Orthodontic appliances for bite correction in children

The authors | Last update: 2019

Modern orthodontic treatment is a whole complex of measures aimed at normalizing the patient’s bite, both from the point of view of restoring the full function of chewing and from an aesthetic point of view. The most important role is played by special devices that the orthodontist uses to correct the bite.

At the age of 12-14 years, during the period of bite of temporary teeth, as well as their replacement for permanent ones, doctors use a variety of removable and fixed orthodontic appliances, which allow not only to move the teeth to the desired position, but also (importantly) to expand the size of the jaw a child. The need to apply this or that design depends on the particular type of patient's bite, and orthodontic appliances are used not only to treat existing abnormalities, but also to prevent the formation of an abnormal bite and to consolidate the achieved treatment results.

So, let's take a closer look at the most frequently used bite correction devices in orthodontic practice today ...

Devices for preventing the formation of abnormal occlusion in children

Already in infancy, the active formation of the dentofacial system begins - the development and growth of the jaws occurs due to the natural act of sucking. However, there are a number of factors that can have a negative impact on this process, which is important for the future bite.

For example, improperly conducted artificial feeding, which for one reason or another is resorted to by parents, as well as a child’s sleep, mainly on only one side, contributes to the occurrence of deviations.

To minimize the negative impact of artificial feeding on the development of the dentoalveolar system of babies, a special orthodontic nipple for a bottle was invented (in fact, this nipple is the simplest orthodontic device to prevent the formation of malocclusion in the future).

The photo below shows an orthodontic silicone nozzle for a bottle:

In shape, the product resembles the nipple of the mother and creates optimal conditions for convenient feeding and proper sucking (therefore, such nipples are also called anatomical). Nozzles come in various types - depending on the age of the baby and the nature of the food.

Standard sizes:

1st - from 0 to 6 months;
2nd - from 6 to 18 months;
3rd - after 18 months.

Number of holes:

One - up to 2 months;
Two holes - the age of 2-3 months;
4 holes - to reach 6 months of age.

Hole diameter:

S - a small hole for liquid food (juice, milk, water);
M is the middle hole for dry milk mixtures;
L - For feeding thick foods (soups, cereals).

From the practice of an orthodontist

It should be borne in mind that the nozzles on the bottles can be made either from latex or from silicone. If you suspect an allergic reaction in response to the use of latex nipples, the orthodontist will primarily advise a silicone nipple. Signs of an allergy in the baby are itching, redness of the oral mucosa, anxiety during feeding, and refusal to eat. As a rule, the propensity for certain allergic reactions is inherited from parents to the child - pay attention to this when choosing a nipple.

The simplest devices for the prevention of malocclusion in children include orthodontic pacifiers (see example in the photo below):

Such a nipple provides a therapeutic effect:

Stimulates the growth of the upper jaw, as well as the formation of the arch of the palate;
Provides setting the language in the correct position;
Promotes the formation of a physiological bite.

Contraindications to the use of an orthodontic pacifier-pacifier are congenital defects of the alveolar ridge and palate.

Orthodontists recommend using soothers until the first temporary tooth erupts, and then gradually begin to wean the child from this habit. 12-18 months is the deadline for using these devices, and after a year and a half, the sucking of various objects, including soothers, contributes to the formation of malocclusion.

In practice, it is quite difficult to separate a child from a dummy independently, therefore, if necessary, you can consult a doctor for the selection of replacement devices - for example, various modifications of vestibular shields, named after their inventors (for example, the Kerbitz vestibular shield). Vestibular shields are designed to train the circular muscles of the mouth, as well as to combat the bad habits of sucking fingers, lips, cheeks and foreign objects.

Shields can be used in children aged one year to the beginning of the change of temporary teeth to permanent.

Such an apparatus fits snugly on the labial surfaces of the teeth, normalizes their closure, improves breathing, teaching a child to breathe through his nose. In addition, the vestibular shield helps to prevent the development of an open bite (provided that the teeth are located in the lateral parts of the dentition).

On a note

Contraindications to the use of vestibular shields are the habit of laying the tongue between the teeth, tongue dysfunction, as well as the impossibility or severe difficulty of nasal breathing.

