Doctor insights on:
Herbst Appliance For Adults
Many: Depending on the cause (dental, skeletal, or both) of the vertical overbite and/or horizontal overjet, treatment alternatives for a 50-year old non-growing adult may require both fixed appliance/elastics and surgery. For a growing child/tween/teen there are many options including Herbst, Carrier, Forsus, springs in association with braces & elastics. Removable appliances are less effective. ...Read more
My 8 year old daughter has been recommended the Herbst appliance but I am not sure this is the best route to take. What alternatives are there?
Dental fixation : The Herbst appliance is a dental device that is used on children to help the lower jaw develop in a forward direction. Herbst appliances correct overbites in young children before their mouths have fully developed. The devices are usually not used in adults or children older than 13 years due to reduced effectiveness. Lesser alternatives include traditional headgear, or Damon braces ...Read more
What are the possilbe long term effects of a herbst appliance used in orthodontics? My stepdaugher had the herbst appliance and it seemed very invasive. Her mom had the braces put on her. Her dad and I were going with another treatment plan that was not a
Answer: the herbst appliance is one type of orthopedic (as opposed to orthodontic) treatment appliance. These type of appliances are used in situations where the upper teeth are biting too far "forward" relative to the lower teeth. About 80% of the time that this type of bite problem exists it is the result of the lower jaw not growing far enough forward to allow the lower teeth to occlude (bite) in the proper position relative to the upper teeth. The purpose of an orthopedic appliance, like the herbst appliance, is to create change in the upper and lower jaw bone relationships, typically by helping the lower jaw bone grow to a more forward position relative to the upper jaw bone. As the lower jaw bone comes forward the teeth are carried with it and the biting discrepancy is resolved. The herbst appliance is one type of many orthopedic appliances which are used to encourage improvements in jaw bone growth and relationship. These appliances can be fixed/cemented, like the herbst or removable like a bionator appliance. There are many other specific appliances which are variations on both of these themes. The use of a headgear appliance in conjunction with braces is an attempt to accomplish the same goals as the herbst appliance (correcting the bite), however the orthopedic appliances tend to be a little more proactive in their ability to potentate forward lower jaw re-positioning through growth than the headgear. Usually the forward re-positioning of the lower jaw also has the advantage of improving the overall facial profile (giving the individual a "stronger" looking chin).
The advantage to the herbst appliance is that it is cemented in place, so compliance in appliance wear is less a problem. The trade-off is that the herbst appliance is cemented in and the hygiene demands on the patient are significantly more than presented by a removable appliance such as the bionator. An additional problem with the herbst appliance is that it is fairly bulky and will intrude on the soft tissue inside the check — comfort can be a problem. Removable appliances such as the bionator are extremely comfortable to wear and, with a little effort learning to talk with it in, can be quite easy to acclimate to. With the bionator there is nothing cemented on the teeth so there are really no hygiene problems to deal with. An additional advantage to a removable appliance is that it can be removed for sports and other activities. However, the bionator is removable and requires significant wear time, typically 20 hours per day, and thus requires excellent patient cooperation in its use.
For any orthopedic appliances, fixed or removable, the patient must be growing. If the patient has completed their growth time orthopedic appliances will not be effective. The only way to resolve jaw position/relationship problems in the non-growing individual is through jaw surgical procedures, usually referred to as orthognathic surgery. ...Read more
A full third: A full third of all orthodontic specialty practices today are adult patients. There are so many wonderful things that can be done for adults including aligning smiles, balancing faces, improving function, reducing jaw joint symptoms, providing a better platform on which to do restorative treatment, and improve gum/bone healt, just to mention a few. See a pro, a qualified orthodontic specialist. ...Read moreSee 6 more doctor answers
What's the difference between devices like the Homeoblock or DNA appliance and regular palate expanders? Is one preferred in adults over another?
