- What is headgear and why is it used?
Headgear is usually used in a growing patient to modify the growth pattern by slowing down the forward growth of the upper jaw and letting the lower jaw continue to grow. It can have a significant effect if worn properly over an extended period of time.
- What are the different types of headgear?
There are three main types of headgear. One uses a strap that fits over the top of the head (that's why it's called headgear). Another uses a strap that goes behind the neck and is often called neckgear. These two types usually attach to the molar area with a wire part called the facebow and work on overbite, where the upper teeth are ahead of the lowers. A third type of headgear is called reverse headgear because it actually helps to speed up the growth of the upper jaw and work on underbite or crossbite. It uses facial pads on the chin and forehead along with elastics to pull the upper teeth and jaw forward.
- My child's headgear is hurting. What should I do?
If the headgear is hurting when it is first put on at night this is a sign the headgear is out of adjustment and needs attention from the doctor. Call the office and schedule a special visit to have the headgear adjusted. If the teeth where the headgear attaches are slightly sore in the morning after wearing the headgear all night, this is normal and no adjustment is needed. This morning soreness will often subside after about one week of consistent wear. If several days are missed, this morning soreness may start up again when headgear wear is resumed. This sore time is known as the "break-in period".
- Can headgear be used in adults?
Because headgears are usually designed for growing patients, they are seldom used in adults. Their effectiveness would be limited to preventing back teeth from moving forward while closing upper extraction spaces.
- Will my child need to wear headgear to school?
Since we realize that most children do not want to wear their headgear to school, we have designed treatments so that nighttime wear is all that is needed. This also helps prevent the headgear from getting lost at school.
- Can my child wear the headgear more than the prescribed number of hours?
Because the headgear is applying a gentle pressure to the sutures of the mid-face to adjust the growth at those sutures, the more the headgear is worn, the greater the effect on growth. Time of wear is calculated on an hourly average per day. So remember, if an hour is missed one day it needs to be made up the next day to keep the hourly average high. While the headgear is on it is restricting the growth, but when it is removed the growth rebounds slightly. Therefore, it is important to keep the average hours per day high and limit the number of hours not worn.
- What will happen if my child does not wear the headgear? Are there other options?
Every treatment is unique. In some cases where the headgear is not worn critical growth changes cannot be made, leading to a poor outcome. In the worst situations, only jaw surgery as an adult can complete the result. In other situations, permanent tooth extraction can substitute for poor headgear wear. Check with the doctor to see if other options exist if headgear becomes a problem.
- Can my child increase the tension on the headgear to make it work faster?
Unfortunately, increasing the tension on the headgear does not make up for lost hours. This is due to the mechanism of headgear action. Because an optimal tension is needed to have an effect on suture growth, increasing tension beyond the optimum can have a negative effect. Three things are needed for positive headgear effect:
1) consistent and adequate number of hours worn, 2) optimal tension and adjustment and 3) the patient must be growing.