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Dentistry/Herbst Appliance Alternatives


Hi my daughter is 12 1/2 and three weeks ago got a Herbst Appliance with a rapid palatial expander to wear for a year and then follow up with braces for a year. Her Herbst has an acrylic shint for the bottom that is removed only to brush her teeth. It is a lot of stuff in her mouth and she is miserable. She was a picky eater to begin with and now she barely eats, not due to pain but due to the annoyance of everything in her mouth. She has an 8mm overbite and a minor crossbite on her lower left side. Can braces alone fix this, or are there any other appliances that are not so big that she can use? I just do not want her to suffer with this thing for a whole year. Thanks for you help.

There are many different approaches to treating each of the many different aspects of bite problems.  Each single orthodontist utilizes those particular methods that are best applied in view of his or her training and experience.  If I were to suggest an alternative approach you would then have to appeal to any number of orthodontists until you might find one who could utilize such an alternative method.
Here's a better way to proceed: Go to your daughter's orthodontist and present the problem as you've done in this message and see what he/she recommends.  If that is not satisfactory then find another orthodontist and see what suggestions that person recommends.  You may need to change providers if that works best for you or you may need to make the best of your current situation.  In either case you should be open and frank with your daughter's orthodontist and try to work together to seek the best approach for your daughter.


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Dr. Randolph Myerson


Please limit your inquiry to questions about orthodontics (braces) and children's dentistry. I am both an Orthodontist and a Pediatric Dentist, having been trained in both of these dental specialty fields. Orthodontics is the dental specialty that treats problems of tooth, bite and jaw alignment using braces and removable appliances. Pediatric Dentistry is the dental specialty also known as dentistry for children, which deals specifically with the dental problems of this special age group from infants to adolescents. I am also experienced in Forensic Dentistry, the application of dentistry to law enforcement and identification using dental records.


I have been in the private practice of orthodontics and pediatric dentistry for over 20 years. Prior to that I served for three years on the Cleft Palate and Cranio-facial Reconstruction team at Children''s Hospital of Philadelphia and was an Assistant Professor of Dentistry at University of Pennsylvania School of Dental Medicine. I also served as a dentist in the U.S.Air Force, stationed at Andrews AFB in Washington, DC.

I am a Fellow in the American Academy of Pediatric Dentistry, and a member of the American Association of Orthodontics, as well as a member of the American Dental Association and the Dental Society of the State of New York.

I received my BA in Biology from Frankin & Marshall College in 1969, and my dental degree from University of Pennsylvania School of Dental Medicine in 1973. In 1978 I received both my Certificate in Orthodontics from University of Pennsylvania School of Dental Medicine, and my Certificate in Pediatric Dentistry from Children''s Hospital of Philadelphia after completing a three year Teaching Fellowship in Orthodontics and Pediatric Dentistry in 1978.

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