The Herbst appliance is used to enhance the growth of the lower jaw in a forward direction.

A tube and rod work together similar to a shock absorber to connect the upper and lower jaws. This does not interfere with opening and closing the mouth or with eating. Side to side movement is somewhat restricted. If you open wide and the appliance comes apart, open wide again and guide the appliance back together as you close.

1. You may notice some tenderness in the muscles of your cheeks and jaw area. Take Tylenol or Advil as needed.

2. You may find chewing difficult at first. Cut food into small pieces and chew more carefully. Remember, in the first week let your knife and fork do most of your chewing for you! No sticky or hard foods such as gum, caramel, taffy, etc.

3. The insides of your cheeks may be slightly irritated by the Herbst appliance until these areas have built up "calluses." Use warm salt water rinses two times a day for a few days to help condition your mouth to the Herbst (one teaspoon salt in a glass of warm water). It is also best to sleep on your back as pressure on the cheeks can cause irritation.

4. It may take up to one week to adjust to your appliance, so hang in there!