Early Orthodontic Treatment

The American Association of Orthodontics recommends children be seen by an orthodontist at the age of 7. That being said, we love seeing children at any age that parents or the dentist think there is a problem. In many instances, we will decide to just monitor skeletal growth and development. If and when treatment is warranted, we decide with the family if the child is ready and we choose our appliance based on what is best for each child.

When skeletal growth is not favorable, it is important to identify and treat these problems early at ages 7, 8, and 9. Misaligned jaws and certain issues seen in children may be early signs of airway issues, oral habits, or other skeletal and growth issues. In early treatment, our focus is on getting skeletal growth and development on track.

The use of expansion appliances and other habit appliances can really help children in this age group. Common problems to watch out for that could indicate the need for early treatment are: crossbites, crowded teeth, protruded teeth, mouth breathing, the early loss of primary (baby) teeth, and damaging oral habits (such as thumb sucking or tongue thrusting).

When Earlier is Better

For some children, orthodontic treatment might need to start as early as four years old, before the jawbones are fully developed. At this stage, we will have the chance to guide development and reduce the time spent wearing braces. It is also an opportunity to correct harmful oral habits that can make orthodontic treatment more complicated.

• Guide jaw growth to a better position
• Improve the way lips meet
• Improve appearance
• Lower the risk of trauma to protruded front teeth
• Correct harmful oral habits

Early treatment not only provides a visually pleasing smile but corrects issues that could otherwise lead to jaw problems, headaches, decay, and tooth loss. Children and teens respond more quickly to orthodontics because treatments can take advantage of growth spurts, guiding development toward better alignment and symmetry.

What Problems Can Orthodontics Treat?

Orthodontics can treat a wide range of dental problems and in most cases, completely realign the teeth. Orthodontists may work alone or in combination with a maxillofacial surgeon.

The typical irregularities requiring orthodontic treatment are as follows:

• Overcrowding – An overcrowded mouth means there is insufficient space within the jaw for all of the adult teeth to fit naturally. Overcrowding may lead to displaced, rotated, or completely misaligned teeth.
• Overbite – An overbite refers to the protrusion of the maxilla (upper jaw) relative to the mandible (lower jaw). An overbite gives the smile a “toothy” appearance and the chin looks like it has receded.
• Underbite – An underbite, also known as a negative underjet, refers to the protrusion of the mandible (lower jaw) in relation to the maxilla (upper jaw). An underbite makes the chin look overly prominent. Developmental delays and genetic factors generally cause underbites and overbites.

Does Your Child Snore?

Snoring and mouth breathing in growing children can indicate an underlying problem. Chronic mouth breathing in growing individuals alters the way their upper and lower jaws grow. Such abnormal growth patterns in the jaws may necessitate surgical correction if not diagnosed and treated early. Mouth breathing may also indicate an airway obstruction, leading to poor sleep quality and subsequent problems with neurocognitive development. If caught and treated early, we have the ability to alter the skeletal growth trajectory and make tremendous positive changes in your child’s life!

Normal growth of the face and jaws depends on equal pressure from the lips and cheeks on the outside, and from the tongue on the inside of the mouth. Children who cannot breathe well through their nose for reasons such as allergies, asthma, a deviated septum, and large tonsils and adenoids are forced to breathe through their mouths. This mouth breathing can cause an imbalance between the pressures of the lips, cheeks, and tongue and lead to an underdeveloped upper jaw and irregular skeletal growth pattern. Other contributing factors can be a tongue tie where the tongue cannot rest on the roof of the mouth, preventing normal development of the upper jaw. Early treatment has the potential to help these sorts of issues.

What to Look for in Your Growing Child?

Do you think your child may need early treatment? Here are some things to look out for that may indicate a need for early treatment. Please feel free to call our office with any questions.

Signs of an underdeveloped jaw:

• Dental crossbite
• Dental crowding
• Delayed eruption of adult teeth
• Anterior open bite (front teeth do not overlap)
• Underbite or overbite
• Red or swollen upper gums
• Always eats with mouth opened
• Opened-mouth posture while the child is sitting still (inability to keep lips together)
• Chronic runny nose and or allergies
• History of chronic ear infections

Signs of a possible tongue-tie:

• History of speech therapy
• History of difficulty swallowing or extreme food preferences
• Inability of child to put tongue to roof of mouth comfortably

A dental crossbite is a sign that the tongue is not resting on the roof of the mouth. If not treated early, a small upper jaw may lead to incorrect or even blocked eruption of adult teeth and a compromised airway.

Signs of obstructed airway:

• Does your child snore?
• Have you heard your child stop breathing while asleep?
• Have you heard your child grind his or her teeth?
• Does your child toss and turn through the night?
• Is there a history of bedwetting?
• Do you observe daytime sleepiness?
• Does your child have morning headaches?
• Do you observe hyperactivity and/or an inability to pay attention to tasks?

What Happens Without Early Treatment?

In some cases, the misalignment is too severe; for these cases, if the child’s jaw bones fully develop without treatment, surgical intervention may be needed to achieve a healthy bite. If surgery is required, we will refer your child to a specialized oral surgeon. We will work together as a team to ensure optimal results with the least amount of time and expense. We understand that orthodontic care can be costly, and we do all we can to make this process easier. Early intervention allows us to guide alignment and, in some cases, remove the need for full braces later.

About the Hyrax Expander

One of the devices our orthodontists will use during early orthodontic treatment is called the Hyrax Expander. The purpose of this appliance is to make the upper jaw wider. By expanding the upper jaw, we can connect crossbites and make space so that the adult teeth can be aligned properly.

This Sounds Just Like My Child! What Are the Next Steps?

When these types of situations do come up, one of our orthodontists can make a recommendation on what the next steps should be. That could include early treatment with orthodontic expanders, referral for a pediatric sleep study, referral to an ENT doctor if tonsils or adenoids need to be looked at, the correction of a tongue tie, the need for myofunctional therapy, or a combination of these. Please schedule an appointment with us today to see how we can help your child!

Smile with Style with WildSmiles Braces

Besides looking forward to a beautiful, healthy smile, children love the designs they get to choose from with WildSmiles Braces. You get to choose from fun bracket designs featuring Disney characters or Signature shapes. Take a look at how you can mix and match brackets with our WildSmiles Design Tool.