Our skilled orthodontic team at Park Smiles NYC Pediatrics specializes in using early orthodontic appliances to begin the process of helping your child achieve normal dental and facial development together with beautiful and straight teeth.

Early Orthodontic Intervention Utilizing Habit Breakers, Expanders And Space Maintainers Provides Important And Significant Benefits For Children.

What is early orthodontic intervention?

Problems with the alignment of a child’s teeth can begin at a very young age, even with baby teeth. Several factors influence the dental and facial bone’s growth and development. If some adverse factors present are not recognized in a timely manner, they can result in significant dental and/or facial developmental problems. Not only can these problems interfere with the aesthetics of your child’s smile, but they can also affect their speech, general health and even disrupt their breathing during sleep.

Early orthodontic intervention addresses these problems by using problem specific, custom designed appliances to correct skeletal development as well as proper teeth alignment and bite.

Some factors to consider in early orthodontic intervention:

• Narrow upper jaw
• Crossbite
• Underbite
• Open bite
• Habits
• Tongue thrusting
• Misaligned/positioned teeth
• Jaw shift
• Trauma
• Early loss of tooth/teeth
• Missing tooth/teeth

What appliances are used in early orthodontic intervention?

There are several specialized orthodontic appliances that are used in early orthodontic treatment, also known as Phase 1 . Phase 1 is done before most of the permanent teeth have erupted and often occurs between the ages of six and ten. Some of the appliances can also be used as retainers after Phase I treatment. These appliances include:

Rapid Palatal Expander (RPE)

The rapid palatal expander (RPE) is one of the common appliances used in early orthodontic intervention treatment. Also called an expander, the RPE is used for the upper jaw (palate) and widens it by turning the screw in the middle of the expander. There are two types of expander: fixed and removable. Depending on the problem and condition of your child, the most appropriate treatment option will be recommended.

Expanders have multiple uses. First, when the upper jaw is narrow and does not match the width of the lower, the upper jaw can be widened so they properly match. Also, when the width of the upper and lower jaws is coordinated, this creates an ideal setting for normal bone growth and further teeth eruption. The expander is especially useful for young children who are still actively growing and corrections are easy to make.

Discomfort with expanders is usually very minor and most patients say it feels more like mild pressure than pain. Expanders can either be used before or along with braces and usually remain in the mouth for six to eight months until the bone expansion is stabilized. During its presence in the mouth, it’s important that the patient avoids eating sticky foods, as they could cause the appliance to come loose. It’s also a good idea to avoid hard foods like ice, nuts and hard candy, as they can damage the appliance.

Habit breakers

Certain oral habits can lead to many problems, especially when the habits aren’t addressed in the early stages of childhood. Common issues include tongue thrusting or thumb sucking. While some may dismiss a young child sucking their thumb or using a pacifier, these habits can cause significant dental and jaw issues. Habit breakers help young patients break or stop a dysfunctional habit.Two of the most common intra-oral habit breaker appliances are:

• Tongue crib. A tongue crib is a custom fabricated appliance that’s used to help combat habits like tongue thrusting or thumb sucking. The tongue crib is placed across the upper arch (palate) with two rings (also known as bands) glued around the molars. The rings will connect to a small cage or gate behind the front teeth. This cage/gate helps prevent the tongue from protruding and pushing against the front teeth that cause flaring of the teeth and open bite. The cage/gate reminds the child to not place their tongue in front and against or in between upper and lower front teeth. It also helps the child keep their tongue back when swallowing. For a thumb habit, it acts as a physical barrier against putting a thumb in the mouth. The length of time a patient has to wear a tongue crib varies from case to case, from as little as a few months up to the entire duration of orthodontic treatment.
• Blue Grass appliance. The Blue Grass appliance is another effective appliance for young patientswith a tongue or thumb habit. It acts by disrupting the behavior of the thumb or tongue and providing an alternative to the behavior. This fixed appliance has a spinning roller that the tongue can play with and trains the tongue to be in correct position. Its mere presence also distracts a child putting the thumb into their mouth. This appliance is effective in helping to break the patient’s habit and allow the anterior teeth to return to their normal position.

Orthodontic space maintainers

Space maintainers are used when a child loses a tooth too early and there is no imminent eruption of permanent tooth following the gap/space that needs to be saved for the adult tooth coming in later. By preserving the space, space maintainers prevent unwanted shifting and further blocking or crowding of erupting teeth. If a child loses one or more teeth, however, orthodontic space maintainers are needed. These can also act as retainers after Phase I treatment. Some examples include:

• Nance Appliance. The Nance appliance fits comfortably along the roof of the mouth with bands that are placed on the upper arch of the two back molars. A wire connects the bands and a small piece of acrylic button is located at the center of the wire. The Nance appliance prevents upper molars from shifting forward and other teeth from moving more drastically by keeping the arch length.
• Trans-Palatal Arch. The Trans-Palatal Arch (TPA) is comprised of stainless steel rings or bands around the posterior teeth and a looped wire that spans across the palate without touching it. Similar to the Nance appliance, TPA is used to hold posterior teeth in place, stabilizing the position of these teeth. The appliance can also be used to rotate teeth into more ideal positions in case space needs to be regained after teeth shifting. It can also be used to close an anterior open bite.
• Lower Lingual Holding Arch. The lower lingual holding arch consists of two metal bands attached to the lower molars connected by a wire that runs along the inside of your child’s lower teeth. The purpose of this appliance is to prevent your child’s lower molars from moving and maintaining the midline by reserving the spaces symmetrically.

Schedule your consultation at Park Smiles NYC Pediatrics today Our skilled orthodontic team is here to help your child achieve a sparkling, straight and healthy smile for years to come. Schedule a consultation today by contacting us at (212) 988-6724.

Attaining healthy, straight teeth and a beautiful smile is like a Walk in the Park – at Park Smiles NYC Pediatrics!