Head Gear

We try to keep the need to use a headgear down to an absolute minimum. However, there are some circumstances that require the use of a headgear.

A headgear is an orthodontic appliance used in the treatment of some patients. A headgear creates a push or pulling (depending on the type of head gear) force to guide the teeth and jaws into correct jaw alignment.

A cervical pull, combination pull or high pull headgear are designed to correct certain forms of over jet (Class 2). An over jet is characterized by the upper jaw "bucking" out over the lower jaw. Once a proper diagnosis is made the orthodontist will prescribe the headgear that will work best for your situation. For an example of an over jet please click on the photo below.

A reverse pull headgear (protraction headgear) is designed to correct an under bite or a (Class 3) problem. An under bite is characterized by the lower jaw biting over the upper jaw.

It is extremely important that the orthodontist correctly diagnosis this problem. In some instances an under bite can be characterized as an over growth of the lower jaw called mandibular prognathism or simply a strong chin. In this case reverse pull head gear would not be indicated. Only when a diagnosis of maxillary (upper jaw) deficiency (under development) is observed should protraction head gear be used.

Protraction headgear therapy is often restricted to growing patients only. Adult (non-growing) patients are often ineligible for this type of treatment. In the majority of cases, surgical intervention is often needed to help achieve an ideal result.

In some cases a cross bite may exist. A cross bite is when the upper teeth are biting inside of the lower teeth. In some situations the cross bite may exist only on one side (Unilateral cross bite), both sides (Bilateral cross bite) or the entire upper jaw (Global cross bite) may bite inside of the lower jaw. In any event expansion is often indicated. Some researches have found that expanding the upper jaw while wearing the protraction face mask will help facilitate a more rapid forward movement of the upper jaw.

A bonded Rapid Palatal Expander with protraction hooks is often the appliance of choice. Hook are placed on the appliance to serve as a site for elastic or rubber band attachment. Once the rubber bands are in place and correctly attached to the reverse pull head gear, traction is placed on the upper jaw to stimulate its growth and forward movement. Reverse pull headgear is very effective if it is worn properly. Wearing a face mask may not be fun, but neither is surgery. Parents and patients must understand that this may be the last viable option before surgery. So I strongly encourage you to cooperate and wear your mask as directed.

For an example, please on the one of the photos below.

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Cross Bite Under Bite (Class 3) Bonded Rapid Palatal Expander

Living with your protraction face mask

Wearing a protraction face mask may not be easy but here are some helpful pointers that many of our patients have found to be very useful.

During the summer months wearing a protraction mask can be uncomfortable. Your perspiration can be absorbed by the spongy material. The moisture in the sponge now serves as an area where fungus can grow and multiply. Some patients have experienced rashes and discomfort. Many of our patients have suggested the use of "Beaver cloth".

Beaver Cloth
Fibre: Wool. Also sotton and napped on both sides - double faced.
Weave: Twill and very heavily napped, and fulled.
Characteristics: Originally English. Made to simulate beaver fur. Thick, gives excellent wear and very warm - resembles kersey. Length of nap varies with the cloth and its uses. Has a luxurious look. Has the longest nap of all the napped fabrics and usually somewhat silky. Often light colored fibers added to nap to increase shine.

Beaver Cloth: A heavily fulled twill wool cloth that resembles the animal of that name. Has softer body and longer nap than kersey and melton. If term is used, it must be referred to as imitation beaver cloth to distinguish it from real beaver fur.
Uses: Mostly used for warm coats. Cotton beaver is used for caps, shoe linings, work cloths, Maritime clothes and sports clothes where work is required.

It is soft and when placed over the padding makes the mask more comfortable. Beaver cloth does not hold moisture like the sponge, therefore it is less likely to promote the growth of fungus.

One of our patients recommended this routine. Make 3 sets of padding (Six total). One for the forehead and one for the chin area. The cloth is put in place but before it is worn it is briefly sprayed as needed with an anti-fungal spray and allowed to dry. (It is imperative that your child must not have any known allergies to beaver cloth or any of the ingredients in the anti-fungal spray). The Beaver padding should be rotated through out the day. In warm weather climates the padding should be changed every 6 hours. If your child begins to feel any itching change the padding as often as necessary. The padding should be rinsed and allowed to dry before it is worn again. Beaver cloth may be hard to find in some areas. We recommend that you contact your local fabric store, or visit: http://www.fabrics.net/swatch/Default.htm .

It is very important to wear your headgear for the specified time and duration. In the majority of cases you are expected to wear your headgear while you sleep. Forgetting to wear your headgear will reduce the success, increase your treatment time, and in some cases make our goals impossible to achieve.

Things to remember

Bring Your Headgear To Every Appointment so that it can be checked and adjusted. Each headgear is custom fit and adjusted, you should not change yours in any way, without consulting us first.

Tender Teeth are normal the first few days the headgear is worn. Don't be discouraged, because the tenderness will disappear as you adjust to the new pressure. Wear it consistently, and do not put it on and off. Please inform us if your discomfort is longer that one week.

	Do not under any circumstances play with your headgear on or allow others to snap or pull on it. Mistreatment of your headgear could result in harm to you or someone else. Always remove the strap or elastics before removing the headgear.
	Never wear your headgear when running swimming, or playing contact sports.

It may not be fun wearing your headgear, but it is necessary in some cases. Wearing your headgear can help prevent the future need of having permanent teeth removed or jaw surgery. You can enjoy a lifetime of benefits from a few moments of sacrifice.

If you ever have any problems, please feel free to contact the our office by

(301)333-3900(301)333-3900

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