Surgery: You CANNOT widen upper jaw in an adult whose sutures have fused without doing surgery. You can push teeth outward, but often at the detriment to the tooth-supporting bone. PLEASE seek consultation with qualified Orthodontic Specialist. Avoid quick-fixes and snake oil. Remember, of it sounds too good to be true... ...Read moreSee 1 more doctor answer
Jaw expansion appliances for adults in braces? I've been told by 3 different orthodontists that due to overcrowding I need to have either 4 bicuspids pulled or have orthognathic surgery. They all told me I need to decide before I get the braces put on
Caution: Seeking second opinions are an excellent way to proceed towards making an informed decision for what's best for you. The extraction of teeth is an evidenced-based approach that is superior treatment for patients with substantial crowding or protrusion. Typically, surgery and extractions are not interchangeable. In l.A., it might be advisable to visit an ortho dept. At usc, ucla, or loma linda. ...Read moreSee 5 more doctor answers
See an orthodontist: First see an orthodontist for complementary evaluation. No matter what age you are, how complicated is your situation. They complete at least two extra years of schooling to practice their skills. The 2mm overbite correction could be a serious problem if not managed properly. Even, if a minimal correction is needed, the orthodontist is always first. Congratulation on your new smile. ...Read moreSee 4 more doctor answers
6 years (usually): Most tongue thrust appliances hook onto the 6-yr molars, so this is about the earliest one could be done. There are different options here, so speak with either an orthodontist (recommended) or your dentist to discuss the best way to approach this. ...Read moreSee 1 more doctor answer
Adjunct: A headgear is an adjunct to orthodontic treatment used to modify skeletal growth and/or to affect tooth position. Headgear can be used in addition to any fixed appliance (braces) system. Don't get hung up on gadgets. Focus on finding the best qualified orthodontic specialist in your area to treat your family. Let him pick the best appliance for the individual's needs. ...Read moreSee 7 more doctor answers
Consult manufacturer: Consult the manufacturer of your pacemaker.Get a more detailed answer ›
Does relax and tone appliance can help in buring fats or reducing weight or breaking cellulite or what its benefits, what it really does?
Weight loss gimics: These appliances do not do anything for losing weight, burning fat, or breaking down cellulite. Weight loss and fat burning can only be achieved through a combination of eat the correct foods and exercise. Cellulite can be treated with a mesotherapy regimen. ...Read moreSee 1 more doctor answer
What can I expect after being fitted for an oral appliance to correct apnea? I have an appointment coming up to be fitted for an oral appliance to hopefully correct my apnea. I'll be glad to get it, but I'd like to know if there are any side effects or ch
CPAP works by forcing air into the nose, through either a fitted mask or nose prongs, to maintain an open airway passage. The most effective dental devices work by pushing the lower jaw forward, thereby opening the air passage behind the tongue. Most are custom-made by dentists and are adjusted periodically to find the most comfortable and effective position for the individual patient.
Some things to expect:
dry mouth when it occurs is usually transient and can often be compensated for by simple changes to the appliance. A small subgroup of patients has persistent dry mouth that is impossible to accept. There are patients with sjorgrenâs syndrome, medication side effects and other conditions that predispose them to dry mouth and there are many over the counter and prescription remedies available. I have found two products that patients report great success with use. The first is rinsinol by oral b. It is not marketed as a product for dry mouth but as a product for treating oral ulcers but it provides excellent coverage of mucosal tissues. The second product is a prescription item made specifically to treat oral mucositis associated with chemotherapy. I use it in an off label method with amazing success. The product is gel-clair and it comes packaged in a box of 21 small packages meant to be diluted with two tablespoons of water and rinsed around the mouth. I found the product roughly equivalent to rinsinol when used in that fashion and very expensive. I have many patients who use this product full strength and apply a small amount to their tissues and find it miraculous in how it controls dry mouth all night long. An advantage to the off label method is one package can be used for several nights making it inexpensive to use. It also works extremely well for oral ulcers in its undiluted form.
A problem frequently seen with oral appliances is pet dogs and cats have an affinity for eating, chewing and destroying them. I have never heard of this happening with CPAP masks and hoses. Patients also are more likely to leave an oral appliance somewhere because it so small and does not require a special case.
Bite changes are a more common phenomenon with oral appliances and are also easily reversible early on. When the patient wears the appliance that keeps their jaw in a different position for eight hours healing occurs in joints and adaptation will often occur. Dentists usually give their patients exercisers or positioners to return to their original position. Patients are often not aware of the bite changes. When patients are aware of the changes about 50% find them to be favorable. It is rare to see a patient discontinue use due to the bite changes. Dentists are often more upset with the bite changes than the patients are.
There is also a subgroup of patients who experience tm joint problems or muscle pain when wearing appliances. These problems are almost never a reason to not use oral appliances but they need to be addressed and treated by a dentist trained to deal with TMJ disorders.
The remarkable fact is that 90â95% of oral appliance users report long-term satisfaction with their treatment. The problems associated with appliance use are usually easily solved or well tolerated by patients. Many patients who start with treating their sleep apnea problems find that correcting the underlying TMJ disorders an advantage not a problem. Similarly, many patients who start seeking treatment for TMJ disorders find that they move on to treating their sleep problems. Because the underlying problems are the same it turns out that treating either problem usually helps both problems.
Good luck! ...Read more
Many Uses: There are many dental appliances with different uses depending on your dental need. I will give you some examples. Night Guards and Day Guards are used to help with bruxing or tooth grinding, retainers are used to maintain tooth position after orthodontics and Oral Sleep Appliances are used to treat sleep apnea and snoring. ...Read moreSee 4 more doctor answers