Crooked Teeth in Babies: 4 things you should know

Parents often take their children to the dentist when they are concerned about crooked teeth in babies. But should this be a cause for concern? We will talk about dental crowding in children, how to prevent it, and what to do to solve it.

What is dental crowding?

Dentists use the term dental crowding when referring to crooked teeth. It is usually caused by a marked difference between the size of the teeth and the jaws. Thus, dental crowding can be generated when a child has:

1. Normal size teeth in very small jaws.
2. Teeth too big for normal jaws.
3. Teeth too big for very small maxilla.

What causes dental crowding?

There are many causes of dental crowding; in general, it is caused by several factors at the same time. Some are modifiable, while others are not. The most well-known and frequent causes of dental crowding are:

Non-modifiable factors:

• Inheritance:

Many physical characteristics are determined by genetics. Thus, families can present overly small jaws or large teeth, and this is transmitted to children from generation to generation. In some cases, crowding occurs by combining the genes obtained from each parent. For example it may happen that a child inherits large teeth from one parent and a small jaw from the other, resulting in dental crowding. It is also possible for some teeth to come in in a different position than expected, known as ectopic eruption.

Modifiable factors:

• Abnormal habits:

The shape of various structures of the body is determined by the function they fulfill. Some habits can cause the bones to modify their growth, leading to changes in the shape of the jaws. Often, placing foreign objects on top of the teeth, between the jaws, or in contact with the roof of the mouth can cause the bones to narrow or the teeth to fail to settle in the proper position.

Among the most frequent abnormal habits are:

• Use of a bottle or pacifiers after two years of age.
• Sucking of fingers (especially the thumb) or lips
• The interposition of the tongue between the jaws.
• Pushing the teeth with the tongue.
• Breathing through the mouth.

• Early tooth loss:

When teeth are lost prematurely, either due to decay or trauma, the neighboring teeth tend to move to close the space, leading to an incorrect dental position.

Can dental crowding be normal during growth?

The short answer is yes. It is very common to see children with crooked teeth. This happens because the first permanent teeth appear in their mouths around the age of 6, when the jawbones are still too small. In many cases, dental crowding can be normal to some extent. However, this must be determined by a dentist, since after performing an examination, it will be possible to identify a deficiency of space or a temporary disorder.

The dentist did not start treatment for my son’s crooked teeth, why?

Due to the reasons stated above, during dental replacement, especially between the ages of 6 and 9, a certain degree of crowding can be normal. On some occasions when consulting the dentist because their children have crooked teeth, the professional will tell the parents that it is best to wait for the jawbones to grow, and schedule checkups scheduled every 6 months to evaluate growth.

 These are cases where crowding should not be a cause for concern. It is important to remember that adult teeth are trying to erupt in the small mouth of a child. However, it is essential to regularly schedule a dental consultation to monitor dental eruption, growth, and development, and thus determine the need to start treatment for dental crowding in time.

What happens if the dental crowding is not solved??

Although in some cases dental crowding is solved with the growth of the jawbones, in others, this does not happen. When a person has crooked teeth, it is said that they have dental malocclusion. This means that the upper and lower teeth fail to mesh properly to perform their functions, increasing the risk of various problems such as cavities, gum disease, pain in the joint that joins the jaw to the skull (temporomandibular joint), and severe dental wear, among others.

How to avoid crooked teeth in babies?

As mentioned, some causes of dental crowding can be modified or avoided, while others (such as genetics) cannot. Therefore, it is possible to act on the modifiable factors to reduce the risk of children presenting crowded teeth and future bite problems. Here are some tips: 

• Eradicate sucking habits (use of pacifier, bottle, finger sucking). A good idea is to replace the usual bottle with a child’s cup with a spout.
• Prevent children over 2 years of age from sucking their thumbs to prevent the palate from becoming too deep and the maxilla very narrow.
• Prevent children from biting or placing foreign objects in their mouths for long periods of time.
• If the child is breathing through their mouth, it is important to seek medical attention, as this can be caused by various abnormalities, such as overgrown tonsils or allergic rhinitis. Treatment for breathing problems will promote the general health of the child and prevent jaw growth problems.
• Take children to a preventive consultation every 6 months from 2 years of age. In addition to taking care of oral health in general, the dentist will  control the eruption of the teeth and the growth and development of the jaws. The dentist may refer the child for management to an orthodontic specialist in case of detecting a space deficiency or alterations in the growth of the jaws.

What is the treatment for crowding?

To prevent occlusion (bite) problems and oral health problems in general, it is advisable to take children for dental check-ups from the age of 2 years. Depending upon the case, the dentist or orthodontist may carry out special studies. The most frequent are:

Space analysis: Plaster models of the mouth are taken and the size of the teeth is measured to predict the likelihood that the child will experience crowding in the future.

X-ray studies: The dentist may request a panoramic X-ray to see the position of teeth that have not yet erupted. He or she might also request a lateral X-ray to take a cephalometry, a test that assesses the growth of the jawbones.

In the event that the child presents severe crowding or problems related to maxillary growth, it is possible that the treating professional will recommend the use of orthopedic devices that, in the case of dental crowding, have several functions:

1. Stimulate the growth of the jaws.
2. Eliminate a bad habit.
3. Prevent neighboring teeth from shifting after premature tooth loss.

The dentist will suggest the most appropriate treatment for the patient’s particular case.

Conclusion

Dental crowding is a fairly common condition and is usually identified during childhood. Although in many cases, crooked teeth in young children are not a real cause for concern, they may reflect a problem related to growth abnormalities in the jawbones, and thus may require early attention. For this reason, it is recommended that children visit the dentist every 6 months from the age of 2 to detect dental and growth abnormalities in time and thus provide proper management.

Contact us

If you have any questions about this or other topics, you can contact us at Channel Islands Family Dental as well as our page on Facebook. We look forward to your visit and we will make a timely diagnosis. Our dentists in  Oxnard, Santa Paula, Ventura, Newbury Park, and  Port Hueneme will be able to guide you toward the best treatment to take care of your health and give you back your best smile.

Bibliography

1. What is the best treatment for children with crowded teeth? (s. f.). Cochrane. https://www.cochrane.org/CD003453/ORAL_what-best-treatment-children-crowded-teeth
2. American Association of Orthodontists. (May 1, 2018). Understanding Early Check-Ups | Parents Guide to Orthodontics. https://www3.aaoinfo.org/blog/parent-s-guide-post/understanding-early-check-ups/
3. Malocclusion: Classes, Definition & Treatment. (Ago 28, 2021). Cleveland Clinic. https://my.clevelandclinic.org/health/diseases/22010-malocclusion
4. Burke, D. (Dic 19, 2016). Malocclusion of the Teeth. Healthline. https://www.healthline.com/health/malocclusion-of-teeth
5. Tsai, H. H. (2003). Dental crowding in primary dentition and its relationship to arch and crown dimensions. Journal of dentistry for children, 70(2), 164-169. https://www.ingentaconnect.com/content/aapd/jodc/2003/00000070/00000002/art00015
6. Hafez, H. S., Shaarawy, S. M., Al-Sakiti, A. A., & Mostafa, Y. A. (2012). Dental crowding as a caries risk factor: a systematic review. American Journal of Orthodontics and Dentofacial Orthopedics, 142(4), 443-450. https://www.sciencedirect.com/science/article/pii/S0889540612005781