Orthodontics is concerned with the movement of teeth through bone. In order to create the most harmonious looking smile, we also want to be sure facial growth and development is on pace. Dentofacial orthopedics focuses on improving the position and dimensions of the bones that house the teeth, and goes hand in hand with orthodontics to ensure growth and development is on track.
If your child receives two phase treatment, dentofacial orthopedics will be the first phase of treatment. This is the phase that guides the growth of the jaw to ensure the jaw bone is properly aligned before beginning the straightening phase of treatment.
Dentofacial orthopedics can also benefit adults, however, it may involve surgery. This is why adolescence is the ideal time to have orthodontic treatment begin – we can take advantage of a still growing jaw to control and guide the growth. Adults do not have this benefit, so it is slightly more involved to straighten their teeth and perfect their bites. Dr. Pavlo may recommend jaw surgery to correct the bite before moving on to orthodontic treatment.
As you grow, your upper and lower jaws grow in three different dimensions. This growth determines the final positions of the mid and lower parts of the face. Growth stops around the age of 15 in girls and 18 in boys.
We run into issues when the upper and lower jaws do not grow at the same rates. This then creates alignment issues and an unstable bite. An ideally formed mouth should have an upper jaw that is slightly forward of and wider than the lower jaw.
We can begin to see problems with jaw formation as early as two, or when all of a child’s baby teeth have erupted. Your dentist will monitor how the growth continues, and then by the age of seven, you should visit an orthodontist for the first time. At this point, the orthodontist will take impressions, scans and images to determine if there is a diagnosis and if treatment is needed.
If Dr. Pavlo believes your child could benefit from early intervention, there are several different appliances that may be used to direct and correct jaw growth. They can be fixed or removable, and include:
- Palatal expanders are fixed devices that slowly widen the upper jaw by pushing the cartilage above the upper jaw apart. This is used when the upper jaw is too small.
- Lower jaw expanders gradually move the teeth apart to accommodate all permanent teeth. The bone of the lower jaw cannot be stretched, so this can ensure there is adequate space for the permanent teeth.
- Activators have been used since the 1930s to guide erupting teeth while also moving the upper and lower jaws forward.
- A fixed bite block takes advantage of bite force to move teeth and correct bite issues.
- The Herbst appliance replaces old-fashioned headgear and is used when the upper jaw is too far forward in comparison to the lower jaw.