Herbst & MARA Appliance in Shelby Township
The Herbst and the MARA are appliances attached to the back teeth. Dr. Thomas Fredal Jr. uses both for jaw advancement (bringing the lower jaw forward).
*For new patients only. Patients transferring from another orthodontist: $250 consultation fee, credited toward treatment if they start here.
Every new-patient consultation at Fredal Orthodontics includes a free 3D CBCT scan (a 3D X-ray of the teeth and jaws), reviewed with Dr. Fredal.
What Is a Class II Overbite?
An overbite is when the upper front teeth cover the lower front teeth. Orthodontists call a bite Class II when the lower teeth sit too far back compared with the upper teeth.
A Class II bite is called skeletal when the difference lies in the size or position of the upper or lower jaw. It is called dental when the difference lies in the position of the teeth.
Every case at Fredal Orthodontics is diagnosed in three dimensions with an i-CAT CBCT scan and an iTero digital scan (a 3D scan of the teeth). With them, Dr. Fredal evaluates the roots, the surrounding bone, the skeletal relationships, the airway and the face, not only the crowns of the teeth.
Dr. Fredal is an advocate of Phase 1 (early) treatment. Fredal Orthodontics treats children from age 7, as well as teens and adults.
Functional Appliances for Jaw Advancement
Fredal Orthodontics offers functional appliances, including the Herbst and the MARA. Dr. Fredal also uses the Forsus spring (a small spring fitted to the braces) and the Carriere appliance.
The Carriere Appliance
The Carriere appliance is bonded to the upper teeth and worn with elastics (small rubber bands) to the lower teeth. It is one of the appliances Fredal Orthodontics can fit at the same visit. Like every appliance a case needs, it is included in the treatment fee.
Herbst vs. MARA: How Fredal Orthodontics Chooses
Dr. Fredal uses both appliances. He gives his recommendation after reviewing your child’s complete records with you at the consultation.
MARA
Herbst
Fixed vs. Removable Appliances at Fredal Orthodontics
A removable appliance is one you take in and out at home. A fixed appliance stays attached to the teeth until the orthodontist removes it.
The Herbst and the MARA are fixed appliances, so they stay in place between visits.
The Forsus spring and the Carriere appliance, which Dr. Fredal also uses, are fixed as well.
The elastics worn with the Carriere appliance are included in the comprehensive treatment fee.
Timing: How Dr. Fredal Decides When to Start
Dr. Fredal looks at growth, how the teeth are developing, how the jaws relate and the goals of treatment. From these, he decides not only how to treat, but when to start.
| Stage | At Fredal Orthodontics | Fee |
|---|---|---|
| By age 7 | A first orthodontic evaluation, with a 3D i-CAT CBCT scan to assess jaw growth, the teeth coming in and the airway | Free for new patients; transfer patients pay $250, credited toward treatment |
| Phase 1 (early) treatment | From age 7, when Dr. Fredal finds early treatment indicated | Phase 1 with braces starts at $2,980 |
| Ages eight to ten (mixed dentition: baby and adult teeth together) | Invisalign with mandibular advancement wings, when indicated | Included in the treatment fee |
| Herbst or MARA | Placed when Dr. Fredal decides the timing is right | Included in the treatment fee |
| Jaw difference too large for tooth movement alone | Surgical orthodontic treatment may be discussed, coordinated with an oral surgeon. Fredal Orthodontics does not do surgery first. | The surgeon and the hospital or surgery center bill for surgery on their own |
Daily Life with a Herbst or MARA
For discomfort, Dr. Fredal advises Tylenol as needed, following the recommended dosing instructions. If your child has discomfort and cannot come to the office during patient hours, orthodontic wax can be applied to the area for temporary relief.
Check-ins Between Visits
Between visits, you can text photos and questions to the team through Weave. There is no monthly fee for it.
If Something Goes Wrong
Call/text the office if your child has an orthodontic problem. The team will help decide whether it needs attention right away or can safely wait until the next visit. After hours, existing patients can call/text the main line, and the team usually responds within 24 hours.
Activities
Fredal Orthodontics does not make custom sports guards. For sports, it recommends the Shock Doctor orthodontic mouthguard.
Cost, Insurance, and Financing
The Herbst or MARA appliance is included in the treatment fee. The fee does not change with how long treatment takes.
Fredal Orthodontics is in network with Delta Dental. If your plan is out of network, the team files the claims for you. You get your benefits verification in writing. HSA and FSA funds are accepted.
In-house financing through Ortho 2 has 0% interest and no credit check, with a down payment. Monthly payments start as low as $179, and amounts vary with the treatment cost, the down payment and the financing terms. In-house plans run up to 30 months. Cherry and CareCredit financing are also offered.
Discounts come off the part you pay after insurance. A community discount takes $250 off, one per patient. Community discounts are open to military service members and veterans, teachers and school staff, first responders, healthcare workers, students and additional family members in treatment. Paying in full takes 5% off, and it can be combined with a community discount.
Frequently Asked Questions About the Herbst and MARA
Does Dr. Fredal use the Herbst or the MARA?
Both. Dr. Fredal prefers the Herbst for jaw advancement, and he will also treat a case with the MARA. Each one attaches to the back teeth and stays in place until the orthodontist removes it. He says which he recommends when he reviews your child’s complete records with you, and he conducts every consultation himself.
What does Dr. Fredal consider before placing a Herbst or MARA?
Dr. Fredal weighs growth, dental development, the way the jaws relate and the goals of treatment, and from those he decides both how to treat and when to begin. Every case is diagnosed in three dimensions from an i-CAT CBCT scan and an iTero digital scan, so he can assess jaw growth and the teeth coming in.
Is the Herbst or MARA appliance included in the treatment fee?
Yes. The appliance is included in the treatment fee, and so is every other appliance a case needs. The fee does not change with how long treatment takes. Phase 1 treatment with braces starts at $2,980, and Dr. Fredal gives you the exact cost in writing at the consultation.
Does Dr. Fredal use the Forsus spring or the Carriere appliance?
Yes, he uses both. The Forsus is a spring that attaches to the braces. The Carriere is one of the appliances Fredal Orthodontics can fit at the same visit, along with Essix retainers, and the elastics worn with the Carriere are included in the comprehensive treatment fee.
Can we send the team photos while my child wears the appliance?
Yes. Fredal Orthodontics offers remote check-ins through Weave, with no monthly fee. You text photos and questions to the team, and the clinical team reviews them during business hours and replies with next steps, so a broken bracket or a poking wire can be addressed between appointments.
What if the jaw difference is too large for an appliance?
Dr. Fredal may discuss surgical orthodontic treatment, coordinated with an oral surgeon. He weighs the severity of the skeletal difference, facial balance and profile, the bite, tooth position, function and your goals. Fredal Orthodontics does not do surgery first. The surgeon and the hospital or surgery center bill for the surgery on their own.
Is a Herbst or MARA Right for Your Child?
A free consultation at Fredal Orthodontics includes a 3D CBCT scan, an iTero digital scan and photos. Dr. Fredal goes over all of the records with you. He tells you what he recommends and gives you the exact cost in writing. Community discounts are available.
*For new patients only. Patients transferring from another orthodontist: $250 consultation fee, credited toward treatment if they start here.