Guide To Headgear Braces: Pros, Cons, Alternatives

Is Wearing Headgear Braces In 2022 Worth It?

Orthodontists often use headgear braces to help patients correct different types of dental misalignment and malocclusions. They can help you realign your jaw, straighten your teeth and give you a new radiant smile.

In this article, we’ll take an in-depth look into headgear orthodontics, explore their parts and types, and teach you how to care for them. We’ll also look at some alternatives you can pick from if you dislike headgear.

Key Takeaways: Headgear Braces

  • Orthodontic headgear braces are an effective way of realigning your jaws and teeth while fixing severe malocclusions.

  • Headgear braces have three parts: the head cap, J hooks, and the attachments.

  • They come in three types: high pull, reverse pull and cervical pull.

  • For best results, wear headgear braces for 12 to 14 hours daily for 1 to 2 years.

  • Choosing headgear braces for your children early may save them from possible jaw surgery when they’re older.

What Are Headgear Braces?

Headgear braces are an orthodontic appliance used to correct severe tooth misalignment and support proper jaw growth.

Orthodontic headgear differs slightly from traditional metal braces because patients wear them partially outside the mouth [1]. Often, dentists prescribe them to growing children, although you can still use them as an adult.

Your dentist will recommend wearing orthodontic headgear if your bite is severely out of alignment (malocclusion) or if you have teeth overcrowding [1]. Headgear can also help straighten teeth, particularly molars (or back teeth).

Although not obsolete, dentists don’t use orthodontic headgear as much as they used to in the past. However, if your case requires the use of headgear, your orthodontist creates a unique treatment plan, recommends a specific appliance, and gives you instructions on how to use it.

Parts of Headgear Braces

Headgear braces consist of three parts:

  1. The head cap
  2. Attachments
  3. Facebow (J hooks)

The Head Cap

The head cap on your headgear braces has straps to help you secure the vertical frame of your facebow to your head in a safe and comfortable way.


These can be elastic bands, springs, or rubber bands. Attachments join the head cap to the facebow in a way that provides the right pressure to move your upper or lower jaw and teeth to align them properly.


Also known as J hooks, they attach to the bands on your upper and lower teeth, extending to the outside of the mouth and around your face.

Modern Headgear Braces

Headgear Braces

Headgear Braces 80s

Headgear Braces

Headgear Braces 1990s

Headgear Braces

Types of Headgear Orthodontics

The three common types of orthodontic headgear include:

  1. Reverse pull
  2. Cervical pull
  3. High pull

Reverse Pull

Reverse pull headgear usually has pads that attach to the chin and the forehead with a facemask frame in between them [2][3]. Orthodontists often prescribe this type of headgear for young children to reduce or eliminate the need for extensive jaw surgery later in life.

To achieve its result, you or your child should follow this treatment precisely. You may require reverse-pull headgear to treat Class III malocclusions: underbites and crossbites


An orthodontist will diagnose an underbite if your bottom front jaw protrudes in front of your top front jaw. Braces alone cannot treat an underbite. Over time, this dental device will shift the upper jaw forward, aligning it to the lower jaw.


If the upper and lower jaws do not align properly when you bite down, this malocclusion is a crossbite. Reverse pull headgear shifts the upper jaw forward to realign it with your lower jaw.

Cervical Pull

The cervical pull type of headgear uses a u-shaped wire to pull on the bands on your upper and lower molars and comes with a strap worn partially behind your neck [2][4]. This type of headgear is usually used to treat overbite and overjet cases.


Cervical headgear treats overbites, a condition where your upper teeth overlap with your lower one. An overbite is a class II malocclusion and requires a better solution than traditional metal braces. Cervical pull headgear holds your upper teeth in place as it shifts the lower jaw forward.


An overjet malocclusion refers to the severe protrusion of your upper front teeth, also known as “buck teeth.” Cervical headgear corrects an overjet similarly to an overbite, bringing in the correct tooth spacing as well.

High Pull

The high pull type of headgear attaches either to the top or the back of your head and the upper jaw. This device directs the growth of your jaw and improves your jaw alignment [2]. It’s generally used to treat an open bite.

Open Bite

High pull headgear treats this rare type of malocclusion that affects about 0.6% of the American population.

