Orthodontic headgear

Page updated October 14, 2026. Medically reviewed by Dr. Abraham Thomas and Dr. Jennifer Loucks-Buren.

Orthodontic headgear is an appliance worn partly outside the mouth that guides a growing child's jaws into line. It treats overjet ("buck teeth"), overbites and underbites. Most children wear it 12 to 14 hours a day, usually after school and overnight, for about 1 to 2 years.

What orthodontic headgear is

Headgear is a device that helps position a child's teeth and jaws into alignment by placing gentle pressure on them; over time it encourages still-forming jaw bones to line up (Cleveland Clinic). It treats malocclusion, or a "bad bite", which over time can cause dental and jaw problems and even trouble speaking and eating (Cleveland Clinic). Unlike braces, it's worn partly outside the mouth (Healthline).

Depending on the type, headgear has some of these parts (Healthline):

• Head cap or straps that anchor the appliance around the head or neck.
• Facebow: a U-shaped metal wire attached to the molars. The AAO's glossary describes it as used with headgear mainly to move the upper first molars back, creating room for crowded or protruding front teeth (AAO).
• Elastic bands, tubes and hooks that connect the parts to the teeth.
• Chin cup, forehead pad and mouth yoke on headgear for underbites.
• Braces: some headgear hooks onto braces; not all headgear uses them.

Types of headgear

Healthline adds that high-pull headgear is often used for children with an open bite or excess jaw growth at the back of the mouth, and that reverse-pull headgear often uses rubber bands attached to braces on the top teeth (Healthline). For underbites caused by jaw development, the AAO says a palatal expander may be used together with reverse-pull headgear to encourage forward growth of the upper jaw (AAO).

Why orthodontists use headgear

Headgear corrects the more severe classes of malocclusion, Class II and Class III, and can also make room for crowded teeth (Healthline). It works by putting force on the upper or lower jaw, and it only works while a child is still growing, because it guides how the jaw grows (Healthline). Healthline says it can help a child avoid corrective jaw surgery later (Healthline); for comparison, see jaw surgery cost.

It's typically recommended for children whose jaws are still growing (Healthline), which is one reason the AAO recommends a first orthodontic check by age 7 (AAO). Learn about the bite problems it treats on overbite and underbite.

How long you wear headgear

Consistency is everything. Even skipping a day can roll back progress (Cleveland Clinic), and small lapses can make the whole treatment take longer (Healthline). Your orthodontist may start with a few hours a day and build up (Cleveland Clinic). Once treatment is done, a child is unlikely to need headgear again (Healthline).

What happens at appointments

After fitting the headgear, the orthodontist explains how many hours a day to wear it and how to care for it, and sees your child regularly to check the bite and gradually adjust the tension as the jaws grow into place (Cleveland Clinic). Tell the orthodontist about any change in fit rather than adjusting anything at home (Healthline).

Daily life with headgear

For safety, a child should take headgear off when (Cleveland Clinic):

• Eating, and when drinking unless using a straw.
• Playing or being active, with any risk of falling or getting hurt. Healthline suggests swapping contact sports, ball games, skateboarding and skating for activities such as swimming (Healthline).

Brushing and flossing are possible with headgear on, though most children find it easier to take it off (Cleveland Clinic). Never force headgear on or off, which can damage it or cut the gums or face; following the orthodontist's instructions helps avoid snapping bands or wires (Healthline). Never adjust it yourself (Healthline). If it's attached to braces, avoid gum, hard candy and hard-to-chew foods (Healthline).

Cleaning: wash the hard parts daily with warm water and mild soap and rinse well; wash soft pads and straps every few days with mild detergent and dry them thoroughly (Healthline).

Soreness and side effects

Headgear is a safe and effective treatment, but sore teeth are common at the start, and there may be some soreness and even slightly loose teeth as bones grow and shift (Cleveland Clinic). Discomfort also returns briefly when the orthodontist increases the pressure (Healthline). To help (Cleveland Clinic):

• Ice packs on the sore part of the jaw
• Soft foods until it feels better; cold foods such as ice pops can soothe the gums (Healthline)
• Pain medicine: ask the orthodontist or pediatrician which is safe

Call the orthodontist if a piece breaks or comes loose, if the fit changes, or if pain is severe or doesn't go away (Cleveland Clinic) (Healthline).

Helping your child wear it

Wearing something everyone can see is hard for many kids, and some are tempted to hide it (Cleveland Clinic). Cleveland Clinic's suggestions (Cleveland Clinic):

• Acknowledge it's OK to wish they didn't have to wear it, and remind them that consistent wear means finishing sooner.
• Book the first appointment on a Friday so they have a day to adjust.
• Plan fun, low-key after-school activities such as games, movies and reading.
• Keep soft favorites on hand, like ice cream, smoothies and mac and cheese.
• Help with sleep: a set bedtime and a supportive pillow for back sleeping.

Ask the orthodontist for a schedule that works; some children can skip school hours and put it on as soon as they get home (Cleveland Clinic).

Alternatives to headgear

Headgear isn't used as much as it once was (Cleveland Clinic) (Healthline). Cleveland Clinic mentions clear aligners for mild alignment problems, and the Herbst appliance, which repositions the jaws from inside the mouth and stays hidden (Cleveland Clinic). Healthline lists other options such as temporary anchorage devices, small screws placed in the jawbone, and fixed appliances like Forsus and PowerScope (Healthline). Which one your child needs depends on their bite (Cleveland Clinic).

More on the small bone screws used as anchors in TADs in orthodontics.

Does headgear cost extra?

We found no reliable published price for headgear on its own. It's usually part of an orthodontic treatment plan, often an early phase for a growing child, so ask for a written quote that lists every appliance and phase. See braces cost for kids and braces for kids and teens.