Any tips/experiences about headgear?

[Taf]

My daughter is soon to be the proud wearer of headgear to pull her teeth backwards and make room for others to come through. We are excited about this, because the other option was to extract 4 permenant teeth - but thanks to the great advice from Dr. Rick & Helen on this site, we sought a 2nd opinion and are taking the headgear route.

So - any tips or advice about headgear would be appreciated! How do your kids get on with wearing it?, Is it comfortable?, does it hinder speach? etc, etc...

Thanks for your comments - it`s great to have ths forum and share experiences and advice!

Tracey

[Hordeotech]

Dear readers,

even if my comments are not welcome to everyone here, I have again something to add and to show. It cannot be healthy to pull the upper molars with high force painfully through the bone.

the other option was to extract 4 permenant teeth - but thanks to the great advice from..

I advise a 3. option, that is gentler and more comfortable. See it e.g. as the lower of fig. 5 under
http://www.naol-ortho.com/newsletters/v ... ssue_1.htm
(information sheets of a supplier in Texas).
This is also moving molar teeth backwards, by acting the screws in front of them, isn´t it? BE AWARE that the headgear was invented before these screw parts existed, which allow painless movements 1/10 mm by 1/10 mm. The shown plate appliance gives no problems with appearance or during sleep, and the risk of damage to the tooth roots is much lower. It disturbs speech a little, but is removable.
Further reading about differences between USA and European techniques, where the Europeans seem to be weaker in marketing theirs, is under „a little bit of history“ under
http://www.holisticdentist.com/A%20holi ... ontics.htm

Greetings from Berlin, Larissa

[Taf]

Thanks taking the time to pass on your comments - but now I´m even more confused !!!

Headgear seems a great alternative to pulling out 4 health new teeth, and all the doctors I´ve had contact with say it`s a very effective method.

If it is so much easier and less painful with the devices you mention - why aren`t these mainstream appliances available at every dental practice? I can`t believe that the all othodontic professionals only wanting to "sell" the most expensive and time consuming treatment methods. These are caring medical professionals, giving their best advice (even if I didn`t agree with my 1st docs diagnosis, I still respect his integrity)

At our consultation, the doctor had a range of appliances to show us, for various functions - and similar looking equipment to your photos was on display - but this wasn`t an option for my daughters needs. I`m sure if it was - we`d we using it. Now I really am confused .

What does anyone else think???? .

[Metal Mouth Guy]

What does anyone else think???? .

Ignore Hordeotech. There's some kind of hidden agenda here of which this person is not forthcoming. If phpBB had message filters, I'm sure he/she would be in it for most readers here.

MMG

[Hordeotech]

now I´m even more confused !!!

Lean back, breathe deeply and read the following. Then you can start searching for doctors apart from the „mainstream“.

Headgear seems a great alternative to pulling out 4 health new teeth, and all the doctors I´ve had contact with say it`s a very effective method.

The headgear is only for the upper jaw. How will the lack of space in the lower jaw be resolved then? Or is there no crowding, and nevertheless healthy teeth should have been extracted?
And what means effective? Rapid, assembled of prefabricated parts, with low instantaneous failure ... but pain, awkwardness, and possible damages to the roots of the teeth, which become not immediately obvious, are not accounted for.
Is there a reader here, or someones mother or father, who had a headgear 40 or more years ago, and who still has healthy upper molars (those teeth which supported the force of the headgear)?

If it is so much easier and less painful with the devices you mention - why aren`t these mainstream appliances available at every dental practice?

What means easier? They have to be individually handcrafted, designed properly and handled properly, otherwise they will fail. A specialist told me about a child with sagittal screw appliances to distalize all 4 molars, which worked so well, that after completing the permanent dentition, there was some space in excess. I also know somebody who closed a gap of a small missing tooth (a 5) by a sagittal appliance that was equipped with a traction screw, that means for the opposite movement.

I can`t believe that the all othodontic professionals only wanting to "sell" the most expensive and time consuming treatment methods.

You have not asked all. And this has to be viewed in greater context. The headgear itself is inexpensive, but is better compatible to fixed braces, than plate appliances are. And fixed braces are more profitable than removables, especially in adult treatment business.