An open bite is a condition where front lower and upper teeth slant outwards and do not touch into a proper bite when you close your mouth. You can also use it to correct an overbite.

Why Do You Wear Headgear With Braces?

Here are some reasons you can wear headgear with braces:

headgear braces

When Correcting a Malocclusion in a Child

Headgear can help quickly correct misaligned teeth in a child’s jaw, as it can slow down the growth of the jawbone and force a proper alignment.

When Your Case Needs Headgear

Orthodontics rarely prescribe headgear unless it’s necessary to align your jaws or teeth. Where your orthodontist needs to close a huge gap between your teeth or you have a severe underbite or overbite, they’ll recommend headgear.

In Cases That Traditional Braces Can’t Treat

Your orthodontist will prescribe headgear, especially for cases that metal braces alone cannot correct. Some conditions that warrant headgear may be moderate or severe.

To Speed Up Treatment Time

Sometimes, you may need to speed up the time of your treatment. In such a case, your dentist may prescribe headgear [5]. You’ll experience fast recovery, even from malocclusions that could otherwise take 2-3 years to correct.

Check out some headgear braces alternatives here for more information.

How Long Does Headgear Take To Work?

Headgear treatment takes about one to two years to correct moderate-to-severe malocclusions. Also, as a patient, you must wear your headgear consistently for 12 to 14 hours each day for the treatment to be effective [4].

As your teeth slowly move into position, you may visit your orthodontist to shorten the period of your headgear phase each day.

Find out more about other braces alternatives that you can use to treat orthodontic problems.

Tips for Living With Headgear Braces

Wearing headgear can be daunting, as it’s not always the most attractive facial appliance. However, here are some tips to help you use them as easily as possible:

Orthodontic Headgear Side Effects

Wearing orthodontic headgear is safe most of the time. Although rare, you may experience some mild-to-moderate side effects.

headgear braces

  • You may develop sleep apnea, or if you have already experienced it, it may worsen. Sleep apnea can be potentially serious, resulting in erratic breathing that starts and stops as you sleep.
  • Your headgear may fit loosely, or not fit properly, to align your jaws.
  • Sometimes, you may experience tooth or jaw soreness that only gets worse. Pain is quite rare while using high pull headgear, but if it doesn’t decrease after a few weeks of use, visit your orthodontist’s office immediately.
  • Other times, the band on your molars may detach from your braces because of headgear use. Visit your orthodontist to help you replace them.
  • You’ll experience a loosening of your teeth. Some tooth soreness may accompany this. Although you may expect this, it may be uncomfortable at first.

How to Sleep With Headgear Braces

Here’s what to do when you sleep with headgear:

  • Lay on your back while sleeping with headgear to rest your head comfortably. Besides pressure exerted on your jaws by wearing the headgear, you’ll not experience unexpected pain or strain. You’ll also easily position yourself in a way that does not come into contact with your pillow.
  • Always adjust the straps and headpiece of your headgear in a way that’s comfortable to wear to bed. Get accustomed to how the device feels on your face, head, neck, and teeth before you wear it to bed.
  • Ensure you have a comfortable pillow that complements your headgear. Where possible, purchase a pillow designed to give you amazing comfort, especially if you’re using cervical pull or high pull headgear.

Try out these braces alternatives to help realign your teeth.

Maintaining Your Headgear

Maintaining headgear is straightforward. Here’s how to do it:

  • First, brush your teeth as regularly as you did before treatment. This helps remove food particles that are stuck around the metal orthodontic bands and hooks of your braces.
  • Use dental floss to clean in between your teeth, as recommended by your orthodontist. Do it carefully to avoid causing damage to your brace brackets, hooks, and bands.
  • Clean the parts of the facebow that go inside your mouth with a toothbrush and toothpaste. Wash the other metal parts with antibacterial soap and rinse well before replacing them.
  • Although the straps of your headgear may pick stains from food and other places, you don’t need to wash them often. Instead, wipe them with a damp cloth and follow your orthodontist’s cleaning instructions.
  • Don’t remove the headgear suddenly. Be gentle. Always remove your headgear by detaching its elastic strap from the bow. Doing this protects your eyes and relieves any stress on the device.

