Looking Beyond the Teeth

When we evaluate a growing child, we're looking at much more than whether the teeth are straight.

We're looking at the development of the jaws and palate, how the teeth are coming in, the bite, tongue position and function, oral habits, and how your child breathes and sleeps.

All of these things can affect how the mouth and face develop during childhood, which is why we believe they should be evaluated together.

Why Breathing and Oral Function Matter

Children should primarily breathe through their nose. When we see chronic mouth breathing, snoring, restless sleep, difficulty breathing through the nose, or a child who constantly rests with their mouth open, we want to know why.

We also pay close attention to the tongue. Where the tongue rests, how it moves and how a child swallows are all part of the functional environment in which the teeth and jaws are developing.

Sometimes what we find is primarily dental. Other times, we may recommend an evaluation with an ENT, physician, sleep specialist, myofunctional therapist, speech or feeding therapist, or another provider.

What Are We Looking For?

Some of the things that may catch our attention include:

• Mouth breathing or difficulty breathing through the nose
• Snoring, noisy breathing or restless sleep
• Lips that remain apart at rest
• A narrow or high palate
• Crossbites
• Crowding or lack of space for developing teeth
• Abnormal bite or jaw relationships
• Prolonged thumb, finger or pacifier habits
• Tongue thrust or low tongue resting posture
• Teeth grinding
• Enlarged tonsils or chronic nasal congestion
• Concerns with tongue mobility or oral restrictions
• Facial or jaw growth patterns that we want to monitor

Having one or even several of these findings does not automatically mean that something is wrong or that your child needs treatment. They simply tell us that we may need to look a little closer.

Why Consider Orthodontics So Early?

This is probably one of the most common questions we hear from parents.

“My child is only 4 or 5. Why are we already talking about orthodontics?”

Because at this age, we're not necessarily talking about braces or trying to straighten every tooth. We're evaluating how the jaws, palate, bite and dental arches are developing while your child is still actively growing.

There are certain problems that may be better addressed during growth rather than waiting until all of the permanent teeth have erupted.

That doesn't mean every child should be treated early. Many children are evaluated and simply monitored until the timing is right.

What Can Early Treatment Address?

Depending on the child, early treatment may be considered for concerns such as a narrow palate, crossbite, significant crowding, abnormal jaw relationships, harmful oral habits or other problems affecting dental and facial development.

Treatment may include palatal expansion, growth modification, habit correction, limited orthodontic treatment or other approaches based on your child's individual needs.

Early treatment also does not necessarily mean your child will never need braces or orthodontic treatment again. The purpose is to address problems that make sense to address now, while growth is on our side.

An Individual Approach

There isn't one appliance, one treatment plan or one “right age” that applies to every child.

We consider your child's age, stage of dental development, jaw growth, bite, oral function, habits, breathing and sleep history before deciding whether anything needs to be done.

Sometimes we recommend treatment. Sometimes we recommend another evaluation. And very often, we simply watch your child grow.

Our goal is to intervene when there is a reason to intervene, and not simply because we can.