These are caring medical professionals, giving their best advice (even if I didn`t agree with my 1st docs diagnosis, I still respect his integrity)

Most are doing what they have been taught, the 1st and the following. If you search for it, you may find one who knows a third way. Who has also studied sagittal, or „Crozat appliances“ (a forth way). I have already quoted elsewhere a passage from the bottom of a trumpet SPAMMERS LIKE ME site http://www.dallasmusic.org/gearhead/Braces%20FAQ.html
where the author was not even believing at first, what 1. a dentist told him about the Crozat option whom he 2. knew personally. I have found elsewhere that Crozat can be used for distalizing teeth, when searching „Crozat appliance“ under Google.com. And finally, this is from chapter „Infotexte, Kräfte..“ from my own page:

These quite spectacularly slammed lower teeth are tidyed by a Crozat. Look closely: the 2nd molar is already pushed back. The impression was taken on the occasion of modifying the appliance for making the 1st molar follow. Then, the premolars were also straightened with it, and the treatment was reported to be completed successfully with some slenderizing of teeth in addition. And why should this not work for the upper jaw also?
Crozat appliances have little impact on everyday life, but have the drawback of being slow, and one could consider them as old-fashioned.
The following further reading is from searching „sagittal appliance“. As you see, they mention several designs, of which the proper is to be selected.

http://www.murdocklaboratory.com/ > Active Appliances

The sagittal appliance is probably one of the individually most used active appliances. Designed by Dr. Hermann Voss of Dortmund, Germany, there is no finer appliance to gain arch length. It can be designed for either anterior or posterior arch development.

http://www.johnsdental.com/articles/ort ... gittal.htm

SAGITTAL APPLIANCE Designed primarily to gain anterior-posterior arch length, this appliance encourages either forward or distal movement of the teeth, depending on the anchorage.
The Sagittal can be constructed for wear on either the upper or lower dentition, and utilizes from one to three (usually two side) screws to lengthen the arches. The acrylic makes anterior contact in the cuspid area and posterior contact with bite pads. The cuts are distal to the cuspids, and create arch length when turned.
Working from a single basic design, the Sagittal may take various forms depending on the prescribed treatment. Five basic types are explained in our Ortho Handbook.

[drrick]

There are a gazillion different ways to get to the desired end result.

THere are hundreds, if not thousands, of different appliances used to get the desired end results.

SOme are easier to use than others if the hands of different practicioners.

FWIW, I dont use headgear, but I also dont use crozats. I prefer other typs of appliances.

Many docs find crozats hard to work with. SOme others really like them.

The key is thefollowing: Know where you are - know where you want to go- and then go there.
IOW, proper diagnosis and then the proper tx plan then go there.

[Taf]

I must admit - I was expecting replies along the lines of´"buy your girl a nice soft goose down pillow" or "stock up on chocolate flavoured Hagen Daas to numb the mouth!!" lol

Larissa, you obviously feel very stongly about these removable devices - thanks for your detailed comments.
But I was under the impression that the head gear IS type of a distal saggital device - to gain space in the mouth.

My focus is:
1. To get my daughter a beautiful wide smile using ALL of her natural teeth
2. To create space to make this happen
3. To find a doc who I trust (tick) who also wants Nr 1. (tick) and knows how to acheive Nr 2 (tick)

The next step for us is the impressions, photos, measurements and then a final detailed treatment plan.
I will ask about "Crozat"
I will ask about distaljet & pendulum.
And then I will trust the doctor to make the right judgment based on his experience and success in this field. He is the expert - I´m the mop (mother of patient!)

Now, where`s that Hagen Daas ? .....Ohhh, it was meant for my daughter.....

[Hordeotech]

I am glad to see that we are approaching.
drrick, thanks for your general considerations.

Many docs find crozats hard to work with. SOme others really like them.

Schwarz-type plate appliances are easier to make and to handle, and can be cheaper than old Crozat. Further, when the patient is screwing himself / herself, the frequency of visits at the doctor can be reduced.

Larissa, you obviously feel very stongly about these removable devices

I have seen here in Germany, and experienced myself (I had a deep bite of 10 mm), what they could do 20 years ago - and how they were pushed out of the market then, or reduced in their functions and then said to be insufficient.

But I was under the impression that the head gear IS type of a distal saggital device - to gain space in the mouth.

Yes. To distinguish it clearly, what I described is the removable sagittal plate appliance (a kind of Schwarz plate). And really gaining space is restricted to the growth phase. After that, any kind of sagittal appliance just shifts the crowding from the front to the back (what about the wisdom teeth?)

