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Braces

Head gear

03/02/2006

Question:

My daughter is currently going through treatment with an Orthodontist, however, I wanted to get a second opinion to make sure I was aware of all of the options for my child. She is experiencing a faster growing upper jaw that has caused an overbite and protruding front teeth. She currently is wearing top and bottom braces to correct her protruding teeth. Her current Orthodontist has requested that she wears head gear every night to slow the growth of her upper jaw to match the lower jaw. It has been very painful and difficult for my daughter to wear the headgear. I was wondering if there are any alternatives that would not require head gear. Please let me know if you have any suggestions.

Answer:

In order to answer your question I have to assume certain information as fact: namely that the problem is a skeletal one and that the offending part is the upper jaw (called the maxilla).  In order to retard the growth of the maxilla, one of the most effective ways is through the use of a headgear. This takes the force out of the mouth and directs the force to the offending part. Especially since she is already wearing upper and lower fixed appliances, this is a time-tested method of reducing a protrusion of the upper arch.

There have been attempts to try to force the lower jaw forward through so-called propulsive devises, but these are most often used when the skeletal part of the problem is in the lower jaw. These also have disadvantages in the form of breakage.

I suggest you have a discussion with the orthodontist about the problem. Perhaps the forces on the headgear could be reduced. Remember that to be effective, the headgear needs to be worn a specific amount of time which should be carefully monitored. Orthodontics is trying hard to find ways to avoid head-gears.

Another recent development has been in the form of fixed screws into the bone as an anchor to retract protruding teeth. Right now, in this country, most orthodontists have been slow to subject their patients to this procedure, but again this could be discussed as an option.

For more information:

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Response by:

Walter C Buchsieb, DDS, MS Walter C Buchsieb, DDS, MS
Professor Emeritus - Clinical, Associate of Dentistry
College of Dentistry
The Ohio State University