While orthodontics involves changing the positions of the teeth, dentofacial orthopedics involves guiding the growth and development of the bones of the face, particularly the upper and lower jaws. These treatments are best used on children before puberty, when there is more potential to change the shapes and sizes of bones. During puberty, the bones fuse and growth stops, making changes in the shape of a bone much more difficult.
Dr. Eleni and Dr. Abraham are specialists in both orthodontics and dentofacial orthopedics. This allows us to provide treatment that integrates both modalities, helping to get the very best outcome for your child. Our office in Whitestone serves the surrounding areas, including Bayside and Queens.
What Types of Treatment Are Used?
There are several appliances that orthodontists use that can influence a child’s facial growth and development. Some of these appliances are removable, meaning that they are inserted and removed by the child. Examples include a headgear or a functional appliance (such as the Twin Block or Bionator). Other appliances are fixed, meaning that they are bonded to the teeth by the orthodontist. Examples of this include a palatal expander, or a Herbst or MARA appliance. Another form of dentofacial orthopedics is the use of bone plates and mini-implants as anchors to influence the direction and amount of bone growth.
One of the most common types of dentofacial orthopedic appliances is the palatal expander. The hard palate is the bone that forms the roof of the mouth. If it’s too narrow, there will be less room for the teeth in the upper jaw, leading to crowding. A crossbite relationship between the upper and lower teeth can also result when the upper jaw is too narrow when compared to the lower jaw. In children, the two halves of the palate are not fused together, so we have an opportunity to encourage the growth of the upper jaw.
Palatal expanders are appliances that are bonded to select upper teeth, and which place gradual pressure on the palate when activated. This pressure widens the palate by applying orthopedic forces on the suture located at the center of the palate. As the palate gradually widens, new bone grows to fill the space. The palatal expander is usually worn for six to nine months, with the exact amount of time depending on the child’s needs. Generally, when a palatal expander is used, braces will still be needed to straighten the teeth and close any spaces between teeth that formed as the palate widens.
The growth of the upper jaw can indirectly lead to changes in the lower jaw and teeth. This happens because the upper teeth will spread out along with the palatal growth, and the pressure of the upper teeth on the lower teeth (for instance, during chewing) will lead to them widening out as well. Thus, crowding of the lower teeth may be relieved by a palatal expander for some children.
After puberty, the palate fuses and expansion becomes more difficult. This is why dentofacial orthopedics should be done early enough to avoid complicated orthodontics, the possibility of an additional surgical procedure, and increasing the overall treatment time.
Dentofacial orthopedic treatment works best when it’s done in a younger age group. If you or your child’s dentist have any questions about your child’s tooth alignment or jaw development, bring your child in for an orthodontic evaluation. The American Academy of Orthodontists recommends that children be evaluated at age 7, so that early treatment can be offered to those children who would benefit from it. Here at Avenue Orthodontics, we offer a free consultation and initial exam. If you’re in the Whitestone area, including Bayside and Queens, we’d love to meet your child, and give you the peace of mind that comes from knowing whether or not your child would benefit from early orthodontic treatment. You don’t want to miss the window!