Removable devices for correcting and preventing malocclusion in children also include orthodontic trainers (trainers). Trainers are silicone caps reminiscent of boxing, have a standard size and the following design features:

Vestibular shield;
Oral shield;
Air holes for the adaptation period;
Tongue;
Spikes.

The mechanism of action of such an apparatus for the normalization of occlusion is as follows:

The device relaxes the muscles of the dentofacial system and contributes to their proper restructuring in the presence of pathologies;
Helps to eliminate bad habits (for example, frequent sucking of fingers is a very bad habit for a bite);
It prevents the laying of the tongue between the teeth (otherwise it would also cause a strong negative effect on the formation of the bite in the child);
Provides restriction of the growth of the upper jaw in the anterior section;
Corrects the position of the language.

A child’s standard age for using an orthodontic trainer is 2 to 5 years. The most frequent indications for use are Angle II anomalies (the so-called distal bite, when the teeth of the upper jaw are strongly advanced forward relative to the lower), especially with a tendency to open bite (that is, when the dentition cannot completely close - there is a gap between them).

In addition, the device can be used to correct a bite in children with complaints of pain in the temporomandibular joint (TMJ).

On a note

The wearing mode of orthodontic trainers is 2 hours during the day and all night. The first week it is allowed to wear the device for 15-20 minutes a day, then remove it. Gradually increase the wearing time, then you can try to fall asleep with a mouth guard. A child can spit it reflexively in a dream - this is normal, and if you continue to use it, then the baby gradually gets used to it.

Various modifications of trainers for the treatment of deep and open bite are also used in adults.

It is also useful to read: Characteristics of orthognathic bite

Therapeutic removable devices for bite correction

There are a large number of varieties of removable orthodontic appliances used to treat malocclusion. The choice of a specific treatment method depends on the specific clinical situation, the experience and skills of the doctor, as well as the patient’s willingness to comply with the doctor’s prescription.

During the period of a removable bite of teeth, treatment of occlusion anomalies is mainly aimed at modifying the growth of the jaws and creating favorable conditions for the eruption of permanent teeth. The expansion of the lagging behind in the growth of the jaw can be achieved both on removable and fixed on the mouth fixed devices.

Next, consider the most commonly used designs.

Passive tooth machines

A feature of this group of orthodontic appliances is that the therapeutic effect is achieved by training the muscles of the maxillofacial region in combination with the forced extension of the jaw (or tongue) to the desired position.

To adjust the growth (expansion) of the upper jaw and align the teeth in the anterior section, for example, a plate on the upper jaw with expanding springs is intended:

The device consists of:

Lamellar basis;
Springs in the middle;
Supporting and retaining elements - clasps;
Metal arc on the front teeth.

The mechanism of action of such a plate:

Expansion of the upper jaw in the front;
Stimulation of the growth of the apical base of the upper jaw.

Age of use: temporary and removable bite of teeth.

Also, a plate for the upper jaw with spring pushers is often used to set the position of individual teeth (for example, if the incisors of the upper jaw are located behind the incisors of the lower jaw).

An example is shown in the photo below:

Mechanism of action:

The plate allows you to tilt this or that tooth in the direction of the oral cavity;
You can rotate the tooth around its axis by the desired angle;
The apparatus also allows the front teeth to be moved towards the oral cavity.

A deep abnormal bite, as a rule, is combined with pathologies in the lateral parts of the jaw (II and III class of Engl occlusion, corresponding to distal and mesial bites). To correct these pathologies, double-jaw plate devices are used.

For example, the Klammt activator of the second or third type for the treatment of distal and mesial bite:

The design includes:

Shield in the area of the posterior teeth for stretching and relaxing the soft tissues of the cheeks;
Occlusive pads on the chewing surfaces of the molars to separate the dentition;
Palatine arch - a metal wire in the middle adjacent to the palate (to expand the upper jaw);
Springs protracting under the upper front teeth (the force of the springs pushes the teeth forward);
Arc on the front teeth.

The mechanism of action of the Klammt activator is due to the implementation of the following effects when wearing the device:

Extension of the lower jaw;
Tilt of the lower incisors towards the lips;
Shortening the front of the jaw;
Elongation of the lateral jaws.

