Headgear Braces: What Headgear Is, Why It Is Used and What to Expect

Headgear has three parts: a bow that fits into tubes on the braces, a strap that goes around the neck or head, and elastic or spring attachments that supply a steady, light force. It is a separate appliance that works alongside fixed braces, such as metal braces.

Because it uses the head or neck as an anchor, it can move teeth or influence jaw growth in a way that braces alone cannot. Modern orthodontics uses it less often than in the past, since small anchor screws and other appliances can do some of its jobs, but it remains a tool for certain cases.

A cervical (neck) headgear pulls the upper back teeth backwards, usually used for a typical overbite and to create space. A high-pull headgear attaches over the top of the head and is used to control the vertical direction in a deep or open bite. A combination headgear uses both. A reverse-pull face mask is a different appliance used in children with an underbite from a small upper jaw.

Headgear is considered mainly while the jaws are still growing, in children and young teenagers, because that is when jaw growth can be guided. In adults the jaw has stopped growing, so alternatives such as elastics, anchor screws or surgery are usually discussed instead.

Results depend on wearing it for the number of hours the orthodontist sets, usually in the evening and overnight rather than at school. Missing hours slows treatment, so many children find a routine helps. Sore teeth in the first week are normal and ease with time.

Safety matters: always remove headgear before sport and rough play, never wear it when not told to, and use only the safety-release strap the orthodontist supplies. If the bow bends or comes out suddenly, or if there is an injury to the face or eye, stop and seek care at once. Keep it clean with a soft brush and mild soap. See an orthodontist for whether it suits your child or whether another approach to an overjet (see our overjet guide) is better.