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.