Activities To Avoid

Avoid these activities while wearing headgear:

  • Remove headgear while eating. However, you can use a straw to enjoy drinks while still wearing headgear.
  • Avoid certain foods including:
    • Chewing gum
    • Sticky and soft foods like gummy bears and skittles
    • Ice
    • Crunchy foods like popcorn and potato chips
    • Hard foods like nuts
  • Don’t use your teeth to open bottle caps or as a tool
  • Avoid wearing headgear while playing sports, cycling, skateboarding, or any other activity that has an increased risk of falling or impact on your face. Where possible, wear a helmet or take a break from the sport entirely.

How Much Does Headgear for Braces Cost?

Headgear for your braces will range from $1,000 to $9,000, depending on the severity of your malocclusion. Your overall treatment strategy and the extent of work needed on your jaw will mostly influence this price.

Alternatives to Headgear Braces

You can align your jaws and correct minor tooth alignment using other alternatives. Let’s look at some of them:

headgear braces


A bionator is a removable orthodontic appliance that extends your lower jaw and helps correct overbite. Although you’re meant to wear a bionator all the time, you can remove it to eat or brush your teeth. If you’re taking part in any sports, then you can also remove it.

A bionator is ideal for children between the ages of 7 and 10, when their jaw bones and muscles are still under development.

Take a look at some braces alternatives you can try out here.

Clear Braces

Clear (or invisible) aligners are also an excellent alternative to headgear braces. Aligners are custom-made to the unique requirements of each patient, depending on the severity of their orthodontic condition [6].

You can use clear aligners to treat crowded teeth, overbites, underbites, and open bites. You can also use them to improve minor tooth alignment issues. Note that clear aligners like Invisalign trays and Byte Aligners are not suitable for severe misalignments or malocclusions.

Check out this AlignerCo Review and Byte Aligners Review for more information on clear braces.

Herbst Appliance

The Herbst Appliances are dental implants that can help fix excessive horizontal overbite in children and adults. They come in unique designs.

Some are removable, while others are cemented to the teeth. Such an appliance is usually effective where the patient is a pre-teen child, has a severe overbite, and doesn’t have overcrowded teeth.

Here are some braces alternatives to check out.


Let’s look at some answers to questions most people have about headgear braces:

Is Headgear Still Used in Orthodontics?

Are Headgear Braces Necessary?

Is Orthodontic Headgear Bad?

Why Do Americans Have Headgear for Braces?

Can You Wear Headgear Without Braces?


Headgear braces can fix moderate-to-severe malocclusion, however, if you don’t like headgear, you can try out alternatives like clear braces, Herbst devices and bionators.

To fix mild and moderate misalignment, you can get Byte Aligners on mail order. Clear aligners are quite efficient and affordable, especially for people looking to improve their smile. However, the American Dental Association and Association of Orthodontists (AAO) do not approve of mail-order aligners. Before buying, seek the approval of an orthodontist.


  1. Capan, Natalie A. Headgear Appliances,
  2. kcam, M. O. “Fuzzy Modelling for Selecting Headgear Types.” The European Journal of Orthodontics, vol. 24, no. 1, 2002, pp. 99–106., doi:10.1093/ejo/24.1.99.
  3. Wells, Andrew P., et al. “Long-Term Efficacy of Reverse Pull Headgear Therapy.” The Angle Orthodontist, vol. 76, no. 6, 2006, pp. 915–922., doi:10.2319/091605-328.
  4. DC;, Henriques FP;Janson G;Henriques JF;Pupulim. “Effects of Cervical Headgear Appliance: A Systematic Review.” Dental Press Journal of Orthodontics, U.S. National Library of Medicine,
  5. Talvitie, Tuula, et al. “Adherence to Instructions and Fluctuation of Force Magnitude in Cervical Headgear Therapy.” The Angle Orthodontist, vol. 89, no. 2, 2018, pp. 268–274., doi:10.2319/030718-188.1.
  6. Rossini, Gabriele, et al. “Efficacy of Clear Aligners in Controlling Orthodontic Tooth Movement: A Systematic Review.” The Angle Orthodontist, vol. 85, no. 5, 2014, pp. 881–889., doi:10.2319/061614-436.1.

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