Early Treatment (Phase 1 or Interceptive Treatment)
Orthodontic problems very rarely fix themselves. And between the ages of 7 and 9, there is a great opportunity for you to really make a change in your kids’ life by preventing a much bigger problem later on in life. Between the ages of 7 and 10, there is a lot of active growth that can be used to your advantage as well as the jaw bones are softer and so can be directed or molded with more ease. All this makes Early Treatment a smart investment in your child’s dental health future.
Cross Bite (or X-Bite)
This is a misalignment of the jaws, the teeth, or a combination. The upper teeth (maxillary teeth) should always cover the lower teeth (mandibular teeth). When the upper jaw or the upper teeth fit inside the lower jaw or the lower teeth– then you have a Cross Bite. So, you always want the upper jaw and teeth to be naturally wider.
- Front (or Anterior) Cross Bite teeth: When an upper tooth or teeth is on the inside of the lower teeth in the front of the mouth.
- Back (or Posterior) Cross Bite teeth: When an upper tooth or teeth is on the inside of the lower teeth in the back of the mouth.
- Front (or Anterior) Cross Bite Jaws: When the upper jaw is more short or narrow than the lower jaw in the front.
- Back (or Posterior) Cross Bite: When the upper jaw is more short or narrow than the lower jaw in the back.
If it is on the one side – then it’s called unilateral. If it is on both sides then it is called bilateral.
What Causes It?
This can be caused by a variety of reasons such as a mismatch between teeth size and jaw size, upper airway problems, abnormal eruption of teeth, delayed eruption of teeth, trauma, asymmetrical growth, functional shifts, genetics, abnormal swallowing patterns, thumb sucking or finger sucking.
What Happens If It Is Left Untreated?
There are a number of consequences that may occur such as lopsided jaw growth, uneven wear of teeth/enamel, chipped teeth, problems with the TMJ (TemporoMandibular Joint) leading to joint pain and possible headaches, gum recession leading to sensitivity or even bone loss, cavities and loose teeth.
How To Treat A Cross Bite?
This will depend on the type of Cross Bite listed above but here are some treatments:
There are many designs and types but they all are focused on doing one thing – correcting a Cross Bite whether it is for the teeth (dental) or a jaw bone (skeletal). There are glued-in (Fixed) and ones you can take out (removable) expanders. The one we use most at Stellar Smiles Ortho is called a “Hyrax”. This stands for Hygienic Rapid Expander. We love the design because it is minimal and much easier to clean. The Hyrax is glued in.
The expansion will be either slow or fast and that depends on the problem that needs to be fixed and the age of the patient. The widening (expansion) is done by a screw in the center that is attached to metal rings or a plastic base that wraps around your back teeth. This will gently with a steady force push apart the teeth or bones and correct the Cross Bite.
We will give you clear instructions on how and when to turn the screw in the mouth in your own home.
The amount of widening (expansion) will vary from patient to patient. You may or may not see a gap open between your two front teeth. This is a good sign but not required.
If the Cross Bite only involves teeth then this can be corrected with braces. Because at an early age, there is a mix of baby (primary) and adult (permanent) teeth we usually put braces on the adult teeth. With the help of wires, we can correct Cross Bites with great success.
Face Mask (Reverse Pull Headgear)
If the Cross Bite is in the front and it involves the jaws then is it called an underbite (CL III skeletal malocclusion or reverse overjet). The Face Mask pulls on two rounded hooks that rest right outside the mouth/lips with rubber bands. These rounded hooks are usually attached to a metal appliance that is glued near the roof of your mouth and your back molars.
The Face mask is worn around 14 hours per day and it applies a constant force to move the upper jaw (maxilla) forward and the lower jaw (mandible) back in order to correct the Cross Bite. It is lightweight, fully adjustable for different size faces, has air vents, and is very durable. This treatment with excellent compliance can help prevent jaw surgery later in life.
