During regular dental check-ups and cleanings, your child is being screened for potential orthodontic problems such as crowding, bite problems, ectopic (misplaced) adult teeth under the gums and extra or missing adult teeth under the gums. X-rays are a handy tool to assess the future growth and position of the adult teeth in the jaw. Several x-rays are used to make assessments, including panoramic x-rays, which show the entire mouth and jaw and smaller x-rays used to see specific teeth and their roots. If there are any diagnosed issues, a referral to an orthodontist can be made to address it before it may lead to more problems with crowding and a misaligned bite down the road.
An indication that there may not be enough space for the adult teeth to erupt in an aligned way is if there are no spaces between the baby teeth. Spaces between baby teeth are a good sign and allow for space for the adult teeth to erupt. Sometimes baby teeth can be removed so other teeth can shift around, allowing more space for the adult teeth to erupt. The baby canines are often recommended to be removed when there is a clear lack of space to enable the adult to canines to erupt into position.
When baby teeth are removed in a crowding situation, the remaining teeth can shift around, allowing the incoming adult teeth to erupt in a better alignment. If no early intervention is done, oftentimes, the adult teeth will erupt out of alignment, and more orthodontic work will need to be done in the future to correct the problem.
An orthodontist may recommend several different appliances to correct bite problems early on, so they don’t grow into larger issues. For instance, a thumb-sucking or soother habit can lead to a narrow upper jaw and an open bite, so a palatal expander can be put in to apply slow pressure to expand the jaw back into its proper position. The same sort of appliance can also be placed on the lower jaw to maintain space and prevent tipping of the teeth. If these bite issues aren’t corrected with early intervention orthodontics, jaw surgery may be required later.