Often times teeth appear to protrude because the lower jaw is back.
To a greater or lesser extent it occurs in about one in five people and can be corrected in a child with growth appliances. These essentially hold the jaw forward for a time while growth is occurring.
Unless there is a need to do this sooner, for instance because of name calling at school or because the lips do not readily come together thus encouraging mouth breathing, we can introduce a pair of removable appliances around puberty. For efficiency, we can combine this orthopaedic treatment with teeth straightening where that is also necessary. This saves treatment time.
While it takes a week or so to get used to wearing appliances that hold your jaw forward, the alternatives are far worse. Those alternatives are removing teeth to provide space to pull the top front teeth back, or surgery to bring the lower jaw forward when growth has ceased (see orthognathic surgery page), or doing nothing and having protruding teeth for life.
As you can see in the cases on the right and on our smile gallery page, it can make a dramatic difference.
Another form of orthopaedic facial treatment is expansion of the palate with a fixed expander such as this.
It may look a bit like an instrument of torture but it does not hurt.
Unlike a removable expander (which is more prone to being lost and damaged) it doesn’t just tip the teeth outwards, but actually widens the upper jaw by further opening the join running up the centre of the palate that normally shuts by about 14 or 15 years of age.
With this orthopaedic expansion of the upper jaw we can correct cross bites, provide a little more space for teeth to erupt into the mouth and possibly even improve nose breathing/snoring.