When underbites, known medically as Class III malocclusions, throw off jaw alignment and facial balance in young patients, the solution may be non-surgical yet powerful: reverse pull headgear braces, also known as a protraction facemask. In Jacksonville, FL, Dr. Marty Greenberg at Bold Bite Orthodontics offers this specialized treatment with precision, compassion, and cutting-edge orthodontic technology.
What Is Reverse Pull Headgear?
A reverse pull headgear is an orthodontic appliance designed to guide the upper jaw forward, helping correct underbites caused by delayed or limited maxillary development. According to Dr. Owais Naeem, a local orthodontist in Manassas, VA, early use of reverse pull headgear can maximize facial symmetry and reduce the need for invasive procedures later. Unlike traditional headgear that restrains upper jaw growth, this facemask applies gentle, consistent forward and downward force viaelastics connected to dental braces or expanders inside the mouth.Typically, it features three main components:
- A padded facial frame resting on the forehead and chin.
- Elastics attaching the frame to mouth-based braces or expanders.
- A supportive head cap or straps to anchor the appliance. Patients are typically asked to wear the appliance 14–16 hours daily, often during evenings and overnight, for about 12 to 18 months, depending on the severity of the underbite and growth rate.
Why Early Intervention Matters
Harnessing this treatment during childhood or early adolescence, when bones are still growing, cansignificantly reduce the risk of needing future jaw surgery, enhance facial harmony, and improve functionalbite alignment. Long-term studies reveal that 70–75% of treated cases maintain a proper overjet, thoughsome relapse (25–30%) may occur due to late mandibular growth.
Spotlight: Dr. Marty Greenberg & Bold Bite Orthodontics in Jacksonville
At Bold Bite Orthodontics, Dr. Marty Greenberg brings a rare blend of research-informed expertise and family-focused care to Jacksonville. Earning his DMD from Boston University, followed by both an MS in Orthodontics and a Research fellowship at Jacksonville University, he harnesses tech-forward methods like 3D scanning, auto-expanding appliances, and digital planning.
The clinic embodies a uniquely collaborative spirit—Dr. Greenberg and board-certified Dr. Trang Cao coreview each treatment plan, combining precision with empathy. They even practice what they preach: family values guide their approach, with patient care often discussed over dinner at home.
The Underbite Treatment Journey at Bold Bite
- Initial EvaluationYou begin with a request a free orthodontic consultation for kids and X-rays, followed by a 3D preview of your future smile and a tailored treatment plan, no commitment required. Financing options are transparently presented.
- Personalized Treatment DesignIf reverse pull headgear is recommended, your plan may be paired with braces (metal, ceramic, or clearaligners) or a palatal expander, depending on your child’s age and bite complexity.
- Patient Education & Comfort
Dr. Greenberg ensures every patient and family understands how to wear, handle, and care for their
headgear. Clear instructions help ensure compliance, essential for success. - Progress Monitoring
Regular follow-ups help monitor jaw movement, adjust force levels as needed, and ensure comfort remains a priority throughout the treatment journey. - Results & RetentionOnce the upper jaw aligns properly, braces help final tooth positioning. A retainer may follow to secureresults long-term.
Benefits of Choosing Bold Bite
Audiobook-level comfort with grown-up precision: Combining research-based treatment with welcoming care.
- Two experts on your side: Every case benefits from dual-doctor input.
- Technologically advanced & stress-free: Digital previews and appliance innovations make treatment smoother.
- Avoids unnecessary surgery: Early intervention often sidesteps more invasive options.
- A community-centered approach: Kindness, clarity, and collaboration are woven into every visit.
Who’s a Good Candidate?
Young patients, typically ages 6–9, who are still developing.
- Children showing early signs of a skeletal underbite or maxillary deficiency.
- Ideal candidates are those whose growth phase allows jaw guidance, often preventing surgery and improving facial symmetry.
Alternatives to Facemask Therapy
While reverse pull headgear is the gold standard for early Class III correction, it is not the only option. For patients who cannot tolerate a facemask, are non-compliant, or present with different growth patterns, BoldBite Orthodontics offers several alternatives:
- Tandem Appliance
A fixed or removable device that uses intraoral anchorage to gently move the upper jaw forward without external straps. It’s well-suited for younger patients who may not want to wear a visible appliance. - Bone-Anchored Maxillary Protraction (BAMP)
For older children or teens, temporary anchorage devices (TADs) can be placed in the upper jaw to apply protraction forces internally. This method often requires less wear time and is more discreet. - Class III Elastics with Braces or Aligners
For mild cases, elastics between upper and lower teeth can correct bite discrepancies, especially when combined with braces or Angel Aligners. - Growth Modification with Chin Cup
Less common today but still used selectively, a chin cup restricts lower jaw forward growth rather than advancing the upper jaw. - Surgical Orthodontics
If growth is complete or the discrepancy is severe, orthognathic jaw surgery combined with braces or aligners may be necessary in adulthood.
New Advances: Angel Aligners with Facemask Therapy & the Tandem Appliance
Bold Bite Orthodontics is at the forefront of combining clear aligner technology with orthopedic correction. For selected Class III cases, Angel Aligners (a transparent aligner system similar to Invisalign) can be integrated with facemask therapy. This hybrid approach allows:
- Early orthopedic correction of the underbite
- Simultaneous tooth alignment with near-invisible trays
- Improved comfort and aesthetics compared to traditional braces
Dr. Greenberg customizes aligner staging to coordinate with facemask elastics, maximizing skeletal change while minimizing treatment time. This is ideal for image-conscious teens or adults seeking a less conspicuous option.
Another innovative option is the tandem appliance, a fixed or removable system designed for younger patients (typically ages 6–9). It uses an upper expander and lower anchoring device connected with elastics or arms to gently advance the upper jaw while redirecting lower jaw growth. The tandem appliance can serve as:
- A precursor to reverse pull headgear
- A standalone interceptive tool for mild to moderate Class III cases
- A compliance-friendly alternative when full-time facemask wear is challenging
By offering both Angel Aligners with facemask therapy and the tandem appliance, Bold Bite Orthodontics ensures greater flexibility in Class III treatment planning, making early intervention more accessible and patient-friendly.
Conclusion: Jacksonville’s Best Choice for Reverse Pull Headgear
Bold Bite Orthodontics, led by the expert and approachable Dr. Marty Greenberg, stands out in Jacksonville for providing high-impact, compassionate care when it comes to underbite correction.
If you’re curious whether reverse pull headgear could help your child—and want a blend of advanced orthodontics, free consultations, and friendly service—I’d be happy to help shape FAQs, add patient referrals, or design a streamlined parent info packet. Just let me know how you’d like to take the next step!
Realistic Expectations & Family FAQs
Daily Commitment: Consistent wear is key. Missing hours can delay or limit results.
Comfort Level: Modern facemasks are padded and adjustable, initial soreness is normal but usually fades within hours.
Long-term Outcomes: Most cases hold the improved bite long-term, though a minority may see some relapse due to growth changes.
Social Considerations: Wearing headgear at home and night reduces social discomfort during school hours.
About the Authors
Dr. Marty Greenberg – Orthodontist in Jacksonville, FLDr. Owais Naeem – Orthodontist in Manassas, VA
