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Information about the Herbst Appliance

The HerbstŪ appliance is designed to correct bites and improve facial profiles. The most common bite problem the HerbstŪ will correct is when the upper teeth protrude too far beyond the lower. We tend to think that the upper jaw and teeth are too far forward but, more often than not, this condition is due to a small lower jaw that is further back than it should be. Side view of a Herbst appliance

The HerbstŪ will encourage the lower jaw to catch up in growth. The appliance is cemented and will work for even the most sensitive patient because a constant force is much less painful and disruptive than intermittent forces, like a head gear, and is much more predictable as far as results. It is called a "functional" appliance because it causes the patient to function (speak, swallow, and eat) in a new jaw position. If the patient functions in this new position for long enough, the change becomes permanent.

It is often necessary to expand the upper jaw while the lower jaw advances, this is done with the addition of a Palatal Expander. The PSA is turned with a special key until the upper jaw is wide enough. The doctor will advise you about using the key and what to expect from this combination.

The HerbstŪ appliance can eliminate the need for extracting permanent teeth and/or the need for surgical corrections.

The HerbstŪ appliance is completely contained in your mouth, and is cemented on your upper and lower teeth, staying there until the bite is corrected. A piston and cylinder devices, which we usually call rods and tubes are attached to the upper and lower segments of the appliance and operate together. These sliding pistons will allow the jaw to open and close, but keep the jaw forward in the desired position. At first your mouth will feel full and speaking will be temporarily awkward. You may also notice more saliva than normal, but this will decrease as you become accustomed to the appliance. Even though the HerbstŪ 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.

The Herbst is checked every 6-10 weeks and can be advanced or moved forward more by adding "shims" to the pistons. It stays in place for 8 to 12 months to make sure the correction is permanent and then is removed and full braces are placed to continue and finish the straightening process.

The most common problem with the HerbstŪ is the rod coming out of the tube when the patient opens their mouth too wide. This is easily fixed at home by having the patient open overly wide again and sliding the rod back into the tube as shown below.

1: Open wide

2: Align rod & tube

3: Slide together

As with all kinds of braces, patients with the HerbstŪ need to be careful about what they eat. Hard, sticky, chewy and crunchy foods can loosen the cement and pull the braces from the teeth. Don?t play with the appliance with your tongue or fingers. More braces are damaged by these careless habits than any thing else.

 
© S. Jeffrey Crews, DMD, PC - No reproduction without authorization.