Hamilton Orthodontics
Herbst® Appliance
How Does a Herbst appliance Work?
The Herbst Appliance is cemented onto the upper and lower molar teeth and requires little compliance. It is hinged and includes two small metal tubes that are attached to the left and right-sided upper molars. Two small tubes on the bottom connect the small metal tubes to the lower teeth. These guidance tubes are designed to slide and create a gentle force meant to push the lower jaw forward.
By activating the Herbst appliance your orthodontist is able to control the jaw’s position in relation to the upper teeth. Depending upon the severity of the jaw discrepancy this is usually done every few months until the proper jaw position is achieved. The appliance is usually worn for a total of 9-12 months. The treatment time will depend on the patients’ unique needs. Upper and lower braces may also be placed during Herbst treatment but not always so. The main goal of orthodontic treatment utilizing the Herbst appliance is the correction of the jaw discrepancy.
Adjusting to a Herbst Appliance
When your child first gets his or her Herbst appliance you can expect it to take about 7 days to get used to it. The Herbst is hinged allowing the mouth to open and close enough to speak and eat normally, but initially, the patient’s bite will feel different and chewing may be affected. There may be some overall muscle tenderness and soreness of the teeth. As your child’s mouth adapts to the appliance, the soreness should fade. Because the Herbst appliance is metal, it may cause some slight tissue irritation, especially on the lower gums. Occasionally, patients can develop sore spots where the appliance rests against the soft tissues of the cheeks and lips. If this happens the application of dental wax can help to ease the irritation. Speaking may be awkward at first and patients often create more saliva than normal. Practicing speaking through singing or reading aloud and becoming accustomed to the appliance should help with saliva reduction and overcoming any awkwardness felt while talking.
Eating with the Herbst appliance.
Eating softer food will help with any muscle soreness, especially after the first week or two after getting the appliance. As with many orthodontic appliances, it’s important to be careful and conscious about the foods you eat while wearing the Herbst appliance. It is very important to eliminate sticky foods, like candy and gum, or hard, crunchy food. Chewing these can damage the appliance and as a result lengthen treatment time. Some examples of foods to avoid are: ice, caramel, whole hard raw vegetables. Our staff will review the foods to avoid once the Herbst appliance is placed. Patients should also be careful not to open their mouths too wide, as this can cause the appliance to come apart.
Care of the Herbst
It is durable and requires little maintenance except for normal cleaning and slight modifications to diet. Since the Herbst appliance lies in contact with the teeth, extreme care must be taken with regards to oral hygiene. The patient should use a daily fluoride mouth rinse and should avoid all sticky and sweet foods that could cause decay. Particular attention should be taken to keep the area of the appliance adjacent to the gum tissue clean and free of food debris. Once the appliance is placed, our staff will review proper cleaning techniques.
What problems can occur with the Herbst?
If any part to the Herbst appliance becomes loose we require you to inform us immediately. A broken appliance will require our attention and we will need to schedule a visit into the office. In addition, please notify us if any irritation of the cheeks or lips persists or if there is an unpleasant smell or taste occurring in the mouth.
What happens when the Herbst appliance is removed?
Once the Herbst appliance is removed, comprehensive orthodontics or braces will be initiated to finalize bite correction and tooth alignment for the greatest stability and esthetics.
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