COMBINATION EXPANSION AND ALIGNMENT

When there is too little room for alignment of the permanent teeth, frequently it is due to inadequate facial width to accommodate all the permanent teeth.  Evidence of the problem may include: crowding of the permanent teeth, mouth breathing, snoring, headaches, difficulty chewing, deviation of the lower jaw to one side, protrusion of the upper teeth and tongue thrust.

 When the upper jaw is too small to accommodate the permanent teeth, due to inadequate development of the palate, there are two choices to correct the condition: extraction of four permanent teeth or expansion of the jaws to gain space.  In this office, the treatment of choice is to expand conservatively and to avoid extraction.  It is our specialty and passion. 

To successfully use jaw expansion techniques, it is essential to treat a growing child.  For girls, the ideal age for evaluation is from age seven to eleven and for boys from age nine to twelve.  Girls normally mature earlier than boys, thus the variation in ages.

 The reason we are able to increase palatal width is because the bones of the face are like a jigsaw puzzle and can be easily moved during the growth years.  As we age, our facial bones become less changeable due to fusion of the various growth centers in the face. 

 Our typical treatment plan is to first expand the palate using an appliance attached to the upper back teeth.  The palatal expander is activated over a period of two to three weeks and then left in place while the teeth slowly respond to the increased space.  After the palate expansion is expanded, then full braces are placed.  For patient comfort, we usually start with just upper braces and add the lower braces later.

 In some children, it is necessary to move the upper and lower front teeth forward to gain a more pleasing and normal soft tissue profile.  When these children are viewed from the side before treatment, their teeth appear to tip inward toward the tongue.  The lips may appear caved-in, due to lack of tooth support.   As the smile is widened and front teeth are brought forward, the profile improves dramatically and looks more pleasing.  In general, it is a more youthful look as opposed to the caved-in look of patients who have unnecessarily had four permanent teeth extracted.  It’s a no-brainer decision: we help produce great-looking smiles, better jaw function, and happy kids.  What more could we want?

  Treatment sequence:

·        Palatal expansion: four to six months total time

·        Remove palatal expansion appliance and add upper braces

·        Add lower braces, and match upper width

·        Align and open space for various teeth as they erupt

·        Use removable elastics to correct teeth and bone positions

·        Removal of braces and appliances: place removable upper and fixed   lower retainers

  Our usual treatment time varies with age and growth of the child, but is generally accomplished in less than two years.  It’s an extremely positive experience for all concerned.

Advanced Topics on Orthodontic Treatment

Invisalign Orthodontic Treatment for Adults and Older Teens

Views of the Whiskey Creek office

Photo Tour of our Fort Myers Whiskey Creek office

Photo Tour of our Cape Coral office

 

Office: Contact information

 

Dr. John M. Richards

Orthodontics for Children and Adults

South Fort Myers, Lehigh, Cape Coral

 

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