Around the age of 6 to 7, baby teeth begin to fall out and permanent teeth start to come in. Many parents seek dental care during this period if their children’s front teeth are misaligned or there are gaps between their teeth. This stage is often referred to as the ugly duckling stage and is considered normal even when the front teeth are slightly spaced or crooked.
On the 10th, Professor Lee Mi Young from Gwanak Seoul National University Dental Hospital suggested, “Unless there are any special abnormalities, the most appropriate time for a child’s first orthodontic visit is around 7 to 8 years old. Regular check-ups with an orthodontic specialist are recommended during this period to monitor skeletal growth and the development of permanent teeth.”
She further added, “If the upper and lower jaws are not growing evenly or if the width of the upper jaw is narrow, it is advisable to start treatment early. Unlike adult orthodontics that focuses on individual tooth alignment, correcting the jaw that houses the teeth is more effective for growing children.”
Immediate treatment may also be necessary in some cases. A prime example is the reverse bite, where the lower jaw protrudes further than the upper jaw, causing the upper and lower teeth to bite in reverse. Reverse bite is primarily treated around the ages of 7 to 8 when permanent teeth erupt, but severe cases may be treated during the primary dentition period before the eruption of permanent teeth.
Lee explains, “During the primary dentition period, the growth of the upper jaw is more important compared to the lower jaw. If there is a reverse bite, the lower jaw impedes the growth of the upper jaw, so treatment primarily focuses on promoting the growth of the upper jaw.”
The main treatment method for the reverse bite is the face mask. It involves attaching a fixed device inside the mouth and connecting it to a face mask with rubber bands. The treatment period typically takes 6 months to a year. It is recommended to wear the face mask for 12 to 14 hours a day, making the most of the time at home.
Contrary to the reverse bite is the mandibular retrognathia. It is commonly referred to as a short chin, which indicates the lower jaw not growing as much as the upper jaw. This may be accompanied by an overbite, where the upper teeth deeply cover the lower teeth or a temporomandibular joint disorder. Treatment for mandibular retrognathia restrains the growth of the upper jaw and promotes the growth of the lower jaw.
Even when the upper jaw is narrow, it is often unnoticed as it is not externally visible. If the widths of the upper and lower jaws are not harmonious, the bite can be unstable, which may lead to asymmetry in severe cases. However, as the upper jaw in growing children has not fully ossified, it is possible to expand the upper jaw with relatively little force through treatment, securing a stable bite and additional space.
Lee emphasized, “Individual skeletal structure and tooth eruption are very diverse, so even similar malocclusions can have very different characteristics. It is important to receive a precise examination and diagnosis through an orthodontic specialist.”