1. To get my daughter a beautiful wide smile using ALL of her natural teeth
2. To create space to make this happen
3. To find a doc who I trust (tick) who also wants Nr 1. (tick) and knows how to acheive Nr 2 (tick)

After 1., I would not omit:
Increasing her chance to keep ALL her teeth and mouth in a good state as long as possible, that means avoid the risk of caries, soreness caused by fixed parts, gum inflammation and so on ..

I will ask about distaljet & pendulum.

Better don´t. Those I would not consider as a more comfortable alternative to a headgear, because they are FIXED.
They are doing the SAME as the removable sagittal plate, are in the same extent speech hindering, but will force your daughter to speak inproperly in ANY situation. Moreover, food gets caught under these fixed plates, makes oral hygiene difficult and gives a risk of inflammation. And the squeezed tissue around the roots of shifted teeth gets no break for relaxation.
They could be approx. 20% faster, compared to a removable that is really worn 20/24 h, but is this worth while these disadvantages?
At least for the distaljet, I suppose that marketing of some patented parts is involved.
About the pendulum, I know a mother who demanded a likewise removable instead of this that was planned for her daughter, and they got the desired and it works perfectly well and was even cheaper.

He is the expert - I´m the mop (mother of patient!)

All of us are human beings, and more or less interested in earning... Some of us are think more technically or politically, others less.

[Dr. Randall]

There are dozens of appliances out that can distalize molars to make room for all teeth. There is also nothing wrong with extracting teeth in appropriate circumstances. As and orthodontists, I am very conservative about extracting premolars, but it is still a valuable treatment option. It is becoming a problem that doctors will pursue non-extraction treatments when it is a hopeless choice. A healthy occlusion with 4 less teeth is preferrable to an unstable end result with all of the teeth in. The decision to extract is usually based on whether adequate space can be made in the lower arch. If that is possible then headgears, or Wilson distalizing appliances or pendulums can be used. Also remeber that patient compliance with a headgear is absolutely necessary for a decent outcome. The real message is that extractions are not as bad as some would make it seem. Every patient is different and some may require extractions. Good luck.

Randall

[Hordeotech]

whether adequate space can be made in the lower arch. If that is possible then headgears, or Wilson distalizing appliances or pendulums can be used.

Appropriate (!) removable plate or Crozat appliances (plate is easier), as in the examples in my second but previous posting herein, are also proven to do this task. They avoid the permanent deterioration of your daughter´s life quality during treatment, which I decribed just above. In addition, consider how the treatment will continue. What will keep the distalized molars distalized, after e.g. a pendulum has distalized them?

Also remeber that patient compliance with a headgear is absolutely necessary for a decent outcome.

This is valid for any removable appliance, but aren´t Schwarz plates or Crozats, or bionators in other cases less awkward to wear than a headgear? And they will keep distalized teeth in place while moving the adjacent ones.

Every patient is different and some may require extractions.

If they appear too late, I would like to add. When it is too late, this is individually different. In case of severe crowing, 11 years can already be late. It is said that when the lower cuspids appear, then no more lower arch width can be gained.
Here in Potsdam, once I have seen a child wearing a function corrector (Fränkel appliance) over entirely milk teeth. This appliance stimulates a healthy jaw growth, find it in
http://www.sanfte-zahnklammern.de/gerae ... isteb.html
See a more common means to gain space in time, along with a nice crowding example under
http://www.junge-kfo.de/index.php?cont= ... gstand.php
(also no commercial)

The real message is that extractions are not as bad as some would make it seem.

Here the result depends on the way of treatment. Extraction treatment with fixed braces often squeezes the frontal arches to an unnatural narrow shape, with the cuspids very much backward, „black triangles“ and comparatively oversized cheeks around these narrowed arches.
In contrast, if extraction treatment is followed by removables, the arches appear much more healthy and „normal“. I know such cases. This is due to the rigid plastic body of the plate, which prevents the narrowing. To get an impression of it, see this quite early treatment case with missing lateral incisors, which were just not formed. The growth helped to keep all the teeth upright while their forward shift was painlessly supported by the plate.
http://www.sanfte-zahnklammern.de/fallb ... htanl.html
Finally, space for the wisdom teeth may be gained. Check before extraction treatment if they are not lacking, as in 25% of cases.

