Minor Orthodontic Problems in Children:

Single Tooth Anterior crossbite

Patient #1. Single tooth anterior cross bite complicated by crowding

This situation occurs when one tooth, usually one of the front upper teeth, comes into the mouth behind the bottom teeth. The tooth needs to be moved forward in front of the bottom teeth but the problem is, there is not enough room for the tooth to come forward due to her crowding problems.

So space must be made with braces on the front teeth and back molars to spread the teeth apart and move them all forward to create space for the tooth in cross bite to come forward.

Once space is made, the tooth in cross bite can easily be pulled forward and out of cross bite.

The four front teeth are then straightened or “level and aligned” to look great!

Class II Malocclusion with overjet

1. Class II Malocclusion with overjet.

In this situation the front upper teeth protrude out over the lower front teeth.

This is sometimes referred to as an overbite or “Buck Teeth”.

It can be corrected with traditional orthodontic treatment but can also be corrected with an orthodontic appliance such as this one.

The appliance moves the lower teeth and jaws forward to correct the overjet (protrusion of the upper front teeth). With the result that the overjet is corrected and upper and lower teeth are in proper relationship to each other.

This makes for a great smile! 

Anterior Open Bite

1. Anterior Open Bite

Pacifier use or thumb sucking for a prolonged period of time will produce an anterior open bite – where the upper and lower front teeth do not bite together when the mouth is closed.

If the pacifier use or thumb sucking stops around age of 3, the anterior open bite may correct itself with no treatment. If the habit does not extinguish at an early age the back teeth may go into cross bite. The best thing to do is to encourage the child not so suck his or her thumb. These are some ways to help the child

A special shirt that does not leave an opening for the hands to come out. This is especially good for children that suck their thumb at bedtime or all night. Use the shirt as pajamas. The special shirt can be purchased at: myspecialshirt.com or just make your own.

The next step is usually the thumb guard. This device is good for the child who sucks the thumb through out the day and not just a certain times. Thumb Guards can be purchased at medetal.com.

The final step in helping the child patient extinguish the thumb sucking habit is a fixed appliance that is attached to the back molars and makes placing the thumb in the mouth no longer pleasurable – for obvious reasons. This must be made at a dentist office by taking molds of the mouth and having a dental laboratory fabricate a custom appliance.

All of the above methods must be combined with positive reinforcement such as a reward for stopping. Without the child being motivated to stop, it is usually very difficult to “make them stop” no matter what you use on the hands or in the mouth.

Complete Anterior Crossbite

1. Complete Anterior Cross Bite.

Complete Anterior Cross Bite occurs when all four of the upper front teeth are fitting behind the lower front teeth when the patient is in the biting position. The upper front teeth may have signs of abnormal were if left in this position for an extended period of time.

The cause of this problem is either that the four upper front teeth are tipped (angled ) back further then they should be,  the upper jaw is actually to far back compared to the lower jaw or that the lower jaw is further forward then it should be.

The only sure way to determine exactly what the problem is, is by taking a cephlametric radiograph and then perform an analysis.

If the upper front teeth are simply angled back an appliance can be used that is either fixed to the back teeth

or is removable (can be taken in and out of the mouth) to simply push the upper front teeth forward and tip them into the correct position in relation to the lower front teeth.

If the upper jaw is actually determined to be to far back compared to the lower jaw, a device called reverse pull head gear may be required to pull the anterior jaw forward using the teeth to attached the head gear to.

If the lower jaw is to far forward compared to the upper jaw, a chin cup photo can be used. If this orthodontic appliance is not used or is not successful, regular orthodontic treatment with braces can change the relationship of the teeth to a correct one, but cannot change the bone in the jaws to the correct relationship – only a surgical procedure can do this.

Posterior Crossbite

1. Posterior cross bite.

This situation occurs when the upper back molars, either primary, permanent or both, fit inside the lower front teeth on one side or the other or both.

Both upper teeth are in crossbite.

This condition can, but is not always, occur as a result of a habit such as thumb sucking or pacifier use.

The cross bite can be corrected with either a removable appliance or a fixed appliance. There are pros and cons to both. The fixed one is in the mouth all the time because it is glued to the teeth. This results in a little quicker results simply because the patient is forced to use it all the time. It is more difficult to activate the appliance to get the back teeth to separate then a removable appliance.

The removable appliance can be easier to clean because it can be removed and is also easier to activate then the fixed appliance. The usual problem is that the patient can and needs to remove the appliance to eat. Sometimes the appliance is lost as a result of this removing and sometimes the patient will just simply forget to wear the appliance thus significantly decreasing its effectiveness.

Either way, you can get great results because it not only corrects the back teeth but allows more room for the front teeth if they are crowded making the smile seem wider and the patient have a more radiant smile.

Before treatment and after treatment photos of the patient
(Notice the fuller smile in the after!)