Headgear is an orthodontic appliance used to correct bite and support proper jaw alignment and growth. There are several types. Headgear is typically recommended for children whose jaw bones are still growing.

Unlike braces, headgear is worn partially outside of the mouth. An orthodontist may recommend headgear for your child if their bite is severely out of alignment.

An unaligned bite is called a malocclusion. This means that the upper and lower teeth don’t fit together the way they should.

There are three classes of malocclusion. Headgear is used to correct Class II and Class III misalignment. These are the more severe types. Headgear may also be used to correct teeth overcrowding.

Headgear has several parts. These parts vary based on the type of headgear and the condition being corrected.

parts of headgear
  • A head cap. As its name implies, a head cap sits on the head and provides anchorage for the rest of the apparatus.
  • Fitting straps. The fitting straps used are determined by the type of headgear. For example, cervical headgear uses one fitting strap attached to the head cap that sits behind the neck. High-pull headgear uses several straps, wrapped around the back of the head.
  • Facebow. This is a U-shaped, metal appliance attached with bands or tubes to the molars, head cap, and straps.
  • Elastic bands, tubes, and hooks. These are used to anchor the various parts of the headgear to the molars and other teeth.
  • Chin cup, forehead pad, and mouth yoke. Headgear designed to correct an underbite typically use a chin cup attached to a forehead pad with wires. This type of apparatus doesn’t require a head cap. It relies on a wire frame which runs from the forehead pad to the chin cup. The frame houses a horizontal mouth yoke.
  • Braces. Not all headgear uses braces. Some forms of headgear utilize hooks or bands to attach to braces worn inside the mouth on either the upper or lower teeth.

Types of headgear include:

Cervical pull

A cervical pull is utilized to correct a malocclusion called an overjet. An overjet is categorized by a protruding top jaw (maxilla) and front teeth. These are sometimes referred to as buck teeth.

Cervical headgear is also used to correct overbite. An overbite is a misalignment between the top and bottom teeth, which cause the top teeth to jut out. Cervical headgear uses straps that wrap behind the neck, or cervical vertebrae. It attaches to braces inside the mouth.

High pull

High-pull headgear is also used to correct an overjet or overbite. It utilizes straps attached from the upper jaw to the top and back of the head.

High-pull headgear is often used in children whose teeth have an open bite categorized by no contact between their top and bottom front teeth. It’s also used in children who have excessive jaw growth in the back of the mouth.

Reverse pull (facemask)

This type of headgear is used to correct an underdeveloped upper jaw or an underbite. An underbite is categorized by jutting lower teeth which extend past the upper teeth. Reverse-pull headgear often uses rubber bands that attach to braces on the top teeth.

It’s important to follow your orthodontist’s instructions when using headgear.

One of the most important elements of successful headgear use is the amount of time required to wear it. This can range anywhere from 12 to 14 hours daily or longer.

It’s understandable that children may balk at wearing headgear outside or to school. Many orthodontists recommend putting headgear on as soon as school is over and wearing it through nighttime until the next day.

The more your child wears their headgear, the faster it will do its job. Unfortunately, some progress made by wearing headgear can be undone if it’s left off for as little as one day.

Headgear is used to correct tooth and jaw misalignment and tooth overcrowding. This, in turn, can enhance facial aesthetics by correcting the profile. It can also, of course, improve the appearance of your child’s smile.

Headgear works by exerting force on the upper or lower jaw. It can also create space between teeth to eliminate overcrowding or overlapping teeth.

Headgear is only effective when a child is still growing. Headgear can hold back the growth of the jawbone, forcing it into proper alignment with ongoing, consistent pressure exerted over time.

Headgear can help your child avoid corrective jaw surgery later in life.

Headgear is typically safe when worn correctly.

Never force headgear on or off as this may damage the device or cut into your gums or face. It’s important that your child follow their orthodontist’s instructions about how to put on and take off headgear. This will help them to avoid getting hit in the face or eyes by snapping rubber bands or wires.

If your child complains of pain that seems severe or doesn’t go away, call your orthodontist.

Also, let your orthodontist know if your child notices a change in the way their headgear seems to fit. Never attempt to adjust headgear yourself.

Headgear should be removed while eating. Drinking through a straw is usually permitted while wearing headgear.

Headgear can remain on while your child is brushing their teeth, though you can remove it to make brushing easier.

Chewing gum or eating hard candies or hard-to-chew foods should be avoided if your child is wearing braces attached to their headgear.

Your child should be instructed to keep their headgear safe from potential damage. Restrictions, such as avoiding contact sports or roughhousing, while they are wearing headgear will protect both them and the device.

Your child should also avoid ball play or activities like skateboarding or skating while wearing headgear. Any sport which might potentially result in an impact to the face or a fall should be swapped out for other activities, such as swimming.

It’s important to try to find activities that your child will enjoy while wearing headgear. Think about at-home activities you can do together which are energetic, such as dancing or family aerobics.

Headgear may be necessary anywhere from 1 to 2 years.

Some discomfort is to be expected, especially when headgear is first introduced to your child. You can also expect your child to feel some discomfort when their orthodontist deepens or adjusts the pressure. This side effect is usually temporary.

If your child is uncomfortable, talk to your orthodontist or pediatrician about types of over-the-counter pain medication they can take.

Providing your child with soft foods may help them avoid additional discomfort from chewing. Cold foods such as ice pops may feel soothing to their gums.

Since headgear should be worn around 12 hours a day, some kids may need to wear it to school or after-school activities. This may be challenging for some kids, who might feel embarrassed by their appearance while wearing headgear. Keep in mind that this temporary problem is better than needing surgical correction later on in life.

It’s very important that your child not sneak off their headgear. Even little lapses in the amount of time they wear the device may inhibit progress, prolonging how long they need to wear headgear overall.

How to keep headgear clean
  • Wash the hard parts of headgear daily with warm water and mild soap. Make sure to rinse thoroughly.
  • Soft pads and straps should be washed every few days with warm water and mild detergent. Make sure to dry thoroughly before wearing.
  • Braces in the mouth can be brushed along with teeth. Your child can also floss while wearing headgear.

Headgear is typically needed anywhere from 12 to 14 hours daily over the course of 1 to 2 years.

Due to innovations in braces and other treatments, headgear isn’t used as often as it once was. However, if your child’s orthodontist recommends it over other orthodontic devices, your child most likely will benefit greatly from it.

Headgear can be used to simultaneously correct several types of malocclusion as well as tooth overcrowding.

It’s unlikely that your child will need to wear headgear again once they’ve completed treatment.

Headgear is designed to correct severe jaw and tooth misalignment. There are several types.

Headgear is typically used in children who are still growing. This ensures that their jawbones can be moved into proper alignment.

Headgear should be worn around 12 hours daily. Treatment typically lasts from 1 to 2 years.