What Is a Herbst Appliance?

It can be overwhelming to keep up with all of the advancements and new devices in the field of orthodontics. It seems as each year passes, orthodontic professionals are discovering new ways to help patients correct the issues with their smiles, and for patients, it can be a lot to take in. One of the treatment options that is prescribed to qualifying patients is a Herbst appliance. 

Introduction To Different Appliances

Before we get into the technical aspects of a very niche device, we should cover different problems and their appliances. By acquainting yourself with these different technologies, you’ll have a better understanding of what a Herbst appliance can and cannot be used for. 

Though there are plenty of different types of orthodontic appliances, we will cover just the appliances that correct the same type of problems the Herbst appliance addresses. Herbst appliances are specifically used to correct overbites, whereas a few in this list may be used to correct both overbites and underbites. 


Being the most dramatic appliance, headgear is typically used for the most complex cases and is used much less often now than it was a decade ago. Orthodontists won’t usually use these if the patient is past the age of 10. Headgear can be used for both overbites and underbites and is normally worn at night.


Also able to be used for overbites and underbites, the Forsus Fatigue Resistant Device is used in place of headgear for adolescents and can often prevent the need for jaw surgery as well. This is still used for more complex cases than the Herbst appliance, but works in a more minimal way headgear.

Palatal Expander

This device is used exclusively for specific underbites. A palatal expander does just as its name suggests, by creating pressure on the edges of your upper jaw to expand it, allowing your upper teeth to rest properly on the lower teeth. 

Braces and Clear Aligners

Braces or clear aligners (such as Invisalign) can be used for very simple applications where the jaw does not need to move, but only the orientation of the teeth and roots. This includes many overbite situations. Braces typically solve more overbites rather than aligners because rubber bands can be added, which speeds up treatment time.

Herbst Appliance

Whereas braces can solve mild overbites and headgear or Forsus devices solve more extreme cases, Herbst appliances are typically used for the middle ground between the two. 

About The Herbst Appliance

Remember headgear? If you didn’t have it yourself as a child, you may have known someone who did. Headgear is used to primarily correct bite issues as a result of problems with the lower jaw. Nowadays, headgear can sometimes be replaced by what is referred to as a Herbst appliance


Although this appliance has been around for quite some time – it was first introduced by Emil Herbst in the early 1900s and reintroduced by Hans Pancherz in the early 1970s – it has since evolved into a tool orthodontists turn to more frequently today. Since there can be issues with headgear, mainly difficulty with patient compliance, the Herbst appliance can alleviate some of the problems. This appliance has many benefits, including:

  • Ease of wear
  • More patient compliance
  • Better range of motion (as opposed to headgear)
  • Minimal issues with speech

When using this type of appliance, orthodontists have reported better compliance among patients, and being that this device is worn at all times, patient success rate has increased. Not only is the Herbst appliance a more comfortable way to correct bite issues, it’s also easier to wear and get used to, making it a go-to for orthodontists around the country.

How Does It Work?

Your orthodontist will be able to tell whether or not the timing is right for a Herbst appliance. Though it’s typically applied before braces are put on, it’s possible for one to be installed during treatment with braces. For installation, your orthodontist will determine the space between the teeth used for the appliance and decide whether or not to put in spacers. Once the teeth have enough space for the Herbst, your orthodontist will insert the device and use oral cement to keep it in place. Cleaning your Herbst appliance will require more attention than with no orthodontic treatment, but it isn’t as complicated as cleaning braces. Be sure to use floss or a waterpik twice daily to clean residue and plaque from the narrow areas. 


Children are typically the ideal candidates for the Herbst appliance. Since children (aged 9-14) are still developing, it’s best to address jaw and bite issues at this point before growth stops and the jaw is set. Waiting makes it much more difficult and it takes more time to correct jaw abnormalities.

What To Expect With The Herbst Appliance

When the Herbst appliance is placed in the patient’s mouth, it gets to work, correcting the patient’s bite. It is attached to the molars by a series of bands. Then, telescoping arms are attached to the outer region of the upper and lower bands, ensuring the device is permanently installed in the mouth. 

It won’t take long to get used to the appliance. Normally, patients start feeling accustomed to the device in about a week. Patients sometimes feel a bit different when they eat and some report slight discomfort at first. Patients can expect to wear this particular appliance for a period of nine to 12 months, and although it is durable and relatively low maintenance, proper oral hygiene is imperative. Orthodontists recommend the daily use of mouthwash, proper brushing and flossing techniques, and avoiding sticky foods altogether.

A Revolution In Orthodontic Treatment

The Herbst appliance was developed over time to alleviate the problems associated with headgear, making for a more comfortable experience for the patient. Though braces are typically can be used for mild cases, this relatively non-invasive device is commonly used for more complex cases.  Speak with your orthodontist to see if a Herbst appliance might be right for your child’s situation, and remember, the success of their treatment depends on the right treatment plan.