Herbst Appliance for overbite?

Post Reply New Topic

Anyone have experience with Herbst appliance for overbite? My DS is getting one next week, I'm a little concerned with sensory isssues... but he is adament we fix his overbite which has become really uncomfortable.

I have never used a Herbst device, but I did have braces with the bands as seen here:

So I can give you my take there. There are a couple things to note:

1. The way that braces or the herbst device works is by slowly putting strain on the teeth which causes the jaw bone to shift. Interestingly enough, while most people assume that bones are fairly static, the reality is that they will stretch and deform if put under strain for a long period of time. A 50 pound thwak isn't going to change the shape of the bones, but a simple 5 ounce pull over the course of weeks will be sufficient to reshape bones as they deform and reform themselves to compensate for the strain. How this relates to braces is simple.

The dentist wires up the braces in such a way to put strain on the teeth pulling them in a certain direction. Once the teeth have shifted (less then a millimeter usually) the strain in the wire is slackened and it is no longer pulling. This process takes about 2-3 days (based on experience). The teeth are then given a few weeks or so to root in their new position before a new wire is applied that again puts strain on the teeth and moves them another millimeter. This is why you go to the orthodontist every month or so for years, so that your teeth can be incrementally shifted, only a millimeter at a time until they are in the correct position. Likewise, a Herbst' device is designed with bars that position the lower jaw. Every few weeks, these bars will be replaced with bars that are 1 mm longer, thus pulling the lower jaw 1mm farther forward at a time, slowly over the course of a year or so.

Now this is interesting and all, but now to the advice portion:

When your teeth are being realigned, it makes your jaw sore. About an hourish after you leave the orthodontist till about 3 days later, your jaw will ache a bit. This is just the feeling of your teeth being under strain. Taking some aspirin usually fixes the problem. So, just expect there to be some mild soreness, and take some aspirin before you go there. And make sure to keep taking the aspirin for a few days after. The 24-hour style may be useful as you don't want to wake up at night with a sore jaw. I had that happen a few times when I took the 4-hour aspirin just before going to sleep. To be honest, the jaw soreness was nothing more then a minor inconvenience. It wasn't that big of a deal if you took the aspirin.

2. The braces/herbst device will be somewhat scratchy on the sides of the mouth. This will go away after a week or two, and can be greatly reduced with the use of wax (available from the orthodontist). It will feel weird at first, and a bit uncomfortable until you get used to it, but not excessively painful. Just make sure that when you first get it installed, you take aspirin regularly, and apply wax a few times a day. After maybe 2 weeks, youll get used to it, and you can stop with the aspirin and wax.

3. Make sure your child is on board and fully aware of the process. The last thing you want to do is force your child into this and use the tired excuse, 'its for your own good'. For example, here is the bad method:
Child: my teeth hurt
Parent: quit complaining, I heard you the first time.
Child: but they hurt
Parent: look, its for your own good, now be quiet.

That's the wrong approach. The better approach is to sit your child down and tell him EVERYTHING that there is to know about the process.

How long will it take?
What will it feel like?
What is being installed?
Why is it being installed?
How does it work?
Why is it necessary?
What problems will there be?
How will these problems be addressed?
What should he expect?
How long will it take to get used to?
What can he do to reduce the problems?
And so forth.

The more your child knows, the better prepared he will be, and the better he will handle it. If he knows what he can do, and what you are doing, to make the situation better, he will less likely to complain. And if he understands the reasons for it, he will be more willing to deal with the problems. Simply put, the more information he has about it, the better.

4. You CANNOT!! !! effectively brush your teeth while wearing braces. I don't care what the orthodontist says, it is impossible to brush effectively and get out all the gunk that gets stuck under your braces. The orthodontist might be able to do it, but thats because they can easily see what they are doing and have an optimal angle. Trying to brush your teeth at home isn't going to do much. I had my braces on for 2 and a half years. After I got them off, I had to have 17 cavities drilled and filled because of the damaged caused by wearing braces. Luckily, the Herbst device seems to attach directly to only 4 teeth, and there isn't a gap between the device and the teeth like with braces. This should cut down on the problem, but expect to have those 4 teeth that they attach to either replaced, or drilled/filled after you get it removed. If your lucky, it wont happen, but don't go into this expecting to be lucky.

