification appliance that is used when the upper jaw is too far forward compared to the lower jaw. It replaces the old-fashioned headgear. It can prevent surgery and or extractions in some patients.
It consists of four stainless steel caps that fit over the back molars – one in each corner of your mouth. The top portion of the appliance consists of an expander (to learn more about the expander click here) ExpanderVideoMoriczOrthodontics or looped wire which runs along your palate. The lower portion has two metal bars that run parallel to the outer sides of your lower back teeth and thin bar that runs along the inner sides of your lower teeth for stability. Two metal cylinders or ‘arms’ connect the top and bottom together. The appliance is glued (with orthodontic cement) into the patient’s mouth and typically stays in your mouth for 9-12 months once the arms are placed.
The Herbst may seem like a large appliance but it does a lot of amazing things to improve your bite and jaw harmony. The appliance works by connecting a top appliance, usually and expander with a bottom piece and a system of metal caps and ‘arms’ or cylinders to connect the top and bottom jaw. All the pieces work together to correct a severe overjet (commonly mis-referred to as an overbite, and also known in slang as ‘buck-toothed’). Many think the Herbst corrects the overjet by moving the lower jaw forward, and while this does happen, it is the sum of 5 movements created by the Herbst appliance that correct the jaw relationships. The five movements are: 1) the expander portion widens the upper jaw, allowing room for teeth to move to a broader smile position rather than stick out or put another way, move from a V-shaped upper jaw to a U-shape; 2) the top jaw moves back; 3) the bottom jaw moves forward; 4) the top teeth move back; and 5) the bottom teeth move forward. All of these movements take 9-12 months and work with growth to improve the facial and dental relationships.
The Herbst is a big appliance because it does a big job. It can prevent extractions and even surgery in many patients. It’s an amazing appliance but does take time to get accustomed to. Be patient and give it time.