Headgear: Dentofacial Orthopedics

Headgear actually changes the direction of growth of the upper jaw, or maxilla. Bands are placed around the upper back molars and a metal bar (called a facebow) slides into the bands and connects to a strap that’s worn either a) around the back of the neck or b) at the crown of the head. This force is measured to be enough to restrict forward upper jaw growth and can be modified to change the direction of the growth. In order to have a therapeutic change on growth, a patient must be in their peak of upper jaw growth, namely between the ages of 8-10.

There are several reasons why Dr. Abdoney or Dr. Cronauer would want to modify your child’s jaw growth, which all arise from an unbalanced hereditary growth of the upper and/or lower jaws. Headgear ideally treats upper jaws that have grown too far forward: Restricting the forward growth of the maxilla allows for the lower jaw, or mandible, to “catch up” in its growth. Skeletal growth issues frequently create moderate to severe bite problems, which appear to be:

• Buck Teeth
• Small chin/lower jaw
• Inability to close one’s lips

Sometimes these bite problems or differences in jaw growth are due to the lower jaw not going enough or enough in the right direction. Unfortunately, growth of the lower jaw can’t be greatly modified. In children with smaller mandibles, their mandibles tend to complete their growth a little earlier than usual and the direction of growth tends to stay consistent. Headgear treatment may help the upper jaw match the lower better, thereby reducing the length of braces treatment once all the permanent teeth are in. That being said, there are many excellent ways to fix bite problems in the early teen years that have similar effects to headgear use. Dr. Abdoney and Dr. Cronauer use their clinical judgement to determine whether headgear treatment would be beneficial in both the short and long term.