Why do some people appear radiant after orthodontic treatment, while others have straight teeth but an unnatural appearance to their smile?

Facial Orthopedics

The answers to these questions are found in a branch of orthodontics called Facial Orthopedics. For many years, orthodontists have been improving the appearance of young people and adults by straightening crowded or poorly aligned teeth. However, some orthodontists have discovered there is more to an attractive smile than straight teeth. More important than perfect alignment is the position of the front teeth related to the rest of the face. In a winning smile, the teeth must properly support the lips and not appear “tipped in.” The upper teeth fill the smile. The profile should look attractive and balanced. These goals are not always accomplished by orthodontic treatment alone.

The bones of the upper and lower jaw are the foundation for the teeth. The growth of the jaws is considered by some orthodontists to be genetically determined and unchangeable. They wait until all permanent teeth are present and then determine where there is enough room for the teeth. If the teeth seem larger than the jaws, they remove teeth so that the others will fit the small jaws. In other cases, if the lower jaw does not grow forward enough to match the upper, the upper teeth are pulled back against the lower teeth, creating a very unnatural look. The lips sink inward, making the nose appear to be large. The face has an unnatural appearance. The teeth appear to be straight, but the face has changed.

What Is Different about Facial Orthopedics?

An orthodontist who understands facial orthopedics knows that the muscles surrounding the teeth and jaws play an important role in establishing proper jaw size and alignment. Thumb sucking, mouth breathing, and improper swallowing have been targeted as prime causes of improper jaw development. When jaws are not properly formed, orthodontic tooth repositioning alone cannot create a balanced face and attractive smile. The foundation must first be corrected if the end result is to be a fully natural, winning smile. Only facial orthopedics can do that.

By starting treatment between ages seven and ten when the head is growing, orthodontists have a window of opportunity to influence the growth of the jaws and to change bad habits. They work with other medical specialists to establish proper breathing and tongue habits. They use jaw growth stimulators and limited braces to guide the jaws to the proper size and position before the last permanent teeth erupt. In most cases, they can avoid the severe crowding and misalignment of teeth that necessitates extraction of permanent teeth. This interceptive phase of treatment lasting twelve to eighteen months is followed by an intermission, while the remaining permanent teeth are erupting. After the early orthopedic phase of treatment and the intermission, braces are usually required on the permanent teeth to perfect their alignment for the best appearance and function. Therefore, the length of time that braces are worn during the teen years is usually reduced. The results of this interceptive approach are a more attractive facial appearance and a winning smile.

Older children who have all of their permanent teeth can also be helped by orthopedic procedures. Facial growth can be influenced until the mid-teens, but to a lesser degree.

What Are the Advantages of Facial Orthopedics?

The orthodontist who uses facial orthopedics and standard braces combines the best of both methods. The advantages of this combined therapy are many:

• More balanced facial features.
• Avoidance of extraction of permanent teeth.
• Less time in braces during teen years.
• Reduced use of headgear.
• Bad habits corrected early.
• Improved speech development.
• A “winning smile!

Why Don't All Orthodontists Use This Technique?

If facial orthopedics brings about such dramatic results, why don’t all orthodontists use these techniques? Some orthodontists simply concentrate only on straight teeth and a good bite and ignore the art that is part of creating a beautifully balanced face and smile. Or, they may be participating in an insurance plan which does not provide for facial orthopedics. Of course, not all children who need orthodontics need orthopedic procedures. But, if they do, the orthodontist who is also a facial orthopedist can make a difference. He or she has the training and experience to combine the best treatment methods to achieve a truly radiant smile. When it comes to your child’s facial appearance, the best result is what you should expect.

When Is the Best Time to Receive Treatment?

The ideal time for an orthodontist to evaluate your child is age 7. There is no charge for an initial evaluation, and it is not necessary to be referred by a dentist.