Herbst Appliance

Using a cephalometric x-ray (the one that takes images from the side of the head (see fig 1), an orthodontist can properly diagnose whether the orthodontic issue is skeletal or dental in nature. If the issue is skeletal, the only way to properly address and correct it is by way of a growth modification appliance such as the Herbst. This growth modification should be performed at an “ideal” time to be effective. If done too early, it will not last. If done too late, it will not be effective and jaw surgery will be required to correct the problem.
Therefore, if an orthodontist has diagnosed your child’s orthodontic issue as being skeletal in nature, treatment with rubber bands will not provide a solution.

Upper airway narrowing is connected to several breathing problems which include obstructive sleep apnea. Upper airway narrowing most commonly occurs in the space directly behind the tongue called the oropharynx. A small or narrow oropharynx is often linked to a retrusive (posterior) lower jaw position. It is worth noting that approximately 25% of the children that visit an orthodontist have a lower jaw that is positioned too far posteriorly which puts them at risk for either having or developing airway problems later in life.
In the simplest of terms, the Herbst appliance positions the lower jaw into a more forward position. In clinical research, Iwasaki verified that orthodontic treatment with a Herbst appliance can significantly enlarge the oropharynx, thereby opening the upper airway and minimizing the risk of developing airway issues later in life (see figure 2). Further research by Shutz showed that the Herbst appliance, used in conjunction with expansion of the upper jaw, will increase the volume of the pharyngeal airway and relieve the symptoms of obstructive sleep apnea. Lastly, Pancherz showed thorough additional clinical research that the Herbst appliance is most effective when used near the pubertal growth spurt. It is for the reason that the American Association of Orthodontists recommends that all children have a screening, performed by an orthodontist, at age 7.

Therefore, as one can glean, proper diagnose and efficient timing of treatment is essential to effectively treat a child with orthodontic issues of a skeletal nature using growth modification. The answer of “what should we do” in such a case that one orthodontist has recommended a Herbst while a second recommends rubber bands comes squarely down to the doctors’ diagnosis. If, in fact, the problem is skeletal, rubber bands are not a viable solution.

Dr. Petrunic has been educated in orthodontic and dento-facial orthopedics and can monitor your child using radiographs to determine if and when your child will benefit the most from growth modification such as the Herbst.

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Our Family has chosen Petrunic Orthodontics because of the overall care that is given to our children. Dr. Chris takes time to learn about each individual and their personality and lifestyle then tailors his plan of care to that child. He only recommended devices or procedures as they became necessary. Dr. Petrunic is also involved in the community supporting the various activities of his patients

Jennifer - Prattville, AL

"Dr. Petrunic and his staff are extremely caring and professional. During every appointment and follow up visit , I always felt he was truly concerned about my satisfaction and always provided a comfortable and caring environment. Now that my daughter is a patient, I look forward to seeing him and his staff every month! I would highly recommend Dr. Petrunic for your orthodontic needs."

Kim - Prattville, AL

Orthodontics FAQ

At Petrunic Orthodontics we are here to walk you through the entire process. From our free consultation to your desired end results, we make sure the process is as easy and seamless as possible.  We have created some FAQ to help you get started, but we would  also love to sit down with you in person and answer any and all of your questions.    

Is it required that my family dentist schedule my appointment with the orthodontist?

No, it is not. Many of our patients are referred by their family dentist, yet many other patients take the initiative to schedule an examination themselves.

At what age should I schedule an appointment for an orthodontic screening?

The American Association of Orthodontists recommends an orthodontic screening at age 7. By this age, several permanent teeth in most children have erupted, allowing us to effectively evaluate your orthodontic condition.

Will my teeth straighten out as they grow?

No, they will not. The space available for the front teeth does not increase as you grow. In most people, after the permanent molars erupt, the space available for the front teeth decreases with age.

How do I schedule an appointment for an initial exam?

If you or your child can potentially benefit from orthodontic treatment, simply call our office or send us an e-mail. We will be happy to schedule an appointment for you. When you call to schedule your appointment, our front office staff will request some basic information from you.

Chris Petrunic, DMD, MS

Braces Prattville, AL | Orthodontist Prattville, AL | Braces Millbrook, AL | Orthodontist Millbrook, AL

Seeing the joy and confidence on my patients' faces when they achieve the smiles of their dreams is the best part of being an orthodontist. Over the past eight years, I have met such wonderful people, and they've all taught me so much. I think people enjoy being around somebody who truly loves what he or she does, and that excitement becomes infectious. I hope that each and every patient I meet becomes as excited as I am about his or her orthodontic treatment.

I am a native of Prattville, AL, and proud to have been born and raised in such a great community. I live here with my wife, Ashley, and our two children. My free time is spent hunting, fishing, playing golf, or really just doing anything outside. I can also be found on my family’s farm. 

Being a part of the community where I practice is very important to me. I enjoy watching the children I treat grow up and thrive in the community that I call home. I see so many of my patients out around town at dinner, ballgames, church and community functions. I believe that a practicing doctor should know his patients as people and not just as a name on a chart. I want my patients to develop a sense of pride and bond with somebody they see as one of their own.

Testimonials

"Dr. Petrunic and his staff are extremely caring and professional. During every appointment and follow up visit , I always felt he was truly concerned about my satisfaction and always provided a comfortable and caring environment. Now that my daughter is a patient, I look forward to seeing him and his staff every month! I would highly recommend Dr. Petrunic for your orthodontic needs." read more 

"Our Family has chosen Petrunic Orthodontics because of the overall care that is given to our children. Dr. Chris takes time to learn about each individual and their personality and lifestyle then tailors his plan of care to that child. He only recommended devices or procedures as they became necessary. Dr. Petrunic is also involved in the community supporting the various activities of his patients..."  read more

"When it was time for my daughter to need braces, we consulted with a few different orthodontists regarding treatment. Since Dr. Petrunic was the third orthodontist we met with, I guess you could say the best was saved for last. My daughter felt at ease as soon as she met Dr. Petrunic. He and his staff have been wonderful to work with. Dr. Petrunic is very thorough in all aspects of the treatment..." read more

Don't Wait Any Longer for The Smile of Your Dreams!