Part Three: A Child’s Clinical Orthodontic Evaluation (3-4)
In this week’s blog, Dr. John continues his explanation of what happens during a child’s orthodontic consultation. Last week we talked about dental development and the bite, and this week we’ll cover skeletal balance and jaw growth, and facial balance.
3) Evaluation of Skeletal Balance and Jaw Growth
The position of the teeth and quality of the smile are ultimately determined by the position of the jaws. Understanding how the jaws are positioned and how they relate to each other is an important part of the orthodontist’s evaluation of the patient.
A few facts about jaws:
The upper and lower jaws are separate entities. The size of the upper jaw comes from one set of genes, and the size of the lower jaw comes from a completely different set of genes. Therefore, they can be very mismatched. If Mom has big jaws and Dad has small jaws, and the child gets one of each, he or she can have a significant orthodontic problem, even though both of the parents have “perfect” teeth and bites.
As part of the skull, the upper jaw consists of nine different bones. Growth in the upper jaw takes place between the bones, where they connect.
The lower jaw is a single bone, much like a femur, and it grows by layering and lengthening of the various parts.
Jaws can be mismatched in three areas.
- One jaw can be too long or too short for the other;
- one jaw can be too wide or too narrow for the other;
- or one jaw can grow away from the other jaw so that front teeth do not touch each other.
Simply put, we evaluate the length, width, and height of the jaws.
A good bite and smile are the result of the jaws fitting together well. Orthodontists can bring mismatched jaws into better position for a better relationship to one another if the issue is treated early in life. This is especially true for upper jaws that are too narrow and for large underbites or overbites.
If a child has significant jaw problems, early treatment is critical. Mismatched jaws are most easily fixed in younger patients. After the age of 12-13, many jaw problems are unfixable, especially in girls who have had their growth spurts.
4) Evaluation of Facial Balance
When evaluating facial balance, the orthodontist considers how the lips, nose, and chin look in relationship to the overall face and how the position of the teeth or potential growth of the jaws will affect this balance. Orthodontists also evaluate how the position of the jaws relates to the upper half of the face. Some people’s jaw structure is recessive, compared to the nose and forehead, while others are prominent.
Facial balance will influence where the orthodontist wants to position the teeth.
Part of the facial balance evaluation is how thick a person’s facial tissue is. Some people have thick lips and facial features, while for others, skin is thinner and more stretched. A good orthodontist takes all of this into consideration when determining the best treatment plan for a patient.
Are you ready to schedule an orthodontic consultation for yourself or your child? Call us at McDonald Orthodontics today at (503) 585-5400 and reserve your no-cost consultation with Dr. John. He’ll take photos, x-rays (including a panoramic x-ray), and spend time discussing your concerns and preferences. Then, he’ll present a treatment plan and answer all of your questions.