Most parents notice teeth before they notice bite. A crooked tooth is visible. A bite problem often isn’t, at least not to the untrained eye. But bite issues in children are common, they tend to worsen as the permanent teeth come in, and many of them are easier to manage when addressed during the years when jaw growth is still underway.
Understanding what the common bite problems look like and what triggers a referral to an orthodontist helps parents know when to act rather than wait and see.
What a Bite Problem Actually Is
The bite, or occlusion, refers to how the upper and lower teeth come together when the mouth closes. In an ideal bite, the upper teeth sit slightly in front of the lower teeth, the back teeth mesh evenly, and the jaw can close without shifting or strain. When any part of that relationship is off, it’s considered a malocclusion.
Bite problems in children range from mild variations that may self-correct as the permanent teeth come in, to significant discrepancies that affect how the jaw develops and won’t improve on their own. The key question a Johns orthodontist answers during an early evaluation is which category the child falls into.
Overbite
An overbite is when the upper front teeth overlap the lower front teeth excessively in a vertical direction. Some degree of overbite is normal. A deep overbite, where the upper teeth cover a significant portion of the lower teeth or the lower teeth bite into the gum tissue behind the upper teeth, is a different situation.
Deep overbites can cause wear on the lower front teeth, gum tissue irritation, and contribute to jaw strain over time. In children, early treatment during the growth phase can use the jaw’s development to help correct the bite relationship. Waiting until growth is complete doesn’t eliminate the treatment options, but it may make the correction more complex.
Underbite
An underbite is when the lower teeth sit in front of the upper teeth. It can affect a few teeth or the entire bite. In children, underbites often have a skeletal component, meaning the lower jaw is positioned further forward than the upper, rather than a purely dental one.
This is a situation where early intervention can make a meaningful difference. Appliances that redirect jaw growth during the years when the facial bones are still developing can modify the relationship between the upper and lower jaws in ways that aren’t possible after growth is complete. An underbite caught and treated early may require less intervention overall than one addressed after adolescence.
Crossbite
A crossbite occurs when one or more upper teeth sit inside the lower teeth rather than outside them when the mouth closes. It can appear at the front of the mouth or the back, and the two locations have different causes and implications.
A posterior crossbite, affecting the back teeth, often causes the jaw to shift to one side when closing. This compensatory shift, if present through childhood, can contribute to asymmetric jaw development over time. Expansion of the upper arch, often using an orthodontic appliance, can correct a posterior crossbite during the growth years when the palatal suture is still open and responsive.
At Brookhaven Orthodontics, orthodontic appliances are used as part of early treatment plans when jaw development needs to be guided before braces or aligners become the primary tool.
Open Bite
An open bite is when the front teeth don’t make contact when the back teeth are closed. The most common cause in children is prolonged thumb-sucking or pacifier use, both of which place sustained pressure on the front teeth and can alter both tooth position and jaw shape.
Addressing the habit is the first step. If the habit stops early enough, some degree of self-correction can occur as the permanent teeth come in. If the habit has been prolonged or the open bite is significant, orthodontic treatment addresses the remaining discrepancy once the habit is resolved. Early evaluation helps determine which situation applies.
When to Have a Child Evaluated
The American Association of Orthodontists recommends an orthodontic evaluation by age seven. At that point, enough permanent teeth have come in to give an orthodontist a clear picture of how the bite is developing and whether any issues are present that would benefit from early attention.
An early evaluation doesn’t mean early treatment. Many children are monitored and treated when the timing is right, rather than immediately. What the evaluation rules out is the scenario where a problem that could have been addressed during growth is only caught after it’s become more complicated.
At Brookhaven Orthodontics, braces for kids and early treatment options are available at both locations. Consultations are complimentary, and no referral is required. Dr. Cox and Dr. Cohen-Sasson have experience evaluating children across a range of ages and presenting bite problems, and the assessment includes a clear explanation of what’s present and what the options are.
Brookhaven Orthodontics | Complimentary Kids’ Consultations
Brookhaven: 804 Town Blvd., Suite A2000, Atlanta, GA | Johns Creek: 3440 Old Alabama Rd., Suite 200, Johns Creek, GA
No referral. No cost to consult. Call or text 404-343-0677 — or visit our clinic.
