Executed in a timely manner, simple and cost effective preventive measures can create and maintain a healthy and pleasing smile!
During my 25+ years in practice, I have observed how some cases of crooked teeth (malocclusion) can be treated inexpensively with simple, pain-free devices that are well tolerated by children and adolescents. In such cases, the patient, the parent and I have all enjoyed success!
Before discussing how to prevent the need for expensive orthodontics, let us first look at some of the main causes of crooked teeth (malocclusion).
- A mismatch in skeletal jaw sizes – for example, the upper jaw is larger than the lower jaw, which creates an overbite or underbite.
- A mismatch in the size of the teeth – for example, large teeth in a small jawbone will cause crowding of the teeth; vice versa, small teeth in a larger jaw leads to spaces between the teeth.
- Enlarged tonsils and adenoids cause structural skeletal defects during development, such as a narrowing of the upper jaw and flaring of the front teeth (buckteeth) as a result of consequential mouth-breathing.
- Genetically (congenitally) missing teeth also increase treatment challenges in people of all ages. The upper lateral incisors (front teeth) and lower bicuspids (behind canine teeth) are the teeth most commonly missing.
- Over-retained baby teeth cause permanent teeth to erupt in the wrong direction, thereby causing the permanent tooth to form in a cross-bite, which can occur in the front or back of the mouth.
- Premature loss of baby teeth can lead to shifting of the adult teeth into the open spaces, causing a collapse of the continuous arch of teeth.
- Habits such as thumb-sucking, improper swallowing – for example, when the tongue thrusts forward against the front teeth causing a flare of the upper or lower teeth.
In the case of mismatched skeletal sizes, one preventative measure would be the timely extraction of the baby teeth in order to allow room for the adult teeth to come in properly. This treatment can be started in the early stages when both the baby teeth and adult teeth are present (mixed dentition).
In addition, mechanical devices are also used to correct and maintain proper development of the jawbones to accommodate adult teeth. One example of a device used for the upper jawbone is a palatal expander, which can be used as early as nine years of age if necessary, to grow and develop the upper jawbone in an effort to correct the size discrepancy. This is very cost-effective and children typically experience minimal pain and discomfort. For lower jaw reshaping and repositioning, one effective device is a lower jaw forward-placement appliance called the twin block, aka functional orthodontics.
When tooth sizes are mismatched, the larger teeth usually create crowding, which can be relieved with the extraction of the adult teeth in the upper, lower or both jaws. When smaller teeth are present, spaces do develop and can be closed with a cost-effective and pain-free device.
Correction of individual, wrongly positioned teeth may be achieved during the early stages of development with simple appliances, such as an aligner device that has finger-springs and mini-screws.
For premature loss of primary (baby) teeth, a space maintainer or space regainer device is used to hold and save the space of the missing baby teeth for the proper development of the adult teeth. These devices are usually custom created and can be made as a partial or full mouth space-saver. An example would be a transpalatel bar, which holds the molars in the proper place until all of the adult teeth have erupted in the mouth. When a primary canine tooth is lost prematurely, a lower lingual arch device will prevent the front teeth from moving into the resulting space.
In some cases, expensive orthodontics can be prevented by monitoring the growth and development during primary and mixed dentition. Executed in a timely manner, simple and cost effective preventive measures can create and maintain a healthy and pleasing smile!