A common misunderstanding is that orthodontic treatment can only commence when all adult teeth have erupted. Early treatment is sometimes required before this, and is aimed at treating functional issues with developing bites and occasionally for psycho-social reasons (e.g. teasing at school due to the appearance of the child’s teeth). Your dentist is usually the first person to detect such problems and may recommend an early referral to an orthodontist for your child to undergo an assessment. Usually early treatment occurs any time after eruption of the front adult teeth and first adult molars (from age 6 onward) up until eruption of the adult teeth (approximately age 12). It is uncommon for treatment to be required earlier than this. Some problems that are best treated early to avoid significant dental issues in the future are listed below: Protrusive upper front teeth: If the upper teeth stick out over the lower teeth to a significant degree, they are more susceptible to trauma. This is particularly so if a patient cannot close their lips over their front teeth or for children engaging in contact sports. Deep bite: Upper teeth cover the lower teeth more than they should, which can cause increased wear to the enamel of the front teeth and sometimes damage to upper gum tissue. Under bite: Lower teeth are forward of the upper teeth. This may be the result of a jaw growth discrepancy and/or tooth problem. Open bite: Upper and lower front teeth do not come together. This is often the result of a finger/thumb sucking habit. Crowding: Jaws are too narrow or teeth are too large causing crowded or misaligned teeth. Spacing: Teeth are too small or jaws are too large causing space between the teeth. Sometimes teeth also fail to develop which can lead to increased spacing of the teeth. Space maintenance: If a baby molar tooth is lost early (e.g. due to decay), it is often necessary to hold the space with a space maintainer for the developing adult tooth to erupt into the arch. Crossbite: Upper teeth are inside the lower teeth, causing wear to the teeth and possible asymmetrical growth of the lower jaw. Malpositioned teeth: Teeth erupting into the wrong position can sometimes cause damage to adjacent teeth as they erupt. It is important to detect this problem early to facilitate treatment to allow for normal dental development. Impacted teeth/delayed eruption: If teeth have not erupted at the usual age or there is a significant delay between corresponding teeth erupting on different sides of the mouth, investigation is required. Teeth can sometimes become ‘stuck’, which is often the result of an extra tooth growing, previous trauma to the baby teeth affecting root development, or incorrect position. If you have concerns that your child may have any of the above issues, it is recommended to speak with your dentist or arrange for a consultation with your local orthodontist. They can then determine if early treatment is required or whether treatment can wait until the child is in the adult dentition. Written by Yvette Ding.
Children often suck their thumbs, fingers, dummies, blankets or toys, as this provides comfort and security. Most children will stop sucking their thumb or fingers naturally between the ages of 2 to 4 years old. As children start to interact with others in a social environment, this habit may also stop due to peer pressure. Some children however, develop a habit that they are unable to break, as it is often a source of comfort during periods of stress, anxiety and worry. If the child continues to suck their thumb or fingers when the adult teeth erupt into the mouth (at around the age of 6 or 7), growth of the jaws can be affected and this can result in significant misalignment of the teeth. Orthodontic treatment will then be required to correct the problems caused by their sucking habit. Common orthodontic problems caused by prolonged thumb sucking Open bite: the teeth do not meet together at the front. Protrusive bite: the upper front teeth are positioned forward relative to the lower front teeth. These teeth are then at risk of trauma. Crossbite: the upper jaw is narrow compared to the lower jaw due to contraction of the cheek muscles used for the sucking motion. Lisp: it may become difficult to pronounce certain sounds due to the teeth being pushed out of place. Trauma to thumbs and fingers: the thumbs or fingers may become swollen and develop sores or calluses. Methods to stop the thumb sucking habit Identify and remove the cause(s) of the stress and anxiety for the child Encourage and offer rewards for breaking the habit Tape the thumb or finger at night with sports tape, to bring the habit into the child’s awareness when sleeping Use unpleasant tasting nail paint If all of the above methods are not successful in breaking the habit, then a Thumb Sucking Appliance can be used. This orthodontic appliance is cemented onto the back teeth and consists of a smooth metal crib positioned on the roof of the mouth, behind the upper front teeth. This acts as a physical reminder for the child not to suck their thumb. Thumb sucking habits can be difficult for a child to break. However this problem is better corrected earlier rather than later, and before the adult teeth start erupting into the mouth. If you are having difficulty getting your child to break the habit, please don’t hesitate to contact us. Written by Jennifer Wu.