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Early Treatment for Malocclusion - Topic Overview

Growth modification (early treatment) is part of the first phase of two-stage orthodontic treatment of children with malocclusion (poor bite). Growth modification is only possible when bones are still growing. It is most effective during children's growth spurts.

Orthodontists use growth modification devices (appliances) to change the position, shape, length, or width of the jawbone(s). Some common devices are:

  • Headgear, an appliance that uses pressure to guide teeth and jaw growth.
  • Herbst, an appliance attached to the upper and lower molars that corrects overbite caused by a small lower jaw.
  • Bionator, a removable appliance that guides teeth and jaw growth.
  • Palatal expander, an appliance that corrects cross bite by widening the upper jaw.

What to think about

Ideal timing of treatment varies depending on what the condition is, when adult teeth come in, and how much growth is needed to correct the malocclusion. Many children who begin growth modification in second or third grade are finished with orthodontic treatment before they begin high school.

Children are often more cooperative than teenagers when it comes to wearing their appliances for a certain number of hours a day. And children don't seem to mind closer parental supervision as much as teens do. But the parent and the health professional must also beware of "burning out" the child on treatment before the second stage of treatment—braces—begins.

Because the jaw continues to grow during childhood and adolescence, growth modification doesn't always last. Some teens and adults keep their new jaw structure and size, while others have short-lived improvement. Relapse can also occur after treatment with braces alone.

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WebMD Medical Reference from Healthwise

Last Updated: January 02, 2013
This information is not intended to replace the advice of a doctor. Healthwise disclaims any liability for the decisions you make based on this information.
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Only 18.5% of Americans never floss. You are missing out on a simple way to make a big difference in the health of your mouth. Regardless of how well you brush, plaque still forms between your teeth and along your gums. Floss removes food trapped between the teeth and removes the film of bacteria that forms there before it turns to plaque, which can cause inflamed gums (gingivitis), cavities, and tooth loss. Try flossing just one tooth to get started.

You are one of 31% of Americans who don't floss daily. You are missing out on a simple way to make a big difference in the health of your mouth. Regardless of how well you brush, plaque still forms between your teeth and along your gums. Toothbrush bristles alone cannot clean effectively between these tight spaces. Flossing removes up to 80% of the film that hardens to plaque, which can cause inflamed gums (gingivitis), cavities, and tooth loss. Aim for 3 more days!

You are one of 31% of Americans who don't floss daily, but you're well on your way to making a positive impact on your teeth and gums. Regardless of how well you brush, plaque still forms between your teeth and along your gums. Toothbrush bristles alone cannot clean effectively between these tight spaces. Flossing removes up to 80% of the film that hardens to plaque, which can cause inflamed gums (gingivitis), cavities, and tooth loss. Aim for all 7 days!

Only 50.5% of Americans floss daily, and good for you that you are one of them! Regardless of how well you brush, plaque still forms between your teeth and along your gums. Toothbrush bristles alone cannot clean effectively between these tight spaces. Flossing removes up to 80% of the film that hardens to plaque, which can cause inflamed gums (gingivitis), cavities, and tooth loss. Congratulations on your good oral health habit!

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American Dental Association, Healthy People 2010

This tool is intended only for adults 18 and older.

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