Age indications: temporary, interchangeable and permanent bite (during the period of active growth of the jaws). A contraindication to the use of this orthodontic apparatus is the absence of fangs.

It is also worth noting the currently quite popular two-jaw removable device with paired blocks (“Twin-block” device):

This design is popular among orthodontists both in Russia and abroad - the reason for this popularity is the quick adaptation of the child to it. The device consists of two removable plates, which are adjusted to each other in the area of the side plates - this is the name of the device (paired blocks of plastic are interconnected during use). Thus, the fixation of the lower jaw and its extension to a normal position.The peculiarity is that in the process of treatment, the doctor can add plastic to increase the height of the pads.

Active tooth machines

Active dentition devices widely used for bite correction are plates in which there is an active screw for expanding the jaws, and if necessary, the doctor can add any elements inherent in passive devices to the design.

The screw is activated by the parents or the child on their own (with a special key, which is inserted into the holes in the screw drum).

On a note

If the child is rubbed by a plate or a breakdown has occurred, then you need to try to get an appointment with a doctor as soon as possible. If you just stop using the device, then it will quickly cease to fit normally on your teeth. As a result, you will have to take the casts again and do the design again. This is due to the fact that the child is growing rapidly, as a result of which the relief elements of the oral cavity are rapidly changing their pattern and size. It is important that such active growth is directed by the device in the right direction in order to achieve maximum benefit for the future permanent bite.

Extraoral bite repair machines

Extraoral orthodontic appliances for occlusal correction are a special type of medical devices that have the following components in their design:

Special arc metal elements that are fixed in the holes on the orthodontic rings, previously fixed on the molars of the upper jaw;
As well as pressing elastic power modules.

Extraoral devices can be used both independently for correction of malocclusion, and as a preparatory stage for treatment on the bracket system, or during the active phase of treatment on braces.

Power elements and their fastening parts are attached to the patient's face (neck, parieto-occipital region, forehead). Facial arc parts can be removed - the doctor teaches this child and parents.

For example, the photo below shows what the so-called chin sling looks like:

The design of the chin sling includes a pressure bandage made of thick fabric (or plastic), a head cap and connecting straps.

Indications for using such a device:

Increased muscle tone, excessively pushing the lower jaw forward (that is, if there is a tendency to form a mesial bite);
And also when the growth rate of the lower jaw prevails over the growth rate of the upper jaw;

Age of use of the chin sling: removable and permanent bite of teeth.

Another type of extraoral orthodontic device for bite correction is a facial mask:

The design of the face mask includes:

Supporting pads (on the chin and forehead);
Fixing screws;
Metal carcass.

Mechanism of action:

Stretching the upper jaw forward;
Changing the vertical ratio of the front teeth.

Indications for use of orthodontic facial mask:

Underdevelopment or posterior position of the upper jaw;
Mesial bite due to the anterior position of the chin.

The facial mask is used to correct the occlusion during the period of a temporary, interchangeable and forming permanent occlusion (which corresponds to the age of the child 4-6 and 9-12 years old).

It is also useful to read: Orthodontic mouth guard

The next type of extraoral device for correcting occlusion in children is the orthodontic facial arch:

It consists of an intraoral tooth part, fixed in a tube adapted for this purpose, and an extraoral front part, at the ends of which there are hooks for fixing the elastic traction with a neck stop.

The front arch is made in three standard sizes - small, medium and large.

Thrust direction options:

Occipital - cap on the type of chin sling is fixed on the crown of the head;
Cervical (with cervical focus) - is fixed to the back of the neck;
Combined traction.

Mechanism of action:

Thanks to the facial arch, the growth of the upper jaw is delayed;
The upper molars are staged according to Engle's I class (that is, in the optimal physiological position);
The front teeth are tilted towards the oral cavity.

Clinical indications for use - the second class of Engl occlusion (that is, a distal bite when the teeth of the upper jaw are strongly advanced).

The age of use of the device is a removable and forming permanent bite.

The regimen for wearing extraoral orthodontic appliances should ideally be 14-16 hours per day. The duration of treatment is from several months to a year or more.

