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Growth Guidance


● Maxillary and Mandibular Growth Control

● Habits Breaking Appliances

● Eruption Guidance

     - Operculectomy

    - Serial Extraction

   - Space Maintainer

● Sleep disorders in children

The pathway for Paediatric Dentistry

Paediatric dentistry is an area that is completely dedicated to the oral health of children. From infancy to teen years are the groups that paediatric dentistry would handle. The doctors take care of children’s teeth, gums, and mouth throughout the different stages of childhood.

Growth guidance under paediatric dentistry includes the following:

Maxillary & Mandibular growth control

The maxilla is the upper fixed bone of the jaw, and mandible is the lower jaw. Any defect on the jaws can be identified at an early age and can be treated. The defects in jaws will not cause any pain to the children. Hence, parents have to notice the points for their growing child.

From a profile view, the three points on the face, including the forehead (the point between the eyebrows), the base of the nose and point in the chin need to be convex for a normal child. If these three points fall as a straight line, then the lower jaw is growing more than the upper jaw. The chin needs to be slightly behind to have the convex shape.

There are appliances used to increase and decrease bone growth. When children have a pragmatic growth, the compression force is performed on the jaws. Whereas, for deficient jaw, a traction force is performed to increase the size of the jaw. These treatments need to be performed during the growing stages of the child. Active growth can be seen before puberty; hence, the treatment needs to begin at the same time. Braces can be used for aligning the jaws correctly. After 18 years, doctors would recommend surgical orthodontics. Doctors share the growth guidance mainly to avoid the surgery. The growth guidance starts in the early stages or when the child is 3 years old. Every child needs to visit orthodontics once in 6 months for the doctor to analyze the proper growth of upper and lower jaws.

Habits Breaking Appliances

Generally, children would have certain bad habits such as thumb sucking, nail-biting, lip biting, tongue thrusting, and mouth breathing. These habits could change the shape of the jaws, change the position of the teeth, and could lead to periodontal diseases. There are various appliances or devices designed to control such oral habits and are termed as habit breaking appliances. These are either removable or fixed type and includes a fixed palatal crib or a rake style appliance.

Eruption Guidance

Orthodontic treatment allows for the expansion of existing erupting teeth long before it appears in the mouth. There are various methods included under eruption guidance, as follows:

● Operculectomy - this procedure is performed to treat pericoronitis, usually appearing in young adults while they develop the wisdom tooth. Operculum causes pain and inflammation. Hence, this procedure is used to remove the operculum

● Serial Extraction - a sequential extraction of the deciduous tooth to facilitate the eruption of a permanent tooth at a particular age

● Space Maintainer - it is used to keeping the space open to allow the permanent tooth to erupt and come into the right place. It is customized with a metal or acrylic material which are either removable or fixed in the child’s mouth.

Sleep disorders in children

It is important to note that kids breathe only through the nose while sleeping. If children breathe through the mouth, it indicates that there is an imbalance caused in the cheek and tongue muscles. Breathing through the mouth would make a V-shaped maxillary. Doctors suggest that parents identify the issue at an early stage so that proper ENT evaluation can be performed and manage the disorder with certain appliances.

With the required treatments and appliances, doctors can bring out the necessary changes at an early stage.

Authored By : Dr. S. Hemamalathi and Dr. K. S Senthil Kumar

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