When you hear "orthodontics", braces or teeth straightening likely come to mind – but did you know that this dentistry field also includes dentofacial orthopaedics, which concentrates on improving position and dimensions of the facial bones and jaw? An easier way to distinguish the two: orthodontics focuses on straightening your teeth, while dentofacial orthopaedics focuses on the bones that house the teeth.
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If a child's bite problems require intervention, we can use various appliances to change the rate, direction, or amount of jaw growth. Some of the more common appliances that we may recommend are:
Palate expander: This fixed device slowly pushes the cartilage above the upper jaw apart to widen a maxilla that is too small to hold the teeth.
Lower jaw expander: Because the lower jaw’s bone can't be stretched, this expander gradually moves the teeth apart to make room.
Activators: These devices have been used since the 1930s to gradually move the upper or lower jaws forward while guiding erupting teeth.
Block: A fixed bite block uses the bite force to gradually and comfortably move teeth and correct malocclusion.
Orthodontic headgear: For bite problems that orthodontists can’t correct from inside the mouth, an appliance that straps around the face to apply forces to the jaw and head may be recommended.
Before or after an orthodontist uses one of these appliances to correct jaw position, they may also fit a patient for ordinary braces to correct tooth positioning and align how the teeth fit together.
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As a child grows, both the maxilla (upper jaw) and mandible (lower jaw) will grow in three dimensions. This growth determines the final positioning of the mid and lower face, as these bones connect to the sinuses, the bottom of the nose, and cheekbones.
Jaw growth typically stops between 14 to 16 years for women and ages 17 to 21 years for men. Sometimes, the upper and lower jaws will grow at different rates and sizes, creating alignment issues between the upper and lower teeth. Ideally, the upper jaw should have a more forward position and be wider than the lower jaw. Underbites (where the mandible protrudes), overbites (where the maxilla protrudes), and other occlusion or bite problems may also be caused by breathing difficulties and thumb sucking.
Some dentofacial orthopaedic appliances are outwardly a little odd-looking and may create a focus for other children to "look and stare".
However, this type of appliance is only used to treat conditions that are serious enough to warrant this and the outcomes will be positively life-changing. On this basis, a relatively short term period of treatment is well-worth the long-term benefits.
