Maxillary expansion in children: The key moment (7 to 11 years old)
By:
Dr. Berta Furió, Orthodontics Specialist
Objective:
- Explain the benefits of bi-maxillary expansion treatment (upper and lower) in children.
- Understand why the 7 to 11-year-old window is crucial for bone development.
- Present how early intervention prevents serious complications in adulthood.
What is Dental Expansion Treatment?
Dental expansion is an interceptive treatment that aims to correct narrow jaws. In many children, the bone does not grow enough to accommodate all permanent teeth, leading to crowding and bone compression.
Unlike adult orthodontics, which focuses on moving teeth, paediatric expansion acts directly on the bone structure, taking advantage of the fact that bones are still in a growth phase and are more malleable.
Why Perform it Between Ages 7 and 11?
This stage is known as the mixed dentition phase, where baby teeth coexist with permanent teeth. It is the ideal time for two reasons:
- Active growth: We can guide bone development before the palatal sutures close permanently.
- Prevention: It is much easier to create space now than to try to correct a severe lack of space once all permanent teeth have erupted.
The Benefits of Dual Expansion (Upper and Lower)
The modern approach favours expanding both jaws to ensure total harmony. These are the key points of the treatment:
- Relieve crowding and compression: By widening the arches, we generate the necessary space for teeth to be positioned correctly. This relieves pressure on the gums, allowing the bone to develop without abnormal tension.
- Facilitate permanent teeth eruption: When there is no room, permanent teeth can become "trapped" (impacted) or erupt in incorrect positions. Expansion creates the proper "pathway" for each tooth to emerge in its place, avoiding complex surgeries in the future.
- Improved bite and function (Occlusion): A healthy mouth is not just an aligned mouth, but one that "fits" well. Dual expansion ensures that the upper and lower jaws are proportionally sized, improving chewing efficiency, pronunciation, speech, and the health of the temporomandibular joint (TMJ).
- Facial aesthetics and breathing: Bone development directly influences facial appearance. By correcting bone compression, we promote a more balanced facial structure, a wider smile, and better harmony in the child's profile.
The 3 Pillars of Success in Treatment
For paediatric maxillary expansion to be effective and stable in the long term, we rely on three foundations:
| Pillar | Key Action |
|---|---|
| Early Diagnosis | Perform the first orthodontic visit at age 6-7. |
| Rigorous Hygiene | Caring for the expander appliance is vital to avoid gingival inflammation. |
| Compliance | Follow the appliance activation guidelines provided during the consultation. |
How Do I Know if My Child Needs Maxillary Expansion?
Although each case requires a personalised evaluation, there are signs that parents can detect:
- "Overlapping" teeth: Evident crowding in the lower or upper incisors.
- Cross-bite: When closing the mouth, the upper teeth sit "inside" the lower ones.
- High-arched palate: The roof of the mouth is shaped like a narrow dome.
- Difficulty pronouncing: Certain phonemes are altered by the position of the tongue in a narrow palate.
Before and After Case
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