Why is children's orthodontics different?
In adults, orthodontics focuses largely on changing the position of the teeth, whereas in children, whose jaws are still growing, it is also possible to guide growth. As a result, some problems can be eased with simpler methods in childhood, or the scope of treatment that may be needed later can be reduced.
On the other hand, not every irregularity needs early treatment. For many children, regular monitoring is enough, and treatment is planned after waiting for the permanent teeth to come in.
Stages by age
| Stage | Approximate age | What is assessed? |
|---|---|---|
| Baby teeth | 3–6 years | Habits such as thumb sucking, dummy use and mouth breathing; crossbite; early loss of teeth |
| Mixed dentition | 6–12 years | Lack of space, a narrow palate, crossbite, protruding front teeth, differences in jaw development |
| Permanent teeth | 12 years and older | Crowding, gaps, bite problems, impacted teeth |
Signs you may notice at home
- Baby teeth falling out very early or very late
- Difficulty chewing or biting
- Sleeping with the mouth open, snoring or constant mouth breathing
- Thumb sucking or dummy use continuing after age 4–5
- Front teeth not touching when the mouth is closed
- Lower front teeth closing in front of the upper front teeth
- Noticeably protruding upper front teeth
- The jaw shifting to one side when closing
- Teeth coming in very crowded, or permanent teeth erupting behind the baby teeth
If you notice any of these signs, it may be helpful to book an orthodontic assessment.
Methods used
Removable appliances
Appliances made of acrylic and wires that can be taken out of the mouth. They can be used for simple tooth movements and small amounts of expansion. How well they work depends on how long the child wears them.
Functional appliances
When the lower jaw is set back, these aim to support its development by positioning it forward during growth. The right timing is usually the growth spurt.
Palatal expanders
In a narrow upper jaw, these widen the upper jaw by opening the midpalatal suture. For details, see the palatal expansion page.
Face mask
When the upper jaw is set back, this is used at an early age to support forward development of the upper jaw.
Space maintainers
When a baby tooth is lost early, these keep the space open until the permanent tooth comes in.
Clear aligners
In suitable cases, clear aligner protocols can be used, such as Invisalign First during the mixed dentition and Invisalign Teen during adolescence.
Brackets (fixed treatment)
Used to align the teeth in detail once the permanent teeth have come in.
Habits and orthodontics
Habits such as thumb sucking, dummy use, tongue thrust and mouth breathing can affect the development of the teeth and jaws if they continue for a long time; open bite and a narrow palate can be linked to them. Stopping the habit is often the first step of treatment. Children who breathe through the mouth may also need an assessment by an ear, nose and throat specialist.
Tips for parents
- Plan the first orthodontic check-up at around age 7.
- Keep track of how long your child wears the appliance or aligners; a daily chart can make this easier.
- Help children with appliances brush their teeth in the evening.
- Explain to your child why sticky and hard foods should be avoided.
- If an appliance breaks, digs in or causes pain, contact the clinic rather than trying to fix it yourself.