An orthodontic facemask is a specialized appliance used by orthodontists for growing children. It is a non-invasive device for therapeutic use, entirely distinct from cosmetic or skincare facemasks. This appliance, also known as reverse-pull headgear, is prescribed to address specific developmental issues concerning the jaw by guiding facial development.
Correcting an Underbite
A facemask is used to correct an underbite, where the lower teeth protrude farther forward than the upper teeth. Medically, this is referred to as a Class III malocclusion. This misalignment is not merely a cosmetic issue; it can stem from an underdeveloped upper jaw (maxilla), an overdeveloped lower jaw (mandible), or a combination of both.
The functional consequences of an uncorrected underbite can be notable. Individuals may experience difficulty with biting and chewing food properly. Speech patterns can also be impacted, and the visible nature of an underbite can alter a child’s facial profile, potentially affecting their self-esteem.
Left unaddressed, a Class III malocclusion can lead to more pronounced dental health issues. The improper bite can cause uneven and excessive wear on the teeth. It may also place strain on the temporomandibular joints (TMJ), leading to discomfort or pain. Early intervention aims to mitigate these future complications by addressing the underlying skeletal issue.
The Mechanics of Treatment
The orthodontic facemask applies a principle called reverse-pull or protraction. Unlike traditional headgear that often aims to restrict lower jaw growth, a facemask is engineered to pull the entire upper jaw forward. The appliance consists of a frame that rests outside the mouth, with pads that brace against the forehead and chin for anchorage.
Attached to this external frame are elastic bands. These elastics are stretched from the frame to a separate appliance fixed inside the child’s mouth, often a palatal expander or braces on the upper teeth. This connection creates a gentle, consistent forward and downward tension on the maxilla to stimulate and guide its natural forward growth.
This process works because a child’s facial bones are still developing and malleable. The sutures, or fibrous joints, in the upper jaw have not yet fused, allowing for skeletal movement and growth modification. The facemask encourages growth in a more favorable direction, gradually repositioning the maxilla into a correct alignment with the mandible.
The Patient Experience
Undergoing facemask therapy requires commitment from both the patient and their parents. The appliance must be worn for 10 to 16 hours daily to be effective. This means the device is primarily worn at home after school and overnight while sleeping. Consistent use is needed to achieve the desired gradual movement of the upper jaw.
The total duration of treatment can vary based on the severity of the underbite and the patient’s individual growth rate. Most children will wear the facemask for a period ranging from 6 to 18 months. During this time, regular appointments with the orthodontist are necessary to monitor progress and make adjustments to the appliance.
There is an initial adjustment period as the child gets used to the sensation of the facemask. The pressure from the forehead and chin pads can sometimes cause minor skin irritation, which can be managed. Encouraging compliance can be a challenge, but framing the treatment positively and establishing a consistent routine are helpful strategies for parents.
Ideal Candidates and Treatment Timing
The success of facemask therapy is dependent on patient selection and precise timing. The ideal candidates are growing children, between the ages of 7 and 10. This age range is strategic because it aligns with a period of active facial growth, particularly before the sutures of the maxilla begin to fuse. The treatment leverages these natural growth spurts to achieve skeletal correction.
Treating an underbite during this developmental window is a form of interceptive orthodontics. The goal is to intervene early to guide growth and prevent a more severe problem from developing. By stimulating the forward movement of the upper jaw, orthodontists can often achieve a stable facial profile. This early correction can reduce the complexity of future orthodontic work.
Once growth is complete, the options for correcting a skeletal Class III malocclusion become much more limited and invasive. For adults with a significant underbite, corrective jaw surgery (orthognathic surgery) is often the only way to achieve a full correction of the jaw alignment. Facemask therapy represents a non-invasive opportunity to address the root cause of the underbite during childhood, potentially avoiding surgery in later years.