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Dentistry/Herbst Appliance

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Question
My son has an over bite (Overjet) with the lower jaw short. My Orthodontist is recommending a Herbst device. This appliance seems large, intrusive and questionable as to its effectiveness.

My question, is this a good course to take, or what are the alternatives we can explore?

Thank you for any advice.

Darren

Answer
Darren - This is a little difficult for me to be completely sure, but I have seen the use of the Herbst device in an attempt to correct a small lower jaw.  In those patients, who I have seen that used this appliance, some received a good jaw position with secondary problems of clicking, pain and alignment problems from the temporomandibular joint the movement.  I saw a few who did well without TMJ problems.  So the main problem I have with this appliance is some degree of being unable to predict future jaw joint problems from the use of this appliance.

Alternatively, is a proper alignment of the upper and lower jaws via orthognathic surgery.  This approach creates a stable foundation for the bite and the face, allowing a more normal growth.  Just so you know, the surgery is done along with an orthontist to properly align the teeth to allow the jaws to come together properly.

You need to have your son evaluated by a board certified orthodontist and oral and maxillofacial surgeon.  The joint use of both is best, as long as they are being objective and not trying to sell their approach.

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Joel S. Teig, DMD, Diplomate ABOMS, retired

Expertise

I am a board certified oral and maxillofacial surgeon and I am available to answer questions related to tooth extractions, implant insertion, facial recontruction, facial and oral tumor removal, TMJ dysfunction and various successful treatments, including surgery if all else fails, and occlusal discrepancy requiring orthognathic or jaw surgery.

Experience

Board Certified Oral and Maxillofacial Surgeon practicine for over 20 years. Assistant Clincal Professor and State University School of Dentistry.

Organizations
American Dental Association, American Association of Oral and Maxillofacial Surgeons, American Board of Oral and Maxillofacial Surgeons

Education/Credentials
BA -University of Connecticut DMD - University of Pennsylvania School of Dental Medicine

Awards and Honors
National Honor Society (OKU), Philadelphia County Dental Society, Mosby Book Award, Oral Surgery Honors, Summa Cum Laude

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