Functional Jaw Orthopedics

In this article we are going to look at functional jaw orthopedics. It is an approach to “orthodontics” originating decades ago in Europe. More and more general orthodontists in the United States have embraced this philosophy and are very successful in the early treatment of children, following functional orthopedic principles.

Removable or fixed appliances are used to address malocclusions which have a skeletal basis. Newer materials and designs, along with the latest research in jaw orthopedics, have opened up even more promising pathways to treat young children.

Light, consistent forces applied through fixed or removable orthopedic appliances will influence the growth of the developing facial and jaw bones in a young child, just when they have the potential for rapid change and growth. 90% of the facial skeletal growth occurs before the age of 8. Boys keep growing until the age of 18, whereas girls grow until age 15. However, growth continues in various forms until the age of 30, and bone remodeling never ceases, being responsible for lifelong alterations of the facial and jawbones due to functional influences. The joints holding the skull-bone segments are not as rigid as people think, and the jaws and the bone complex holding the teeth in place never cease to be in dynamic equilibrium. Thus, a shift in functional forces may drastically affect this sensitive equilibrium, a fact that is easily overlooked, nevertheless part of our daily lives since the day we were born.

Example: An infant fed by bottle and /or hooked on the pacifier will be more likely to develop a small upper jaw, an underdeveloped lower jaw, malocclusion, crowded teeth, recurrent ear infections, and upper airway obstruction. In nursing infants, however, the orthopedically correct forces generated by the mother’s teat at the roof of the mouth encourage a healthy growth pattern in both upper and lower jaws. Evidently, functional orthopedic influences are in effect starting from birth!

As we see, function predetermines form, and the teeth just follow. If one is trained to look at just teeth, they unfortunately are merely seeing the tip of the iceberg.

Early treatment in a growing child using functional orthopedics and jaw expansion helps in:

1. Non-extraction orthodontics: creating the foundation for all the teeth to fit comfortably without resorting to extractions later on.
2. creating a convex, attractive profile with proper lip support.
3. A broad, attractive and spectacular smile.
4. Proper space for the tongue.
5. Less chance for relapse.

There are many signs of early malocclusion or skeletal growth discrepancies that parents should be aware of:

1. If there are no SPACES between the baby teeth, this is a sure indication that there will be crowding in the permanent dentition.
2. If there is PREMATURE LOSS OF A PRIMARY MOLAR before the age of 6, and no provisions have been taken to keep the space open, teeth will migrate towards the void, and no space will be left for the incoming permanent teeth.
3. If you see a GAP BETWEEN THE TOP AND BOTTOM INCISORS when the child is biting, there is a strong possibility that your child may be exhibiting a wrong swallowing pattern. Again, a functional error that is termed “tongue thrust”, enough to prevent the front teeth from meeting each other.
4. WORN-DOWN INCISORS are a sure sign that the child has a grinding problem, or that the lower jaw wants to be positioned more forward, and is being held back by the small upper jaw.
5. GRINDING of the teeth at night has been associated with an airway deficiency during sleep, mainly due to the lower jaw being retruded (further back).
6. Large, protruding BUCK-TEETH in 8-year olds is rarely the result of the upper teeth being too forward, but rather the lower jaw lagging behind.
7. SNORING at night is not normal in children and is usually the result of constricted airways due to adenoids, tonsils, and/or a retruded (underdeveloped) lower jaw.
8. Recurrent EARACHES and excessive earwax in a child have been attributed to the lower jaw being positioned too far back (retruded) and placing pressure on the jaw-joint and the ear.
9. MOUTH BREATHING CHILDREN are susceptible to skeletal jaw anomalies. This may be due to chronic allergies, tonsil and adenoid enlargement, or other upper airway obstructions. It eventually forms a habit, the facial muscles lose their tone, and the mouth stays perpetually open. This paves the way to 1: A constricted upper arch with tooth crowding. 2: A retruded lower jaw (that fails to grow forward.) A mouth breathing child will tend to develop craniofacial deformities, dental crowding, and malocclusion. The far-reaching consequences are just so overwhelming, that dentists and orthodontists with a functional jaw orthopaedic approach, as well as speech therapists, strive to address that issue and turn the child back to nose breathing before anything else.

JAW FACTS

The jawbone is the only double-hinged bone in our body. Its function is regulated by a very sensitive and intricate neuromuscular system.

The position and size of the lower jaw plays a major role in our airway volume.

Obesity, age, and a retruded lower jaw are all factors in snoring and sleep apnea.

Healthy teeth keep the proper vertical dimension between the upper and lower jaws.

Jaw expansion with appliances before adolescence is known to increase the nasal airway space, the tongue space, and eliminates dental crowding.

Most successful athletes and models have properly developed jaws.

Related information:

• Mouth Breathing