Herbst appliance in orthodontics: What is it used for and when?

What is the purpose of the Herbst device?

The Herbst appliance is a fixed functional orthodontic appliance used primarily to correct Class II skeletal discrepancies, i.e. when the mandible (lower jaw) is retruded in relation to the upper jaw. This appliance stimulates forward mandibular growth, improving the maxillomandibular relationship.

When is it placed?

1. Skeletal class II malocclusion (retrognathic mandible) in:
   1. Patients in active growth phase (generally between 9 and 14 years of age).
   2. Cases in which it is desired to avoid orthognathic surgery in young adults (although its efficacy is much lower in adults).
2. As part of a mandibular advancement strategy to improve facial profile.
3. Sometimes in combination with brackets or other appliances.

Orthodontic teeth cleaning Herbst

1. Meticulous tooth brushing:
   • Use a soft bristle brush 3 times a day.
   • Pay attention to the area of the bands and joints of the device.
   • Brush with gentle movements around the appliance, without forcing.

1. Interdental brushes:

1. • For cleaning between the belts and under the appliance, especially in areas where the normal brush cannot reach.
   • It is recommended to use an adequate size to avoid damaging the gums.

1. Oral irrigator (Waterpik):

1. • Very useful for removing food debris trapped in difficult areas of the Herbst.
   • It is recommended as a complement, not a substitute for brushing.

1. Rinse with mouthwash:

1. • Daily use of fluoride and/or chlorhexidine mouthwashes (as indicated by the orthodontist) to prevent gingivitis or caries.

1. Avoid sticky or hard foods:

1. • Such as chewing gum, candy, nuts or large morsels that may dislodge or damage the device.

How much does a Herbst device cost?

The price can vary greatly depending on the country, the clinic and whether it is combined with other orthodontic treatments (such as braces). Here is an approximate range:

*Note: In most cases, Herbst is part of a complete orthodontic treatment, and is not charged separately. Total treatment can range from €3,000 to €6,000, depending on duration, type of appliances, and whether brackets or other devices are included.