Dental Headgear: How It Works, Benefits & Drawbacks

Let’s be honest: headgear braces are among the most misunderstood inventions in orthodontics. Mention the word “headgear,” and people instantly picture ’80s movies, awkward school photos, or some cruel dental torture device that only exists to embarrass teenagers.

However, dental headgear isn’t some medieval punishment. It’s actually one of the most powerful, precise, and biologically smart orthodontic tools ever created, and yes, there are cases where it’s still the best option on the table.

So let’s cut through the noise and talk about what headgear actually does, why it’s used, why it’s avoided, and whether it still deserves a place in modern orthodontics.

What Exactly Is Dental Headgear?

Orthodontic headgear is an external appliance designed to guide jaw growth, shift teeth, and correct bite issues that traditional braces alone simply cannot handle.

Unlike braces, which move teeth within the jaw, headgear can influence the jawbone itself, especially in growing patients. And that’s the key point: Orthodontists use headgear when the bone structure needs guidance, not just the teeth.

The design varies, but the idea is the same:

• A framework or strap system wraps around the head or neck
• A metal facebow attaches to molars inside the mouth
• Gentle pressure is applied to shift the bone, not simply the teeth

Sounds intense? Maybe. Effective? Absolutely. Use them with braces or clear aligners, and you’ve got perfectly aligned jaws and teeth. Hello Hollywood smile!

How Headgear Orthodontics Works

Let’s get something straight: people hear “pressure on the jaw” and imagine something painful or extreme. In reality, headgear orthodontics works through controlled, steady force, delivered at levels the body is already biologically equipped to handle.

Here’s the science in plain English:

The Force Redirects Jaw Growth

Kids and teens have jawbones that are still forming. Headgear gently encourages the upper or lower jaw to grow forward, backward, slower, or faster, depending on the treatment goal.

It Moves Molars in Ways Braces Can’t

Headgear can move molars and even guide the jaw, in ways braces can’t because it uses the head or neck as a strong anchor. This lets it apply a steady, powerful force over time, which is needed for bigger tooth movements and jaw corrections.

It Tackles Severe Bite Problems

Overbites, underbites, open bites, and many other bite issues stem from bone imbalance, not just crooked teeth. Headgear addresses the root cause, not the symptoms.

In Some Cases, It Prevents the Need for Surgery

This is the part most people don’t realize. When used early enough, head gear for teeth can reduce the need for invasive jaw surgery later in life. That’s a massive benefit that rarely gets talked about.

Types of Orthodontic Headgear

Not all headgear looks the same (thankfully). Here are the main types and what they’re used for:

Cervical Pull Headgear

Used For: Overbites, molar stabilization

Where It Goes: Around the neck

Controversial take: Many people think this looks the most “old school,” but it remains incredibly effective for redirecting upper jaw growth.

High Pull Headgear

Used For: Controlling upward and forward jaw growth

Where It Goes: Around the top/back of the head

Fun fact: This can correct vertical growth issues that no aligner or modern appliance can touch.

Reverse-Pull Headgear

Used For: Underbites (promotes forward jaw growth)

Where It Goes: Around the forehead and chin

This is one of the most powerful tools for early intervention in developing underbites, often preventing future jaw surgery.

Combination Pull Headgear

Used For: Complex bite and jaw discrepancy cases

Where It Goes: Combination of head and neck

Orthodontists choose this when multiple force directions are needed.

Who Actually Needs Headgear?

Here’s where the controversy kicks in: headgear isn’t for everyone, and orthodontists don’t recommend it lightly.

You might need it if you have:

• A severe overbite or underbite
• A jaw growing too quickly or too slowly
• Teeth that need backward or controlled movement
• Misaligned molars causing bite collapse
• Bone structure issues that braces alone can’t fix
• A goal to avoid jaw surgery

And yes, the earlier it’s used, the better the results.

Many adults ask if they can use a head brace for teeth, but the truth is: It works best on growing patients. Adults can use it in some cases, but the results are more limited because the jawbone has already fully developed.

Benefits of Dental Headgear

Let’s break down why orthodontists still stand by headgear, despite patients hating the idea of wearing it.

It Treats Jaw Problems at Their Source

Dental headgear applies a constant, steady pressure from outside, helping with the actual bone and jaw issues behind problems like overbites and underbites. It's most helpful for kids since their jaws are still developing and cannot be addressed by braces alone.

Prevents Future Jaw Surgery

Using headgear correctly during a child’s key growth years, usually between ages 7 and 13, gently guides jaw development. Preventing serious problems later on, the ones that could require major treatments or jaw surgeries if not addressed early.

