One concern as parents is if your child will need orthodontic braces. Also, braces can be expensive, and your child might not be excited about it! But of course, you want your child to have a straight smile for many reasons: self-esteem, confidence, oral health, and esthetics.
Braces are one way to straighten a smile. But we also know that your child’s jaw and cranial bones must develop properly for his/her dental health to be optimal and to grow a straight adult dental arch later in life.
The American Academy of Orthodontics recommends that children consult with an orthodontist at age 7.
Problem is: the causes of crooked teeth and/or jaw usually begin long before age 7. Some developmental issues begin at birth, or even before. That’s where myofunctional therapy can help.
What are ‘crooked’ teeth?
Cross-bites: The top teeth bite down inside the bottom teeth.
- Anterior crossbite
- Posterior crossbite (more common in mouth breathers and snorers)
Anterior open bite: The upper and lower front teeth don’t meet when the back teeth touch. This is most commonly due to thumb sucking or a functional habit.
What causes ‘crooked’ teeth?
The following have a direct impact in healthy jaw growth and straight teeth:
- Tongue position
- Lip posture
- Nasal breathing
- Skeletal posture
- Functional habit
Notice if your child has an unusual posture or breathes mainly through their mouth or swallows a certain atypical way. All of that can affect the development of your child’s jaw and teeth, and affect their chances of getting or avoiding braces. When a child is referred to an orthodontist, these problems may have been present for many years.
Incorrect tongue posture
At rest, the tongue should be up against the palate. This activates all the muscles that connect to the jaw, the base of the skull, the spine and the throat. A low and forward tongue posture suggests incorrect tongue positioning.
Notice: What do your children do with their tongue while watching TV? Can you see it? Is it just out of their mouth? Also: Do they have a tongue thrust when they speak? Do they have a lisp or speech impediment? Do they have a tongue-tie? (this can prevent your child from achieving a high tongue posture) Is their palate narrow or V-shaped? All of those can be indicative of incorrect tongue posture.
During swallowing, the tongue should perform a wave motion across the palate. That exerts a widening, forward and upwards force, expanding the upper jaw.
A child should have straight spinal posture, closed lips, and nasal breathing when eating, swallowing and at rest. Watch your child swallow. Can they swallow food comfortably with their teeth together? If it looks uncomfortable for them, it’s likely they have some form of dysphagia (or incorrect swallow).
The most common form of dysphagia is a tongue-thrust. This is where the tongue comes forward between the teeth during the swallow instead of against the palate.
Signs of an incorrect swallow in your children:
- Their front teeth are held slightly apart with their tongue placed between them.
- At rest, there is an inadequate lip seal.
- ”Chubby cheeks”: the facial muscles encompassing your lips and cheeks (buccinator) may become overdeveloped due to incorrect swallowing. It can result in bulging or chubby cheeks.
Deficient lip posture
If the lips don’t sit together at rest, it’s often due to a low and forward tongue posture. Here are signs of lip incompetence:
- A flaccid lower lip lacking adequate muscle tone will appear droopy and it can appear to roll forward.
- Muscle strain (”dimpling” appearance) is seen over the chin muscles as lips are brought together. These muscles extend from each corner of the lower lip downward to an area lateral to the chin.
Nasal airway obstruction
Proper jaw and teeth development is heavily dependent on proper nasal breathing. Considering you take up to 30 000 breaths daily, normal breathing provides the forces that expand the maxilla and upper jaw. If a child has a chronic blocked sinus or nasal obstruction, they may form a mouth breathing habit. It only takes a slight obstruction to increase pressure in the nasal airway and cause a child to revert to open mouth breathing.
Causes for nasal blockages and a chronic blocked sinus include:
- Sinus infections
- Enlarged nasal turbinates
- Deviated septum
- Swollen tonsils and adenoids
- Chronic upper airway infections
- Allergies
- The tongue falling into the airway during sleep
An ENT assessment of nasal airways is an important part of normal childhood facial development.
Incorrect skeletal, jaw and teeth development
Jaw development
Developing a wide palate is key to a child’s healthy teeth and jaw development. Cranial imbalances can involve the skull, jaw, and vertebral bones. The development of the upper jaw and palate is the main factor directing the growth of these bones.
Maxilla (upper jaw)
The maxilla is the center of facial growth. Its development is driven by both nasal breathing and tongue posture.
Signs of an underdeveloped maxilla:
- High, thin, V-shaped palate
- Thin, long face
- Lack of cheek bones
- Sunken midface or nose
- Droopy or uneven eyes
- Crooked upper teeth
The narrow palate and upper jaw distorts the nasal airway by lengthening the pharynx and decreases nasal airway volume. These are a risk factor for obstructive sleep apnea and snoring in children.
Mandible (lower jaw)
Signs of an underdeveloped mandible:
- Retruded chin
- Rounded jawline
- A lack of forward growth in the lower jaw
- A side profile with jawline that swings down and backwards into the airway
Oral behaviors
Non-nutritive sucking on pacifiers and thumb-sucking or even certain chewing habits can signal an oral development impairment. Pacifiers can make a child’s teeth crooked by causing an open bite. But the good news is, there’s time to correct oral behaviors in your young child with proper oral myofunctional therapy.
Crooked Teeth Can Be Prevented! The causes of crooked teeth in children can begin from birth. By identifying proper oral function, you can correct your child’s habits before they cause malocclusion with oral myofunctional therapy. This can help your child avoid braces in the future and grow a straight, strong smile!