We recommend that children have an orthodontic screening examination at around 7 years of age. There are many orthodontic problems that can be solved simply if detected early and this has the benefit of avoiding more complex treatment later.
Our early treatment options include:
- expansion treatment for narrow upper jaws and consequent crowding problems
- creating space for eruption of crowded teeth
- space maintenance when baby teeth are lost prematurely
- guidance of tooth eruption for ectopic teeth
- cross bite correction
- functional appliances for orthopaedic treatment for jaw size and bite discrepancies- bionator, twin blocks, facemask
- thumb or finger sucking habits
- removable appliances (“plates”) for cross bite correction or simple tooth alignment
- management of gum recession- extraction of specific baby teeth for spontaneous alignment of deciduous teeth
- reduction of dental protrusion to reduce risk of trauma to teeth
Constriction of the upper jaw is a relatively common problem that can result in cross bites, facial asymmetry and significant crowding of the top front teeth. It is often associated with thumb-sucking and mouth-breathing habits or chronic nasal obstruction.Expansion appliances are used to expand the upper jaw and upper arch to correct cross bites and create space for the eruption of the permanent incisors. We use both fixed and removable expansion appliances but our preference is for fixed appliances for their predictable outcomes with minimal reliance on patient compliance.
Bonded RME-Mixed Dentition
Crowding of the lower incisors is a common problem. Cases of mild to moderate crowding can be resolved by the use of a lingual arch, a passive device attached to the lower molars that re-distributes space when the deciduous second molars are lost. To be effective this device must be placed prior to the loss of the last remaining deciduous molars in the lower arch. This device relieves crowding of the incisors and in some cases can eliminate the need for extraction of teeth. It is important to understand that use of this device must be considered in the context of the long term orthodontic treatment plan formulated by an orthodontist.
E-space and Lingual Arch
Many common bite problems are caused by underlying jaw size discrepancies. For example, a patient that presents with protruding upper incisors will often have an underdeveloped lower jaw. In other cases, an “underbite” may be caused by underdevelopment of the upper jaw or an excessively long lower jaw.These structural jaw anomalies and associated bite problems can be addressed in young growing patients by manipulating the jaw growth with functional orthopaedic appliances. Such treatment is timing critical and must be considered in the context of the patient’s dental, physical and psychological development together with their long-term treatment plan. An orthodontist is the most qualified practitioner to advise on the suitability of this form of treatment.
A significant number of children have developmental anomalies with the teeth such as missing teeth, crowding of the front teeth or ectopic eruption where the adult tooth does not erupt into a normal position. The latter typically occurs with the adult canine teeth failing to erupt normally and becoming impacted in the jaw. In that case they can result in damage to the roots of the adult front teeth to the point where those front teeth may be lost.If these issues are detected early, simple measures can be employed to intercept the developing problem and encourage the adult teeth to erupt normally. In the case of missing teeth, plans can be made to orthodontically close the space created by the missing tooth, thus eliminating the problem from the mouth and avoiding the need for complex restorative dentistry or dental implants.
For the above reasons, we suggest that children be assessed at 7-8 years of age as many developmental problems can be detected at that age and appropriate but simple management instituted.
Thumb or finger sucking habits can cause serious disturbances in the development of the teeth and jaws that can persist into adulthood.
Dental problems include protrusion of the top front teeth and open bites where the teeth cannot bite together properly. These issues can in turn cause difficulties with speech and eating and increase the risk of trauma to the top front teeth. Skeletal problems can include the development of a narrow top jaw and the resulting cross bite can cause permanent jaw and facial asymmetry.
We recommend treatment to stop thumb or finger sucking habits as soon as possible, especially if the habit persists after the eruption of the adult front teeth. Fixed anti-habit appliances are used to help our patients break the habit.
When baby teeth are lost prematurely through tooth decay, dental trauma or through anomalies in dental development, the adjacent teeth drift into the remaining space. This can lead to worsening of a crowding problem, the development of a crowding problem or a situation where there is no longer sufficient space for the adult tooth to erupt into its normal position.
We recommend that a fixed or removable space maintainer be inserted if deciduous (“baby”) teeth are lost prematurely to avoid the above problems.
Space Maintainer Unilateral
Removable plates can be used for a variety of reasons including:
- correction of a simple cross bite
- simple alignment of a crooked tooth
- correction of spaced and protruding top front teeth
- correction of a deep impinging overbite
This type of treatment is co-operation dependent and patients need to wear their plate almost full-time for it to be effective. Our younger patients like to personalise their plate by choosing their favourite colour.