When skeletal growth is not in our favor, it is important to identify and treat these problems early. Misaligned jaws and certain issues seen in children may be early signs of airway or other skeletal issues. In early treatment, our focus in on getting skeletal growth and development on track.
The Initial Examination
We love seeing children at any age that the parents or the dentist thinks there is a problem. We prefer to see children by age seven, but we love seeing them at all ages – if nothing more than to meet them. In many instances, we will decide to monitor skeletal growth and development. If and when treatment is warranted, we decide with the family if the child is ready and we tailor our appliance choice based on what is best for each child.
When Earlier Treatment Is Better
All adult teeth erupt into the mouth usually between the ages of 10-13 – with a great deal of individual variation. By this age, 90 percent of skeletal growth is complete. We can successfully move teeth at this age, but we lost the opportunity to influence and change skeletal growth patterns.
Crossbite. One is severe crossbite, a condition where the upper teeth close inside the lower teeth. To treat this problem, a device called a palatal expander can be used, which gradually and painlessly widens the upper jaw; it’s especially effective when the jaw itself hasn’t fully developed. If we wait too long, a more complicated treatment — or even oral surgery — might be required to correct the problem.
Crowding. Another condition that may benefit from early treatment is severe crowding. This occurs when the jaws are too small to accommodate all of the permanent teeth. Either palatal expansion or tooth extraction may be recommended at this point, to help the adult teeth erupt (emerge from below the gums) properly. Even if braces are required later, the treatment time will likely be shorter and less complicated.
Protruding teeth. Early intervention may also be helpful in resolving several other problems. Protruding teeth, especially in front, can be prone to chipping and fractures; they may also lead to problems with a child’s self-image. A severe underbite, caused by the lower jaw growing much larger than the upper jaw, can result in serious bite problems. Orthodontic appliances can be successfully used to correct these problems at this stage, when the child’s skeletal development is in full swing, thereby increasing the chances that surgery can be avoided.
Correcting Bad Habits. At one time or another, anyone may pick up a bad habit. But there are some situations where a child’s parafunctional (detrimental to health) habits can actually influence the development and function of his or her teeth, jaws and mouth. Some examples of these are persistent thumb sucking, tongue thrusting and mouth breathing.
Mouth breathing. An abnormal breathing pattern in which the mouth always remains open, passing air directly to the lungs — is related to alterations in the muscular function of the tongue and face. It may cause the upper and lower jaw to grow abnormally, which can lead to serious orthodontic problems. Although mouth breathing may start from a physical difficulty, it can become a habitual action that’s hard to break. Mouth breathing can also indicate underdeveloped nasal passages, large adenoids and tonsils, or a tongue tie. Further evaluation is often indicated when treating openbites.
Various orthodontic treatments are available to help correct these parafunctional habits — and the sooner they’re taken care of, the less damage they may cause. But these potential problems aren’t always easy to recognize. That’s one more reason why you should bring your child in for an early orthodontic screening.