Herbst appliance in Dubai: fixed Class II correction for growing patients

Key facts

• Fixed functional appliance working 24 hours a day
• No reliance on the patient to wear it
• Used for Class II bites with a retruded lower jaw during growth
• Active phase often several months to around a year
• Braces and retainers usually follow

What the Herbst appliance is

The Herbst is fixed to the upper and lower back teeth, usually with metal bands or crowns. On each side, a telescopic tube-and-rod mechanism connects the upper and lower parts so the lower jaw is held in a forward position whenever the mouth closes, while still allowing the patient to open, chew and speak. Because it cannot be removed by the patient, it works around the clock. Like other functional appliances, it uses muscle activity and growth forces to improve the relationship between the jaws in a Class II bite, where the upper front teeth sit well ahead of the lower ones. Changes come from a combination of jaw growth and tooth movement.

Herbst vs Twin Block

Both appliances aim to bring the lower jaw forward during growth, and both are used by Dr. Pacha. The Twin Block is removable: it is easier to clean and can be taken out for sports, but results depend on the patient wearing it many hours a day. The Herbst is fixed: it removes the compliance question entirely, which can make results more predictable for children who are unlikely to wear a removable appliance consistently. On the other hand, the Herbst needs extra attention to cleaning, can feel bulkier at first, and is not adjusted at home. The choice depends on the patient's age, growth stage, bite, oral hygiene and family preference.

Who is a good candidate

The Herbst is usually considered for growing patients — often in early to mid-adolescence — with a Class II bite caused mainly by a retruded lower jaw, a large overjet and sometimes a deep bite. It can be used slightly later in growth than some removable appliances because it works continuously, and it can be combined with fixed braces in the same phase in some plans. It may be less suitable for patients with poor oral hygiene, very short back teeth, or problems that come mainly from the upper jaw. A clinical examination, X-rays and a growth assessment confirm whether the jaw pattern and remaining growth make a functional approach worthwhile.

Duration and what to expect day to day

The active Herbst phase commonly lasts several months to around a year, depending on how much correction is needed and how the patient grows. In the first week or two, many patients feel the cheeks rub on the arms and the jaw muscles ache; orthodontic wax and soft foods help. Chewing gets easier as the muscles adapt. Patients should avoid very hard or sticky foods, clean carefully around the bands and arms with a brush and interdental aids, and attend reviews so the appliance can be checked and, if planned, advanced. Contact the clinic if a part comes loose or a sore spot does not heal within a few days.

After the Herbst: braces and retention

Once the jaw relationship has improved, the Herbst is removed and most patients continue with fixed braces, or in suitable cases aligners, to align the teeth and refine the bite. In some plans braces are already in place alongside the Herbst. Because a corrected Class II bite can partly relapse, especially if growth continues in an unfavourable direction, Dr. Pacha monitors the bite after removal and uses retainers to hold the final result. Families receive a written plan explaining each phase, its likely duration and the alternatives — such as a Twin Block, braces with elastics or skeletal anchorage — so they can decide with full information.

An orthodontic check around age seven can identify crossbites, narrow jaws, habits and crowding while the jaws are still growing. Some problems are easier to correct at this stage; others are simply monitored.

Prepared by the Manhal Medical Center editorial team · Updated: 2026-10-18 · Treating specialist: Dr. Moaiyad Pacha

This page is general information and does not replace a consultation. Suitability, risks and results vary between patients.