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These behaviours can make your child’s teeth crooked

It's not just the obvious lollies, sugary drinks and an aversion to brushing that will cause teeth issues for children. Some of the most innocent baby and childhood habits could be jeopardising the position of your child's impending adult teeth – and paving the path for a crooked future.

Sucking a dummy

Why: Dummy sucking can lead to teeth crowding and shifting.

The attraction: Spokesperson for Orthodontics Australia, Dr Rob Schwartz says dummy sucking becomes an issue if the habit occurs for more than six hours daily. "The general rule is that if an object – whether a dummy, thumb, tongue or other object – interferes with the soft tissue environment of the mouth for more than six hours a day, then it will create semi-permanent to permanent change. This means the teeth will grow around the space where the object is. Less than six hours and usually nature will correct itself."

What to do: "In many cases the non-ideal changes is reversible," says Dr Schwartz. "The child usually loses the dummy at some point, and the teeth correct their positions." However, Dr Schwartz warns that issues arise when the tongue takes the position of the dummy.

"From an orthodontic point of view, we would put in a plate, called a thumb guard. It's like a little fence that prevents the tongue from sitting between the teeth. Plates can be removable or fixed, but I recommend fixed plates, so children don't take it out. They work amazingly well – sometimes bringing the teeth together in just a few weeks, but usually it takes a few months."

Thumb sucking

Why: Protruding upper teeth – aka buck teeth – and an overbite

The attraction: Like a dummy, thumb sucking is used as a soother for babies but it quickly become a habit that's hard to break.

What to do: Thumb sucking usually ceases naturally between the age of two and four but

if it continues it may cause misalignment of the front teeth and narrow the upper jaw. "It's possible for the pressure of the thumb to affect normal tooth eruption, position and bite," explains Dr Schwartz. An 'open bite' occurs when the front teeth don't overlap when the child bites together, which causes the back teeth to wear unevenly. "Like dummy sucking, a fixed or permanent plate can provide amazing results. Alternatively, a narrowing of the upper jaw may require jaw expansion plates and braces."

Thrusting tongue forward

Why: A tongue thrust is an abnormal function of the tongue that protrudes forward through the front teeth ( incisors) during speech, swallowing and resting of the tongue. It can cause bite problems and affect speech.

The attraction: Tongue thrusting is often a follow on from dummy or thumb sucking. "The tongue adapts to the place that's been created previously by the dummy or thumb. In some instances though, a tongue thrust is an inherent natural tongue thrust." Dr Schwartz adds that it's only a problem in kids if it exceeds the general rule of being in place for more than 6 hours.

What to do: "Fit a permanent or fixed plate in the mouth, which will break the habit and allow teeth to grow into their position."

Mouth breathing or snoring

Why: Can cause crooked teeth and overcrowding.

The attraction: Air! "If you mouth breath and snore, you have to open your airway and bring your tongue forward, similar to tongue thrusting," says Dr Schwartz.

What to do: "There are lots of possible causes of chronic mouth breathing in children including allergies, enlarged tonsils and adenoids and obstructive sleep apnoea. I suggest speaking with a GP or an ENT specialist first to investigate. After the all clear, your orthodontist can develop a plan tailored to your child's needs."

Jaw alignment

Why: Misaligned chewing can cause an over bite and buck teeth.

The attraction: "Nature designs a certain position for the upper and lower jaw so that food is chewed properly, and also so that the teeth aren't worn unevenly," explains Dr Schwartz. "If they are not in that position there can be ill effects.

What to do: Dr Schwartz says most bad jaw alignment issues are genetic. "If something is skeletally based – meaning the upper or lower jaw is bigger relative to the opposite jaw, there's not a lot we can do to intervene if the discrepancy is very large especially in older kids," he explains. "However, if the deviation is only 4-6mm as opposed to 10mm, we can 'camouflage' it, for example, by taking the upper teeth and bringing them back in using plates or braces, but leaving the jaw position unaltered."

Bad eating habits

The consequence: Cavities in baby teeth can lead to the loss of space in the dental arch and crowding in the permanent dentition.

The attraction: It's easy to see baby teeth as 'trial runs' for adult teeth – but there can be significant consequences to the eruption and straightness of the adult teeth if you happen to lose them early or if there is loss of space with untreated cavities. "Baby teeth are like place holders for future adult teeth," explains Dr Schwartz. "If you lose a baby tooth early, the tooth behind it could tip forward into that space and stop the tooth that should grow into that space from erupting, and the tooth becomes impacted. Baby teeth also support the development of a healthy jaw. This is why it is highly important to maintain the oral health of your child's teeth to avoid premature tooth loss or extraction."

What to do: "If the baby tooth has been lost early we will often put in a space maintainer to hold that space and ensure the adult tooth underneath can come through when it is ready."

This article has been produced in association with Orthodontics Australia.

All orthodontists were once dentists, but not all dentists are orthodontists. It takes more than a weekend course to become an orthodontist. In fact, it requires an additional three years' study and 5,000 hours of practical training –over and above their dental degree –to become a specialist orthodontist.

Three years is a big deal. And Orthodontics Australia believes you should have total confidence in your specialist's ability to straighten teeth and align jaws.

Your smile is a big deal. Check you're seeing a specialist orthodontist at: orthodonticsaustralia.org.au/check

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