Orthodontic Problems in Children

Updated: Jan 15

So many teeth, so little space


Orthodontics is the specialised branch of dentistry that deals broadly with improving the appearance & positions of the teeth and jaw bones. The aim of Orthodontics is to produce better functioning teeth and more attractive smiles. There are many factors that lead to Orthodontic problems and a Specialist Orthodontist is best positioned and best educated to analyse & determine the causes of your child’s Orthodontic problems, and has had many extra years in education & training in how to best treat these problems, in order to give your child a pleasant & healthy smile. Occasionally what appears to be a simple problem on the surface is, in fact, the surface manifestation of a more complex problem. The wide variety of potential situations indicate why it is worth seeking the advice of a Specialist Orthodontist in order to benefit from their extra education and experience.




As a Consultant Paediatric Dentist there are a number of factors important to my work which have a bearing on how children’s teeth and jaws develop. Crowding is a very common reason for referring a patient to an Orthodontist. Crowing can be the result of a number of factors. Sometimes children’s teeth are too big in relation to the size of the jaws. Sometimes the size of the teeth is not the problem and the jaws are too small to accommodate the teeth. Genetics plays an important role on the size and shape of our teeth and jaws. There are also environmental influences which can affect how jaws and teeth develop which influence the care provided by a Paediatric Dentist.

Up until the age of 18 months, suckling is an important behaviour for the development of facial muscles and the formation and growth and jaws. This type of suckling might be bottle or breast feeding or could include thumb sucking or the use of a soother. Beyond this age having something in the mouth starts to influence how the teeth and bone supporting the teeth grows and expands. The muscular force of sucking can exert strong pressures from the cheeks and the lips. These are powerful enough to mould the roof of the mouth and affect the amount of space available for the adult teeth to grow into as children get older. When prolonged sucking causes the palate or the roof of the mouth to become constricted and narrow, children sometimes have to adapt by displacing their jaw to one side to help the teeth meet together. This causes the jaws to grow asymmetrically and often persists into adulthood.

Another common orthodontic issue which develops in young dental patients is loss of space due to decay or early loss of primary molars. Dental decay frequently results in children’s teeth either developing large holes or being extracted early. Both issues mean that the space which the baby tooth would usually occupy is lost. The teeth next to the gaps drift into the empty space and by the time the adult teeth are ready to erupt, the space they require is no longer there. The result is insufficient room for adult teeth. In making space for the adult teeth, it is sometimes necessary to move large adult molars and this is not always easy and takes time.

The key messages from the article are:

· Eliminate soothers by age 18 months

· Discourage thumb sucking

· Ensure good dental health to prevent early loss of primary molars

· If your child has a baby molar extracted ask your dentist about keeping the space open using a space maintainer

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