The importance of early intervention and habit correction to address crooked teeth

by DP Dental’s Dr Loh Ee Tyug

Who would not want their children to have a healthy smile with perfectly aligned teeth? The good news is that with early intervention, it could be possible. Here we bring all you need to know about what crooked teeth are, how to identify crooked teeth and how early intervention and habit correction can result in healthy teeth.

Let us first understand how to identify crooked teeth in children

Once children get their teeth during the primate phase, some parents may notice that the teeth seem to be tightly arranged and eventually appear disarranged. It usually is because there is less space in the arch for the teeth to appear to be in order. A child’s smaller arch causes the incisors to come out crooked resulting in an overall appearance of crooked teeth.

What is craniofacial growth, and how it impacts the orientation and order of a child’s teeth?

Craniofacial growth involves the complex formation of the head and face, which include the upper and lower jaws where the teeth are placed. The key factors that influence craniofacial growth can be broadly categorised into genetic factors and environmental factors.

Genetic factors strongly influence the nature of the child’s craniofacial growth formation. However, other non-genetic or environmental factors also influence this process that results in the final cranial base or the facial base. Anything generic has to do with DNA and is inherited from parents therefore cannot be changed.

Environmental factors however, can be somewhat changed with intervention at an early stage.

Here are some of the common environmental factors (non-genetic factors) that influence craniofacial growth in children:

1 – Breathing is supported by the nose, which is part of the maxilla (upper jaw) as well as the mandible (lower jaw) that creates the angles of the nose.

2 – Nutrition is an essential aspect of human growth. Sufficient nutrition contributes towards normal development However, malnutrition results in decreased calories and food elements that will impact a child’s natural growth.

3 – Muscles of mastication are the muscles attached to the respective bones. These muscles also have an impact on the craniofacial growth and teeth alignment. The tongue muscles and muscles of mastication become the primary mechanical stimulation in the formation of this bone. Therefore the behaviour of these muscles influences how these bones form and grow.

How early intervention in managing these non-genetic factors can help the prevention of crooked teeth

The practical approach to early intervention is to manage one or more of these non-genetic factors that influence the craniofacial growth in the child. This intervention is done by identifying inappropriate habits that impact this phase and addressing them early.

Breathing is one of the most important environmental factors of all. In the event of an obstruction in the nasal airway, breathing is inevitably done by mouth. This pattern of mouth breathing is commonly associated with changes in the functions of related muscles that can cause undesirable changes in facial growth.

Such changes in facial growth affect the proper formation of upper and lower jaws resulting in discrepancies in the jaw size. Usually this situation gives rise to an underdeveloped jaw size that makes the arch too small to accommodate all of the teeth.

Most often, parents tend to assume that this is a result of adult teeth being too big and therefore the teeth become crooked, whereas the actual reason could be that the jaw is too small.

Adverse effects that can be prevented by early intervention

In case an early intervention is not made, by the time all adult teeth have come through, one would typically have a longer-shaped face. This face shape occurs when the tongue is not in the proper position, and the mandible (upper jaw) grows in a manner that will tend to look narrow resulting in a gummy smile which would be impossible to change as it has already become a part of the bone.

Therefore, early intervention would greatly help the jaw grow naturally in an ideal manner. This will result in the adult teeth to come through evenly and adequately with the mandible and maxilla (upper jaw and lower jaw) correctly formed with a more ideal facial profile.

Even in case the teeth come out crooked, the treatment would generally be easier as it would be a matter of moving teeth not involving any jaw relationship. Sometimes the discrepancy would be so severe, that the patient would have to resort to surgery.

What is the most suitable age to identify teeth discrepancies in children?

Dental care in children has to commence from the time the first tooth erupts. However, a professional recommendation is that children can be observed for dental care from the time a child can sit up and comfortably allow a doctor to examine their teeth, which could ideally be from around two years of age.

These early visits would help children get used to a dental setting and the examination process from a young age, as it involves touching sensitive areas such as the mouth and tongue that could be personal and intrusive to a child.

This way, doctors can follow up on the kids’ dental health, look out for any possibilities for tooth crowding or any other discrepancies and also advise parents on nutrition, diet and habit changing requirements if any, from early on, which will facilitate well-aligned teeth.

Observing young toddlers for well-aligned teeth through early intervention

Upon close monitoring of how a toddler’s teeth erupt, your dentist will check if there is a tendency for overcrowded teeth due to an underdeveloped jaw. We advise parents to focus on proper food texture, food nutrition and diet that will contribute to the adequate development of the muscles of mastication.

For example, frequent consumption of mushy food would not help with the ideal growth of muscles of mastication as there would be minimum chewing of blended and pureed food.

Instead, we recommend that, as the child gets older, harder textured food such as apples are offered to children in bite-size slices or pieces. These food work the muscle of mastication better. And when the muscles work, the jaw grows better.

Slightly advanced measures are taken in terms of habit correction in slightly older children.

Key elements observed and tackled for habit correction in early intervention for older children

Older children of around three to four years of age can be guided and helped in a more advanced manner:

Nasal breathing. In case the child breathes through their mouth rather than the nose, this needs to be checked and addressed. We will do this by observing the child’s breathing and behaviour.

Proper swallowing. At this age, too, we recommend offering your child harder fruits and foods that require munching. The biting motion has a positive impact on the muscle of mastication. The jaws develop better when the muscles work better.

Competent Lips. Three to four-year-old children are physically active as it is a phase children start developing their motor skills. It is therefore vital to encourage children by introducing them to s activities that develop the tongue muscles such as tongue exercises and tongue movement games.

Rehabilitation program for habit correcting in children for oral health

In case it is noticed that the child’s teeth are crooked or misaligned, the first step would be to check if any of the environmental elements are present in the child as these can be rectified through habit correction. When one or more of the environmental elements are observed to be done in an improper manner, early intervention and rectifying efforts should be followed.

Depending on the child’s age, the rehabilitation program will help children change their incorrect breathing habits and focus on proper nasal breathing.

In case the child’s lips are not sufficiently competent, the program will help them achieve those competent levels. This is because, upon continuously breathing through the mouth, the tongue settles into a non-ideal position at the bottom of the mouth that will affect how the jaw grows and forms.

This situation is what would result in an arch with less space to accommodate all teeth in proper order.

Invisalign mandibular advancement features technology

There are instances, however, in spite of all efforts in encouraging the child to breath through the nose, the child finds this impossible due to the severity of the discrepancy that prevents the child from closing his or her mouth.

In this instance, early intervention is made to help older children get started with invisalign due to the inability of using braces or brackets in younger children. Upon having children start with Invisalign, the use of mandibular advancement technology to facilitate the lower jaw in moving forward into a position creates a better relationship with the upper jaw. Along with this relationship, a better outcome can be achieved with significant correction and growth.

In summary, the knowledge shared across this article helps us realise the importance of proper breathing, nutrition and functionality of muscles of mastication in the proper formation of jaws and teeth.

This also gives us a whole new perspective of the importance of early intervention and habit correction to prevent crooked teeth and other disparities in the facial base.

Please do not hesitate to reach out to us if you have any ongoing dental concerns. Call us now at 6219 3082, and our staff will be more than happy to attend to all your enquiries.