Growth Modification for Malocclusion

Treatment Overview

Growth modification (early treatment) is part of the first phase of two-stage orthodontic treatment of children with malocclusion (poor bite). Growth modification is only possible when bones are still growing. It is most effective during children's growth spurts.

Orthodontists use growth modification devices (appliances) to change the position, shape, length, or width of the jawbone(s). Some common devices are:

• Headgear. This is an appliance that uses pressure to guide teeth and jaw growth.
• Herbst device. This appliance is attached to the upper and lower molars. It corrects overbite caused by a small lower jaw.
• Bionator. This is a removable appliance that guides teeth and jaw growth.
• Palatal expander. This appliance corrects cross bite by widening the upper jaw.

What to think about

Ideal timing of treatment varies depending on what the condition is, when adult teeth come in, and how much growth is needed to correct the malocclusion. Many children who start growth modification in second or third grade are finished with orthodontic treatment before they start high school.

Children are often more cooperative than teens when it comes to wearing their appliances for a certain number of hours a day. And children don't seem to mind closer parental supervision as much as teens do.

Because the jaw continues to grow during childhood and adolescence, growth modification doesn't always last. Some teens and adults keep their new jaw structure and size. But others have only short-term improvement. Relapse can also occur after treatment with braces alone.