Growth Modifying Appliances

In the past it was customary to pursue orthodontic treatment once a patient became a teenager. Unfortunately waiting until middle school for treatment often resulted in the extraction of permanent teeth. Why is that so? The roof of the mouth, known as the palate, is a bone that develops in two pieces with a soft spot or suture located in the middle of the roof of your mouth where the two pieces of bone join. As a person enters puberty, those two halves begin to fuse ultimately forming one solid bone.

Once all permanent teeth are in and crowded, it’s often too late to make the jaws the right size once the growth window has closed. Surprisingly, some orthodontists still use a tooth-extraction approach to creating space. Since teeth support our lips, cheeks and face, when permanent teeth are extracted it causes the face to sag. Having full dentition gives a more youthful appearance as we age.

Dr. Brandon Cook’s experience and expertise have shown that when orthodontic intervention starts younger while patients are growing, orthodontic appliances used during growth can help correct issues before they become problematic. Palate expanders, headgears, facemasks and Herbst appliances all use growth to help move jaws and teeth into the ideal position.

How do we determine where a child is in their growth? We take hand-wrist growth x-rays on female patients beginning at age 9 and male patients beginning at age 11. There is a correlation between the wrist bone and the palatal suture; they fuse at the same time. The hand-wrist x-ray tells us the window of opportunity that the palate is still growing so the timing of orthodontic appliances can be planned accordingly. A sesamoid bone present on x-ray indicates a patients is entering or in their growth spurt, which is the ideal time to use appliances such as Herbst appliances, helping the lower jaw grow forward to correct severe overbites.

Even if your child does not require a growth modifying appliance, having orthodontic treatment while a patient is growing has many benefits. Teeth move faster in children compared to adults. When teeth are in proper position before the palatal suture fuses, teeth are less likely to shift as much in adulthood than when teeth are moved after patients are done growing.

Dr. Cook and his experienced staff will let you know if a growth modifying appliance is recommended for your child and fully explain the benefits of the appliance so you feel comfortable with your decision to pursue orthodontic treatment for your child while they are young and growing.