The Herbst Appliance is very effective in correcting large overbites in growing patients. It is used to enhance the growth of the lower jaw in a forward direction, while at the same time applying pressure to the upper jaw in a backward direction. Expansion (widening) of the upper jaw may also be done if necessary.

The Herbst is comprised of a tube and rod on each side of the mouth that work together similar to a shock absorber. It connects the upper and lower jaws, but does not interfere with opening and closing the mouth or with eating. Side to side movement is somewhat restricted, though. The Herbst appliance is cemented on the back teeth, and so it is in place and active 24 hours a day. It is generally worn full time for at least 6 months, and sometimes as long as a year.

It can be worn alone, or at the same time braces are on, depending on the patient's age and orthodontic problem. Once it is removed, braces are usually added to the side teeth to complete the treatment plan.

At first, patients will notice some tenderness to the teeth, the jaw muscles, the cheeks, and near the jaw joints, This is normal and should begin to disappear within a week. If it persists longer, please call our office. Rinsing with warm salt water will help take away the tenderness. The appliance may also irritate the insides of the cheeks for the first week or so.

Patients may find it easier to sleep on their back so there is not as much pressure to the cheeks. Wax may be used as needed to cover the Herbst Appliance for comfort the first week. If the rod slides out of the tube while opening, open wide again and guide the rod back into the tube as you close. If the screw or crown comes loose, save all pieces and call our office so we can repair the appliance as soon as possible to not delay treatment.

Remember, while the Herbst may be difficult to adjust to for a few days, it takes the place of headgear and more difficult appliances. In most cases, it allows large overbite correction without having to extract teeth or have jaw surgery.

Before	After
Before	After
Before	After
Before	After