thumb|right|Full view of combination pull orthodontic headgear with facebow
Orthodontic headgear is a type of orthodontic appliance typically attached to the patient's head with a strap or number of straps around the patient's head or neck. From this, a force is transferred to the mouth/jaw(s) of the subject.
Headgear is used to correct bite and support proper jaw alignment and growth. It 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 a patient if their bite is more severely out of alignment. The device typically transfers the force to the teeth via a facebow or J hooks to the patient's dental braces or a palatal expander that aids in correcting more severe bite problems or is used in retention of the teeth and jaws of the patient.
Need for treatment and concurrent corrections
Headgear is most commonly used to correct the bite of the patient. The headgear attaches to the braces via metal hooks or a facebow. Straps or a head cap anchor the headgear to the back of the head or neck. In some situations, both are used.
Elastic bands are used to apply pressure to the bow or hooks. Its purpose is to slow or stop the upper jaw from growing, thereby preventing or correcting an overjet.
Other forms of headgear treat reverse overjets, in which the top jaw is not forward enough. It is similar to a facemask, also attached to braces, and encourages forward growth of the upper jaw.
Headgear can also be used to make more space for teeth to come in. In this instance the headgear is attached to the molars, via molar headgear bands and tubes, and helps to draw the molars backwards in the mouth, opening up space for the front teeth to be moved back using braces and bands. Multiple appliances and accessories are typically used along with the headgear, such as: power chains, coil springs, twin blocks, plates or retainers, facemasks, a headgear helmet (a headgear helmet is a cervical headgear with a cap or rigid helmet that covers the entire head), lip bumpers, palate expanders, elastics, bionaters, Herbst appliances, Wilson appliances, other headgear, hybrid twinblocks, positioner retainers, and jasper jumpers. Many patients wear a combination of, or all of these appliances at any given time in their treatment.
Forms of headgear treatment
Headgear needs to be worn between 12 and 23 hours each day to be effective in correcting the overbite, typically for 12 to 18 months depending on the severity of the overbite, how much it is worn and what growth stage the patient is in. Typically however the prescribed daily wear time will be between 14 and 16 hours a day.
Overall wear time is usually anywhere from 12 to 18 months depending on the severity of the bite and how much a patient's jaws and bones are growing over this time.
The controversy about headgear intensified beginning in the 1980s when formerly headgear treated patients developed severe health symptoms, such as sleep apnea, breathing problems and acute TMD.
In some cases, eye injuries have been reported, which is minimized with the use of safety release straps and safety facebows.
Teenagers prescribed orthodontic headgear often face social stigma and bullying if seen wearing these appliances. Because of the difficulties in complying with daytime wear of headgear, these appliances are mainly worn in the evenings and while sleeping.
The need for headgear in orthodontics and its application by practitioners has somewhat decreased in recent years as some orthodontists use temporary implants (i.e., temporary anchorage devices) inside the patient's mouth to perform the same tooth movements. However, the headgear is still widely used and a very effective appliance used by orthodontists today.
Soreness of teeth when chewing, or when the teeth touch, is typical. Adults usually feel the soreness 12 to 24 hours later, but younger patients tend to react sooner, (e.g., 2 to 6 hours). Adults are sometimes prescribed headgear but this is less frequent.