J-Hook Headgear Safety

Orthodontists and liability insurers have long been aware of the potential for patient injury from headgear wear. Snap-away devices are commonly used with Kloehn-style facebows, but many of us prefer directional J-hook headgears such as the Hickham type (A), which has no safety feature. If the J-hook dislodges from the archwire, it can snap back 2" or more. Several of my patients have experienced minor intraoral and facial trauma in this way.

I have found a simple technique that minimizes the risk of injury from J-hooks. I first fit the headgear for the desired force and direction of pull (B). I then weld a stop^* or tube to each J-hook, about ¼" anterior to the distal tube (C). This limits the amount of travel to ¼" if the J-hook snaps back, virtually eliminating the possibility of trauma.