Short answer: The Herbst appliance is a fixed functional appliance that is attached to the upper and lower teeth and, thanks to the telescopic arms between them, holds the lower jaw forward continuously. It is used in teenagers who have a retruded lower jaw and are still growing; because the patient cannot remove it, it is effective all day.
Who is it suitable for?
- Teenagers with a retruded lower jaw who are still growing
- Patients who may find it hard to wear a removable functional appliance regularly
- Adolescents approaching the end of their growth spurt
How does it differ from a twin block?
A twin block is removable and its effect depends on how long it is worn. The Herbst is fixed; the patient cannot take it out. This means compliance is less of an issue, but cleaning needs more care. For the removable option, see our article on the twin block appliance.
How long is it worn?
The Herbst appliance usually stays in the mouth for several months. A second phase of treatment with braces or clear aligners then follows to bring the teeth into their final positions. The duration depends on growth and the response to treatment.
What to expect in the first weeks
- Difficulty chewing because the lower jaw is held forward
- Rubbing on the inside of the cheeks; orthodontic wax helps
- Tiredness in the jaw muscles
In most patients these symptoms ease within a few weeks. For general information on a retruded lower jaw, read our page on retruded lower jaw and lower jaw advancement.
Frequently asked questions
Does the Herbst appliance stop you opening your mouth?
No. The telescopic arms allow the mouth to open and close; only the lower jaw is held forward.
Can you eat with a Herbst appliance?
Yes, but hard and sticky foods should be avoided.
Is the Herbst used in adults?
Its effect is linked to growth; in adults it is considered only in limited situations.
Which appliance is right for you?
Which appliance is needed is decided after age, growth stage and the condition of the teeth and jaws have been assessed by examination and X-rays. At our clinic in Oran, Çankaya, Ankara, we discuss the options with you during the first orthodontic examination. To see all types of appliance in one place, take a look at our guide to orthodontic appliances.
