dentofacial orthopedics involves the guidance of facial growth and development, which occurs largely during childhood. Appliances such as headgear and expanders might be used depending on what facial abnormalities are present. Sometimes orthopaedic treatment may precede conventional braces, but often the two are accomplished at the same time. So if your child gets braces and headgear, he’s undergoing orthodontics and dentofacial orthopaedics.

Prominent Upper Jaw

Headgears are worn to correct skeletal and dental problems to allow the bite to be properly established. Most patients that have severely protruded upper teeth will need to wear a headgear approximately 12-14 hours per day to make the necessary skeletal correction by slowing down the growth of the upper jaw bone so that the lower jaw bone can grow and catch up with the upper jaw bones growth. Therefore, this reduces the protrusion of the upper jaw bone and teeth.

Upper Jaw Expansion

A Rapid Palatal Expander (RPE) is an upper appliance that places pressure on the upper jaw (maxilla) by turning a midline screw. The pressure separates the mid-palatal suture thus making the maxilla wider, which can correct crossbites and create space. RPEs are used often to correct posterior crossbites.

Since we are separating a mid-palatal suture, it is better to do this procedure at a younger age before the palatal suture becomes fused. Activation of an RPE is done by a parent, guardian or another person.

Prominent Lower Jaw

A reverse headgear is a removable appliance made up of two soft pads that rest against the forehead and chin, connected together with a wire framework.

Rubber bands are attached from this metal framework to the palatal expander or upper braces. The headgear is designed to work together with a palatal expansion appliance to move the upper teeth forward, to encourage the growth of the upper jaw, and slow down the growth of the lower jaw. When worn properly, it will correct underbites and create a healthy bite.
With consistent wear of the reverse headgear, we have an opportunity to avoid the need for removal of permanent teeth and future jaw surgery. We have found that the reverse headgear is most comfortable and effective when it is worn as a part of early orthodontic treatment, between the ages of 6 and 11, and can be used until the end of adolescence. The reverse headgear is an important part of your orthodontic treatment and needs your cooperation to be effective.