This is another bite problem (malocclusion) where you can see a big space between the upper and lower teeth. “Officially” it is called an open bite because of the space and there is no contact between the upper and lower front teeth when they are biting together.
What Causes It?
This can be caused by a number of factors such as finger/thumb sucking, pacifier sucking, nail/pencil biting, tongue thrust, mouth breathing, enlarged adenoids, tongue tie, and unfavorable growth patterns. It is very important what came first; for example: did the open bite cause the tongue thrust or did the tongue thrust cause the open bite?
What Happens If It Is Left Untreated?
There are a number of consequences such as breathing problems, speech and pronunciation problems, difficulty eating and chewing food, difficulty drinking, unfavorable jaw growth possibly needing jaw surgery later on in life, uneven wear of teeth/enamel, problems with the TMJ (TemporoMandibular Joint) leading to joint pain and possible headaches, gum recession leading to sensitivity or even bone loss, and loose teeth from tongue thrust. This type of condition hardly ever self-corrects. The negative impact on quality of life is high.
How To Treat An Open Bite?
The sooner an open bite is treated the better the outcome so Early Treatment is a highly recommended solution. An Open Bite can be treated with different methods but always depends on the underlying cause:
Orthopedic appliances: Orthopedic appliances directly affect jaw growth and the jaws (bones). Some orthopedic appliances work to move the teeth as well. Here are a few of them: Posterior Bite Block appliance, Bionator for Open Bite, expanders, Fränkel regulator, vertical pull chincups, rapid maxillary intruder, and spring-activated appliances.
Tongue Tamers: To ensure we stop the tongue from pushing straight out and creating the open bite we need to re-train the tongue. The tongue is a muscle, a voluntary one, so yes, you can train it. A really cool treatment is called Tongue Tamers: miniature, metal rounded protrusions that are glued to the inside of the front teeth. Every time the tongue touches them is a reminder that the tongue should not be in that spot. Over time the tongue will adapt to a new position and the open bite will start closing.
Braces: An open bite may be able to correct with braces, wires and elastics. With Early Treatment we put braces on the adult (permanent) teeth so there is a reduced number of braces in the child’s mouth.
Myofunctional Therapy: This is an important evaluation to see if there are any severe underlying issues that have to be addressed such as tongue tie, forward tongue rest posture, and tongue thrust swallow. Your orthodontist can refer you to a Myofunctional Therapy specialist.
Teeth That Stick Out And Are Prone To Trauma
When the teeth are touching tightly they are stronger as a team and more resistant to accidental trauma. Also, if teeth are really sticking out they are more susceptible to trauma. In fact, there is a direct link between how much a kid’s teeth stick out and the chances of dental trauma to those teeth. If a kid’s teeth are broken or knocked out, they may lose those teeth or require a root canal and a crown.
How To Treat Teeth That Stick Out?
This can be a combination of braces with orthopedic appliances or braces with wires and elastics. Remember, we put braces on the adult (permanent) teeth so there is a reduced number of braces in the child’s mouth. This can also be combined with Myofunctional Therapy to correct any habits such as finger/thumb sucking.
Crowding And Protruded Teeth Esthetics
When teeth are not straight is it very noticeable, not only by the dentist but by everyone else. Many kids don’t smile because they have front teeth that are crooked or protruding. When a child feels good about their smile – they just smile more! And confident kids tend to become confident, happier, and successful adults. It is true, whether we like it or not, our appearance makes a strong impact on how we are viewed by others and ourselves.
Crowding With Trauma
When the teeth are so crooked and out of the place where they belong, they are called crowded teeth. And when crowded teeth hit other teeth or the roof of your mouth (palate) then they can cause damage/trauma. This can cause breaks (fractures) on the teeth, and cuts (lacerations) on the tongue, palate, or cheeks. They can get in the way when you are chewing or speaking.
Remember to bring your child for a checkup at age 7!