[Dr. Randall]

Hordeotech, just a few points, and I won't argue this with you. There are no scientific studies that show that any functional appliance (fixed or removable) can gow a jaw or "develop and arch." I have successfully used Frankels, Orthopedic Correctors, Bionators, Pendulums, Maras, Wilson arches, and so on. I have also unsuccessfully used all of those appliances. My person opinion is if I cannot see a significant upside to the treatment by doing it as a 2 phose treatment, then I will not recommend it. Current liturature shows that 1 phase and 2 phase Class II corrections are indistinguishable once completed. Every patient is different and must be evaluated as such. There is no single best way of dealing with a problem.

Randall

[Maggie]

alright, as a college student i'm gonna be frank..I have a headgear because I have a crooked jaw..if your kid needs a HG, do it before college and dating..as a 20 year old model/actress its tough in college..I honestly hardy ever wear the damn thing cuz my roommates are such sweetheart...as a child..at age 8, when I wasnt into guys i would of worn it..just my cheap $.02..and I've been in orthodontic treatment since I was 7 so i know everything..I got braces when I was 10 which made me a social outcast, but these days its different..I think the best age for braces as a biology major is 12-16...after 16 you dont want to be bothered with it..when you have prom, college, and your into guys you dont want braces..i have a roommate who just got her braces taken off because she was so self-consious..i'm personally going to tough it out until its over and i can afford to get my wisdom teeth pulled..

[Hordeotech]

if your kid needs a HG, do it before

Needs? Have you acknowledged all the above that was discussed here with the webmasters? I think this is worth while to consider, before permitting that your child has to suffer ...

I've been in orthodontic treatment since I was 7 ..I got braces when I was 10

So you have been in so long treatment in vain? Therefore, you are a very severe case? Or why has your hard treatment from 7 to > 10 years failed? Lack of retention and subsequent relapse?
Excessive growth of the lower jaw can be so hard to treat, but this is the opposite direction to a (normal) headgear...

I think the best age for braces as a biology major is 12-16

I also had also a crooked jaw and I had an activator which fully corrected it at 13-15. But for some corrections, earlier may be better: here once again my collection
http://www.sanfte-zahnklammern.de/fallb ... beisp.html
Nevertheless, retainer wear should not cease too early... my overbite was also a hard case and finally provided with a second activator for retention until end of growth...

i can afford to get my wisdom teeth pulled

I have no own experience, but I know 2 less-common methods for which many cases are documented where space even for the wisdom teeth was gained. Gently, without headgears or fixed appliances. With treatment begin at <11 years, however, not at 12-16 or adult...[/b]

[Taf]

After a few months lurking around the board, I can finally report that we have started active treatment today with my daughter. Until now it`s been impressions, x-rays, models etc, so I haven`t had much to report.

Today she has had spacers put in, but only on her bottom teeth.

Next week the spacers come out and she gets a palate expander on the roof of her mouth, with a screw that I`ll need to turn every night. I don`t really understand why she needs the spacers below if the expander is going on top (and I forgot to ask) - but maybe she`s getting something else too - a lip bumper?.
She keeps this in for 3 weeks before she had to wear a retainer for a while, and then starts with the headgear.
We were told to expect a gap to appear between her top 2 teeth that will close again later.

So, so far so good - she is happy that it is all going ahead, and was quite disappointed that she "only" got spacers today!!

Thanks & bye for now

Tracey

[Nanski]

I honestly hardy ever wear the damn thing cuz my roommates are such sweetheart....

You don't wear your HG and your roommates are the AHs. S-c-r-e-w them!!! Why are you wasting your ortho's time and your money?? You pay for treatment, then you don't follow through with the prescription for success......I must be missing something.

Let your crooked jaw go...and when you're 45 like me and you're crooked jaw is now causing debilitating TMJ pain you'll think back to this forum, "Ummm, maybe I should have done what the ortho said back when I was in college. Now I'm part of corporate America and being wired up with a mouth full of stuff isn't so fun after all."

I'm not trying to lecture. You're obviously an adult and well on your way to being educated. It's just that if someone had paid attention to my jaw back in college I wouldn't of faced splints and my third go around in braces at 30 years old. My current relapse is unrelated but the pain is real. I can't discribed the pain I'm in and how debilitating it is. I walked around for a week with a broken foot before the doctor knew it was broken...I would take the pain of two broken ankles compared to what I'm living with right now.