How To Avoid Future Extractions and Possibly Full Braces In Children

Solution: Expand The Jaw To Make Room For The Growing Adult Teeth

Since I started performing Orthodontics as a General Dentist for the last 20 years, I often consult with patients who present with the main complaint of crooked teeth. The crooked teeth complaint prevents the patient from smiling so they go through life embarrassed about the appearance of their teeth. This embarrassment affects their day-to-day life. For example, whenever they have photos taken, they hide their teeth by closing their lips/mouth. Whenever they smile, they do so with lips together. Can you imagine that day to day activities can cause so much stress to the individual?!

Crooked teeth are usually the result of teeth being unable to fit in a small jaw. This can be either the top or lower jaw or even both jaws.

If the jaw is too small, then you can imagine when the first (baby or primary) teeth are replaced by the adult (permanent) teeth between the ages of 7-12 years, a perfect fit of these adult teeth will depend on how much room is available for these teeth to grow or erupt into. So typically, with small jaws we are likely to have crowding of the new teeth which results in crooked teeth and leads to an unaesthetic smile.

I commonly consult adult patients for a cosmetic evaluation of their crooked teeth, and I tell them the reason for them having this problem relates to their early years of inadequate jaw development. Fixing this problem in their adult life usually involves quite complex treatments involving teeth extractions, braces and, in some cases, veneers. So, who wants to have complex and expensive treatment?
If we could avoid this issue later in life by acting sooner to solve this problem, then I believe we have the solution. That’s why I like to treat the patient at an earlier age.

So, now we can assess the likelihood of a crooked teeth smile developing, by checking children at an early age, say 6 to 9 years of age and be able to make predictions on how the new developing teeth are going to fit into their current jaws.

What we want to avoid and don’t want to see in their teenage years is severe teeth crowding. The most likely correction being braces after teeth extractions.

What I want to see in their first (primary) teeth.

The ideal situation is having spaces between the primary teeth so there is a good chance of the adult teeth fitting in well and hence giving the opportunity to have a nice smile develop as an adult.


What we propose for patients who have small undersized jaws is to embark on a Jaw Expansion treatment. This is achieved through removable plates worn during the day and night. The treatment program will usually be completed when all the permanent teeth fit into the top and lower arches, which is around age 12-13 years.

These plates are custom designed for your child to achieve slow growth and expansion of the jaw.

Ultimately and the time will vary from child to child, they will achieve nice wide jaw arches that can at least accommodate all their permanent teeth.

In some situations, it may also be necessary to provide jaw exercises that can help change the jaw development that will be favourable to achieving a better long-term bite.

Again, every child is different so an initial Dental assessment must be made to determine where your child is at, with regards to their jaw shape and size.

If you feel your child may have these crooked teeth problems, it is important to act sooner to arrange an initial consultation at Smile To Go with Dr Terry Wong and the team.