Improves Facial Structure

Dental headgear improves facial structure, especially in kids and teens, by guiding the jaw to correct issues like overbites and underbites. The steady pressure during the growth phase helps the jaw reposition, creating better facial balance and a healthier bite.

Stabilizes Molars

Critical for long-term bite health, especially in growing teens.

Yes, dental headgear can help stabilize molars. It’s often used to move them backward or keep them from drifting forward. By applying controlled force, headgear helps correct jaw alignment and can hold or shift teeth, especially the upper molars, which are usually attached to the headgear for support.

Prevents Tooth Extraction

Headgear creates space by gently moving the back teeth backward, reducing overcrowding without extractions. In growing kids and teens, it guides jaw development, and in adults, it keeps molars from shifting forward, maintaining proper spacing during treatment.

Results Last Longer

Dental headgear results are long-lasting because the treatment addresses the root cause of the issue by guiding the growth and jawbone development. Again, especially in growing children and teenagers.

The Drawbacks

Let’s not sugarcoat it. If this is going to be a real, human, slightly controversial conversation, we need to talk about the downsides honestly as well.

The Social Stigma

People fear headgear because they think it looks embarrassing. This is the biggest drawback, hands down.

It Takes Commitment

To ensure that the treatment is effective, dental headgear is to be worn for 12 to 14 hours, which takes commitment. But this is a general guideline; your orthodontist will give you specific instructions based on your treatment plan.

Mild Discomfort

Dental headgear can cause some discomfort at first or after adjustments because of the pressure on the teeth and jaw. The soreness is usually mild and temporary, and over-the-counter pain relievers can help.

Sleep Inconvenience

Dental headgear can make sleeping inconvenient at first. This is totally normal as you or your child adjusts to the pressure and the feel of the appliance, especially since it often needs to be worn overnight.

Not Suitable for Adults in Most Cases

Not that they are never suitable for adults, they may still be used in specific cases. But adult jawbones are fully developed and less malleable than children.

Tips for Surviving with Headgear

If you (or your teen) ends up with a prescription for headgear, here’s how to get through it with your sanity intact:

• Wear it at night → no one has to see it
• Break the discomfort gradually
• Set reminders for wearing time
• Don’t skip days; it delays treatment
• Loosen the stigma → normalize it at home
• Talk to your orthodontist about options for styling or comfort

And remember, most people won’t wear it forever. A few months of consistency can prevent years of complicated orthodontics later.

Why People Avoid Headgear

Headgear may be the most disliked orthodontic appliance on the planetPeople often resist it for reasons like:

• “It looks weird.”
• “I don’t want to wear that to school.”
• “Can’t I just get aligners?”
• “It feels outdated.”

But here’s the bold truth: Sometimes, the thing people avoid the most is the EXACT thing that would fix their bite the right way.

Clear aligners can’t fix everything. Braces can’t fix everything. Not even fancy modern appliances can fix certain skeletal issues. Headgear works when NOTHING ELSE will.

So the question becomes: Are aesthetics for a few months worth sacrificing your long-term bite and facial structure? Most orthodontists, and honestly, most adults who didn’t wear their headgear when they should have, would say no.

The Controversy: Should Headgear Still Be Used in 2025?

Some orthodontists claim headgear is outdated. Others insist it’s irreplaceable. Here’s the controversial take: The tool isn’t outdated; the stigma is.

We live in a time where:

• Kids wear retainers on TikTok
• Clear aligners are a fashion accessory
• Teens love exploring colorful braces options
• Medical devices have become normalized

But headgear? Still treated like a medieval artifact. Orthodontists who remove headgear from their treatment options often do it not because the tool is useless, but because they assume patients won’t cooperate.

Yet research continues to show that headgear remains one of the most effective and biologically sound methods for treating jaw discrepancies in growing patients.

So yes, headgear absolutely still has a place in modern orthodontics, and anyone who says otherwise is prioritizing popularity over science.

Final Thoughts: Is Headgear Worth It?

Let’s bring this full circle. Dental headgear may not look glamorous. It may not be Instagram material. And yes, it may feel a little old-school.

But here’s the truth that most people don’t want to hear: If an orthodontist recommends headgear, it’s usually because nothing else will correct your jaw properly. It can prevent extractions, surgery, and long-term bite damage. It remains one of the most effective skeletal correction tools we have.

So is headgear worth it? If you want a healthy bite, balanced facial structure, and long-term stability, then absolutely. Sometimes the controversial tool is still the smartest one.