It is interesting

When observing the proper mode of wearing extraoral devices, they are recognized as very effective, and in many cases their use avoids fixing braces. In the United States, children often go to school in devices - this is considered quite normal and does not cause a negative reaction in people. In Russia, it is unlikely to be able to meet children in similar designs on the face today.

Fixed structures for bite correction

This group of devices includes various versions of the well-known bracket systems, due to which the bite is gradually aligned, as well as frame structures for expanding the jaws, which are fixed in molar rings.

It is worth mentioning separately about the principles of self-help and diet when wearing braces.

So, there are several problems that almost all patients with braces face in one way or another:

The arc begins to stab, leaving the locks on the last teeth. This is due to the fact that the arc straightens over time to its original position, as the teeth take the right place. If this happens, you need to call the doctor and explain what exactly happened - the doctor will invite you to trim the ends of the arc. If there is no way to quickly get to your doctor, then you can temporarily close the tip of the arc with a special orthodontic wax. Such wax is sold in pharmacies, as well as in online stores;
The arc came out of the last castle. In this case, you can try to very carefully fill the arc yourself with tweezers. Or use wax and glue this part of the arc so as not to injure the cheek before visiting the orthodontist;
The bracket came off. If possible, the bracket should be preserved, the orthodontist should be informed and, having agreed upon the time, come for gluing.

While wearing the braces, it is imperative that you follow the special rules for eating: cut meat, apples and all hard foods into small pieces and gently chew with your side teeth. Biting off food can cause the bracket to peel off. Chewing gum, seeds, chocolate with nougat are completely excluded, as they can unfasten the locks, or cause the arc to exit the castle.

Among the fixed orthodontic appliances for occlusion correction is also a framework for the rapid expansion of the palatine suture:

The design includes:

Rings on the first molars and premolars (6 and 4 teeth);
Rods;
Screw for opening the palatine suture (it is activated by the child himself, or by parents using a key).

The mechanism of action of the apparatus is implemented due to:

Disclosures of the palatine suture;
Extensions of the upper dentition;
Shortening the front of the upper dentition.

The age of applying the orthodontic framework to expand the palatine suture is a removable and permanent bite.

Indications for use - I, II, III class according to Engle, as well as congenital malformations of the maxillofacial region with a narrowing of the dentition by more than 5 mm.

Another non-removable device is the quadrohelix:

Very effective for slow palatine expansion of the upper jaw. The scaffold can be adjusted to obtain greater expansion in the anterior part of the dentition.Activation is done by a doctor.

It is also worth mentioning the palatine clasp:

It is used to adjust the shape of the dental arch and prevent the undesirable movement of molars.

All frame products are fixed on dental cement to the abutment teeth.

About the use of retention devices

Retention devices are used at the end of orthodontic treatment to maintain the achieved occlusion. The fact is that soft tissues and ligaments are prone to return to their usual position, and accordingly, the teeth, under the influence of surrounding tissues, can also take their former pathological position.

As retention can be used the above medical devices that are no longer activated.

Either retention mouth guards made after removing braces from the final cast of the patient’s teeth are used:

The first 3-6 months, such mouthguards should be worn as long as possible, removing only with food. Then you can switch to wearing mode only at night.

On a note

In retention burls, it is not recommended to drink coffee, tea, wine, as well as smoke, because the plastic of the burl may stain and lose its transparency.

After the stage of wearing braces, a metal retainer is often used. This simple orthodontic apparatus is a wire twisted several times, which is fixed on the lingual and palatine side of the first six teeth on the filling material:

It's important to know

If you feel that the retainer has detached from the tooth or from several teeth at once, you must call your orthodontist and glue the structure as soon as possible, because the teeth can quickly change their position.

Depending on the clinical situation, each doctor chooses the orthodontic design, which, in his opinion, will be the most effective given in a particular case. Moreover, in many respects the success of treatment depends on the patient himself - on his discipline and proper observance of all the recommendations of the orthodontist.

If you have personal experience with the use of various orthodontic appliances for bite correction, be sure to share the information by leaving your review at the bottom of this page (in the comments box).