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Herbst Appliance
The Herbst appliance is one of the methods we use for correcting large overbites in our pre-teen and early-teen patients who have smaller than average lower jaws and are still growing. This technique is used to enhance lower jaw growth in a forward direction, while simultaneously applying the opposite pressure to the upper jaw. Widening the arches in both upper and lower jaws can also be incorporated into this device.
Surprisingly, this appliance is quite comfortable. A "sliding rod within a tube" assembly works together, sort of like a shock absorber, to interconnect the upper and lower jaws. This doesn't interfere with normal opening and closing movements of the jaws during eating or talking. The Herbst appliance is attached (not removable) to the upper molars and to several lower teeth so it's working 24/7. It is worn full time for a 12+ months and may incorporate some front braces. Once the appliance is removed, conventional braces are started and treatment time will continue for another 12-18 months to complete tooth alignment.
At first, you may notice some sensitivity to the teeth and/or cheeks. This is normal and usually begins to improve within a week. If it persists, call our office so that we can arrange to see you to check for a problem. You may want to use a non-prescription medication for a few days as well.
The insides of the cheeks can become irritated with the Herbst mechanism during the first week. For this brief adjusting period use wax as needed over the Herbst appliance arms for relief. Rinsing with warm salt water will also help alleviate the tenderness. If the rod slides free from the tube while opening, first open wide and then guide the rod into the tube as you close your mouth. If anything comes loose, save all parts and call our office right away so we can repair the Herbst as soon as possible and avoid delaying your treatment.
Bimetric Distalizer
The bimetric distalizer is an appliance that increases space for upper teeth and helps with correction of overbites. It uses braces, rubber bands and a spring mechanism to move upper molars back within the upper jaw.
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