Orthodontic Headgear Secondary School

[anniema2]

DD (14 years old) has had orthodontic reverse-pull headgear for about 3 months now only wearing at night times. However, following a recent trip to the orthodontist, where apparently she has not been wearing it enough, she now wants her to wear it 24/7 and thus have it wired in so it is permanent and she is completely unable to remove it. I am conscious of the effect this will have at school for her, although of course the benefits are massive. What are your all thoughts on this?

I am really surprised by this.. I used to wear mine of an evening and they said needed to do it for longer so did it overnight but I would hated to have worn it for school. Can they not wear it when they get home then all night?

Her teeth her choice, if the orthodontist is local there may be other schoolmates receiving orthodontic treatment. So it may not seem like a big deal.
What concerns come to mind?

A 14 year old girl wearing that for school. I can't think of anything worse tbh.

Surely if she puts it on when she gets home from school and all night that's a good 14 hours of wear isn't it?

I think I'd want a second opinion from another orthodontist.

I agree on a second opinion. That's pretty drastic. What does the orthodontist say about her wearing it at home only but longer? And what does DD say? Is she more inclined to wear it more at home instead of having it permanently if faced with the option?

I'd be dead against it actually. I think the damage to her self-esteem would be horrendous, unless she's a particularly ballsy character, and even then. And that's without considering the risk of bullying.

I'd have to leave that up to my 14yo and would certainly support him if he decided not to.

I would ask your orthodontist what plan B is if they don't wear it F/T and don't get the result that they want with it.
Essentially the orthodontic treatment is fighting against your child's growth pattern. Your orthodontist feels thatbwearinf it F/T will increase the chances of the class 3 relationship being masked/corrected , but even with F/T wear you might not achieve this.

I assume if the HG doesn't work (wheter worn F/T or P/T) the treatment plan would be surgery at 18+ when the child has stopped growing, but do double check.

Yes, consider a second opinion.

I’d be sceptical. I had the headgear as a teen (for night wear only) and it didn’t have the effect it was meant to. The orthodontist claimed that it was because I wasn’t wearing it. I was (and as my mother said, I was always wearing it when she went to wake me up.)

If she can’t take it off how is she meant to eat, wash her hair etc?

I think I’d be asking for plan B.

Although i will add that there aren't many treatment options for a class 3 patient, especially if they are moderate or severe class 3 case. Don't be surprised if your second opinion doesn't give you any more options than accept the way your DCs teeth look, try F/T HG and hope for a better response, or surgery.

Are they a moderate or severe case? I have assumed that they are, but if it is mild it can sometimes be masked with just fixed appliances (train tracks) on the upper arch and not treating the lower arch.

Is your child currently wearing it as much as possible outside of school hours. As soon as they come in from school, all night and taking it off just before they leave the house. It's important that the orthodontist has an honest view of their wear before deciding that it isn't working. Lots of kids exaggerate how much they wear appliances because they don't want to get into trouble.

In the end I suspect you'll have to weigh up the risks and benefits of surgery which can only be carried out once the child has stopped growing (18+ commonly) vs giving the HG a go F/T. But only your orthodontist knows your case and your teeth properly. I would ring them and ask to come in for a chat to discuss all the treatment options fully.

F/T wear is drastic, but from a medical point of view so is a general anaesthetic for something that could possibly be avoided with F/T wear. So it's a legitimate suggestion.

After a long chat with the orthodontist today, he has convinced me to have it permanently wired in for only 4 months. The huge benefits clearly outweigh the slight social stigma, which she should grow out of in a couple weeks, and it saves much money which might have had to be spent on surgery down the line... in other words, a shrewd long term move! DD going tomorrow for it to be wired in, just praying a scene is created :P

A friend of mine had to wear this at school. It will be a novelty at first but the other children will soon get used to it after the initial embarrassment. Not an easy decision and not easy for a teenager but long term benefits probably outweigh this. Good luck.

anniema2 he has convinced you? What about convincing your 14 year old?!

I would definitely be seeking a second opinion. And I definitely agree this is your daughter's decision, not yours.

Are you sure you would have to pay for the surgery?

If your IOTN score is above 3.6 it should be covered by the NHS, and severe malocclusion should get a high score.

Worth double checking if finances are a major contributing factor to your and your daughters decision.

What about lunch?

Personally, I think wearing it for longer but not during the day would be preferable. It will stop her from being able to talk properly, which means she won't be able to interact with her friends and her teachers won't be able to assess her understanding in lessons by asking her questions.

And good luck whatever you both decide.

No way would any of mine have agreed to that at school.

I hope she's ok with it.

Slight social stigma?! Are you serious? Wow, I honestly think this is the wrong decision. Your poor DD, this will impact her for life.

Not much point in posting was there. Always makes me wonder why people post then totally ignore what everyone says. Maybe they don't have anything better to do with their time.

Definitely get a second opinion

There's no way my DS would have worn his to school. He was consulted every step of the way. I could only advise. You don't say what DC wants.

DS wore his after dinner and overnight so around 13 hours.

Our orthodontist would not have done this unless he heard it direct from his patient's mouth. That s his approach once they turn 12 - he wants them 'in' on the plan. I infer from your remark about 'making a scene' that your dd is actually unaware of your cunning plan. Absolutely shameful, and I feel very sad for your daughter.

Have you seen this youtube video on the causes of crooked teeth and how they should be treated? It suggests that a lot can be achieved without surgery or appliances being permanently wired in. I would be unwilling to commit my daughter to permanently wired-in headgear unless it was a life or death situation.

As someone who wore headgear (& traintracks, plates and numerous extractions and then had to have speech therapy because my mouth had changed so much!) decades ago, I am surprised you aren't going to encourage her to wear it properly out of school first then review. Then, perhaps seek a second opinion. You might save some money this way, but what about your DD's wellbeing?

I'm also a little surprised with the course of action you've chosen.

I think this absolutely needs to be your DD's decision. In your shoes I would get a second opinion about the necessity of wiring in rather than increasing the out of school wear time.