Also, see if you can get your son to use the anti-bacterial mouthwash. I use the Listerine Zero (no alcohol, mild taste). It kinda tastes a bit weird the first few times you use it, but you get used to it quickly. I actually enjoy the flavor now as it tastes fresh and slightly minty. The mint is optional, but it should help to reduce the problems with not being able to brush effectively. At the least, it will take care of the bad breath due to food getting stuck in places you cannot brush.

5. What ever you do, under no circumstances, should you ever, ever, EVER, get the braces that go on the inside of the teeth. Allow me to explain. The braces that go on the outside of the teeth can be a bit itchy on your cheeks, but it isn't that big of a deal. With wax, you get used to it quickly, and it isn't a big problem. I wore braces on the outside of my teeth for 2.5 years with no major problems (aside from the cavities because you can't brush). But after I got my braces removed, my front lower teeth were still a bit crooked, and if left uncontrolled would move out of position. My parents were given 3 options, (shockingly, I was never consulted). I could either keep the lower braces on, get a retainer, or get a small interior set of braces for just the front 4 teeth. My parents decided to go with the interior braces as they wouldn't look bad on photographs, and they didn't trust me to use a retainer. They looked something like this:


These braces lacerated my tongue so badly that I was bleeding non stop. I couldn't open my mouth without drooling out blood. The wax was useless as my tongue would wipe it off, and every time I took a bite, said something, or opened my mouth, the braces would tare into my tongue again. I only wore the interior braces for about 4 days. I told my parents that if they didn't get them removed, I would pull my teeth out with a set of pliers and I was NOT kidding. After that, I got a retainer, which was much better. Keep in mind, that having things on the inside of the mouth isn't necessarily bad. I had a retainer that looked like this:


It didn't bother me much at all. It felt weird, but there was no bleeding and misery. Simply put, the braces had a lot of sharp edges, rough wires, and prongs to rip your tongue on. The retainer was smooth, and the only metal wires were smooth, flat against my jaw, and didn't have pointy ends.

6. If possible, dont try to do braces and the herbst' thingy at the same time. Your better off just doing the herbst thing for a year, then going to with the 'invisalign' system. That's basically a series of retainers that accomplish the same thing as braces, but you can take them out for things like eating, and brushing your teeth. My friend got those, and he was actually able to brush his teeth, so he didn't wind up with 17 cavities. They are also slimmer, and more comfortable then braces as they fit right on your teeth, and don't scratch at the gums at all. If I was actually given a choice, I would definitely have gone that route instead.

My son had a Herbst appliance during grade 7, and it was pretty traumatic. As I recall, it was very painful -- much more so than the adjustments that orthodontists make on braces. It might be worthwhile to prepare him for the possibility of some major discomfort -- particularly just after adjustments -- and maybe dose with ibuprofen prior to the visit.

Good luck. It's one of those gawd-awful "no pain, no gain" things that he's going to need to tough out as best he can.

My 14-year-old son has one. He's had braces for two years, and his teeth are straight, but he still has a bit of an overbite. He HATES this appliance. He cannot bite down normally to eat his food, and this is very annoying to him. Occasionally, when he yawns, the little bar pops out and has to be refastened. He really has handled the braces well for a kid with sensory issues, but this appliance drives him nuts! The orthodontist expects him to wear it for several months; I don't know if he will comply for that long. When he's calm, we can discuss how it's for his own good, and he understands, but it really does bother him.

Make sure your child is comfortable giving feedback to the orthodontist about adjusting things to make it as comfortable as possible while still being effective.

Jane

I hope its not too late to mention this!

I did some research, and it seems that the invisalign system can indeed be used to fix an overbite (as your child has). I understand that it will cost a bit more, but thats only looking at the price of the system itself. When you include the cost of filling the cavities, and surgery to repair the damage done to the gum line, it actually costs less.

So yeah, I would definitely look into it ALOT. Call up some people, and see if you can get a second opinion on whether or not you truly need a Herbst device, or if an invisalign system will work.

Thanks for all the helpful replies everyone! We will see how it goes, he is very determined to fix the overbite as it really bothers him, so maybe that will be enough to deal with the pain. I will ask about invisalign too. Thanks!