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Small Jaw, Big Teeth & What To Do

In the last few issues, we’ve discussed oral habits, treatment options and the benefits of early orthodontic treatment. Another common issue relating to early orthodontic treatment is managing spacing/crowding problems.

Not everyone develops the same size jaws or dental arches. Some are fortunate enough to have large jaws + average size teeth which equals good spacing for all their teeth. Others are not so lucky and have the combination of small jaws and large teeth. Crowding can become evident very early and can cause problems as early as 6-7 years of age. As was mentioned previously, this is a good age to see an orthodontist because managing crowding properly can make a big difference.

It is important to make sure that there is enough space for the upper and lower front teeth and this occurs generally between 6 and 8 years of age. If the crowding is not that bad, that is, if the teeth are mildly crooked but generally in the correct position in the arches, then there is really no need to provide any orthodontic treatment besides periodic observation appointments. Space maintainers may be helpful but generally this would be when the baby molars are starting to loosen up, which would be a few years down the road. There are really two options to manage more significant crowding: removing baby teeth to make room or making more room in the arch.

Removing baby teeth is a perfectly good option but would be considered a “quick fix”. It’s a quick fix because it opens up space for the crowding front teeth to fall into but does nothing to deal with the crowding long term. In fact, once baby teeth are removed, the arches tend to collapse further and this is the opposite of what really needs to happen.

Expanding the dental arch (if it is narrow) provides a more comprehensive correction for crowding because it gains space across the arch. Not only that, but expansion of the palate has been shown to improve the airway and encourage breathing through the nose. Making the arches wider/bigger can be done either with a retainer (removable) or a fixed expander (not removable) or even with partial braces. Therefore, if your child is a mouth breather, snores or has a tendency towards sleep apnea, expansion may be quite beneficial. Your orthodontist is there to help provide guidance to allow your child’s teeth to erupt as best as they can because the better the teeth erupt into position, the healthier the smile, and the more self-esteem your child may have.

Doctors Hill and Gross have the experience to help craft beautiful smiles for all manner of patients, both children and adults.


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