Growth Modification

growth modification

When is the best time to begin orthodontic treatment?

Though we can straighten teeth at any age, there is an optimal time to begin jaw growth modification. Growth modification is best completed when the patient is still growing.

We can take advantage of a child’s growing years by guiding proper jawbone formation using orthodontic appliances. This treatment can prevent malocclusions (bad bites) from forming or correct existing ones. Once the patient is an adult, surgery may be necessary to correct significant jaw misalignments.

The ideal time to start growth modification treatment varies from patient to patient. It is based on the stage of growth of the jaws and whether the jawbones align in an underbite or an overbite.

What are the advantages of interceptive growth modification treatment?

  • Creates optimal facial symmetry
  • Fixes crowded teeth without tooth extractions
  • Corrects a crossbite
  • Corrects  an openbite
  • Corrects an overbite
  • Corrects an underbite

When growth modification is utilized, a severe problem that would require surgery to fix at a later date can be fixed in a non-invasive and gentle way.

By utilizing growth modification, we can increase the self-esteem and confidence of a child since his or her teeth and jawbones align better! This goes a long way in the junior high school years with our patients.

What orthodontic appliances are used during growth modification?

To give you properly functioning and aligned jaws and correctly aligned teeth, we use appliances such as, but not limited to:


Headgear is often used to correct an excessive overbite. This is done by placing gentle pressure against the upper teeth and jaw, which would hold the teeth and upper jawbone in position or help move the teeth and lower jawbone into better positions.

The severity of the problem determines the length of time headgear needs to be worn. The key to success with your headgear appliance is consistency. Headgear must be worn a certain number of hours per day.

Reverse-Pull Headgear

Often referred to as reverse-pull headgear, the protraction face mask is a removable appliance for patients when the upper jaw is not growing fast enough, resulting in a crossbite or underbite. The device consists of a metal bar attached to pads on the forehead and chin with rubber bands hooked to the facemask and upper braces or a palatal expander to gradually move the upper jaw forward.

Patient compliance is extremely important because the facemask must be worn a set number of hours per day to obtain the desired results. The facemask device is generally worn for about 12 months.

Palatal Expander

Attached to the upper molars through bonding or by cemented bands, the palatal expander is an orthodontic device used to create a wider upper jaw. It is typically used when the upper jaw is too narrow for the lower jaw or when the upper teeth are crowded or blocked out of the dental arch.

When patients are still growing, their connective tissue between the left and right halves of their upper jaw is very responsive to expansion. By simply activating the expander by turning a screw in the center with a special key we provide, gradual outward pressure is placed on the left and right halves of the upper jaw.

This pressure causes an increased amount of bone to grow between the right and left halves of the jaw, which ultimately results in an increased upper jawbone width.

Twin Block or a Bionator

The Twin Block or Bionator functional appliances are designed to correct lower jaw or teeth positions to reduce an overbite. Both of these appliances are removable and look a bit like wire and acrylic retainers.

These appliances are usually used to treat children who have an underdeveloped lower jaw. To ensure treatment progresses as planned, the appliance should be worn at all times. It should only be removed for cleaning, eating and during sport activities.

Patients should follow instructions carefully to ensure effective results are achieved in the least amount of time.

MARA and Herbst Fixed Appliances

The Mandibular Anterior Repositioning Appliance (MARA) and the Herbst appliances are two different options of fixed appliances that are suitable for treating bites that are characterized by protrusion of the upper front teeth or a lower jaw and/or teeth that are positioned back in relation to the upper jaw and/or teeth.

The MARA and the Herbst are fixed alternative to the Twin Block or Bionator appliances. They are great options when poor compliance with wear of the Bionator or Twin Block appliances may contraindicate them.

Both MARA and the Herbst appliance are secured to the patient’s first molars via bands that are fitted over the molars and glued into place for as long as the appliances are required. Insertion and removal of the MARA and the Herbst does not require any dental freezing and the teeth surfaces are not changed or modified in any way.

The MARA uses elbows that slide against each other to position the lower jaw forward, and the Herbst uses pistons to do the same. Both are comfortable and unobtrusive, and do not interfere with chewing to any great extent.

These appliances are usually kept in place for nine to 18 months and braces can start while one of these is in place. Your improvements will be noticeable almost immediately!