The Power of Growth Modification in Orthodontics

orthodontics for kids

The Power of Growth Modification in Orthodontics

17 February 2023 | By Dr. Eric Meyer

orthodontics and dentofacial orthopedics

Kids are reflections of their parents. Maybe they have mom’s eyes or dad’s nose. “A chip off the ol’ block”, right? Well, they may have also inherited dad’s underbite or mom’s overbite, in addition to other characteristics.

Genetics play a major role in the growth and development of a child.

That’s not to say growth can’t be modified or influenced by environmental factors, such as orthodontics and dentofacial orthopedics. In orthodontics this would involve therapy to normalize growth and improve imbalances in the position of the upper and lower jaws.

Expanders, for example, increase the width of the upper jaw—perfect for children with constricted upper jaws and side crossbites.

Headgear can effectively correct imbalances in the position of the upper jaw, like restricting or enhancing it’s growth. In a child with deficient growth of the upper jaw, ‘protraction facemask’ (also known as reverse-pull headgear), brings the upper jaw forward and out of an ‘underbite’. This works by opening the sutures of the facial complex as the child is growing, however, the sutures must first be open.

This is why it is crucial to start this therapy at an earlier age before the sutures fuse completely with time.

Is there any evidence to support this type of growth modification? Lots of it! A recent study (Hino et al.)1, using 3D x-rays, showed that on average the upper jaw moved forward 3 mm. In orthodontics every millimeter matters and we will gladly take 3 mm. Imagine if the child is at the right age and compliant—you may be able to double that and save surgical treatment in the future.

I’ll leave you with this example of a child starting with an underbite. This kid corrected his underbite by himself in 9-10 weeks with this appliance!

fixing an underbite at orthodontist
facemask to fix underbite

As always, have great day!

-Dr. E



  1. Hino CT, Cevidanes LH, Nguyen TT, De Clerck HJ, Franchi L, McNamara JA Jr. Three-dimensional analysis of maxillary changes associated with facemask and rapid maxillary expansion compared with bone anchored maxillary protraction. Am J Orthod Dentofacial Orthop. 2013 Nov;144(5):705-14. doi: 10.1016/j.ajodo.2013.07.011. PMID: 24182587; PMCID: PMC3972125.

Does my child need early orthodontic treatment?

braces for kids

Does my child need early orthodontic treatment?

8 August 2022 | By Dr. Eric Meyer

braces for kidsWhen it comes to early orthodontic treatment, we prefer to wait until a child has lost all of their baby. However, some kids benefit greatly from an early phase of treatment while in the the mixed dentition (typically ages 7-10). This means the child has a glaring issue that can really lead to greater problems down the road if left untreated.

Another term for early treatment is “interceptive orthodontics.” Why, because we want to intercept problems before they turn into headaches. We’ll get to a few examples shortly. 

The American Association of Orthodontists recommends seeing an orthodontist around age 7. This allows an orthodontist to evaluate a child in the early stages of growth and diagnose problems related to growth, tooth development, and tooth eruption, among other things. 

So what do we look for in kids who need an early phase of treatment? Common problems, among others, may include:

Tooth related

  • Side (posterior) crossbite – the top back teeth overlap inside the bottom back teeth
  • Front (anterior crossbite – commonly called an “underbite, where the lower front teeth overlap in front of the upper front teeth
  • Severe crowding and malalignment
  • Excessive spacing, often accompanied by protruding front teeth (that stick out)
  • Space maintenance – when baby teeth are lost prematurely, a small appliance holds the space for us
  • Extra teeth, missing teeth, or impacted teeth
Growth and development related
  • A deficient upper jaw or a strong lower jaw contributing to an underbite
  • A strong upper jaw or deficient lower jaw contributing to excessive space between the top and front teeth
  • Asymmetric growth of the jaws due to crossbites or facial trauma
  • Craniofacial anomalies, such as cleft lip and palate
Treating these issues early on and many others will allow for a positive influence on the growth of the child, avoid impaction of teeth, lower the risk of trauma to the front teeth, and in the case of extra or missing teeth, plan for the future. Although a small investment, this early treatment will save you time, money, and unnecessary procedures later on. For more detailed information on early treatment click here to see a description of common problems and how they are solved with early treatment. For a free exam for your child feel free to contact us 🙂

-Dr. E