Let’s face it: we’re busy. Accordingly, when it comes to our kids’ teeth, we often limit ourselves to the semi-annual trip to the dentist, at which we promise more flossing and brushing. Having a healthy mouth is much more important than we think.

smile“The mouth is the first step in the digestive process", explains Dr. Judith M. Medina-Rivera DMD, a general dentist whose practice is entirely dedicated to functional orthopedics and orthodontics.  If we don’t have good occlusion—that is, the relation between the upper and lower arches—we can’t chew properly and we’re likely to end up with digestive problems later".

“Also, an undetected jaw position problem can lead to your child suffering from headaches and other muscle problems in their head and neck. At night, they might not be getting enough oxygen because the jaw moves back and the airway may be partially blocked by the tongue. Kids that are hyperactive or have attention deficit problems are often observed with having airway issues. Then of course there is the smile. Often a once shy and insecure patient begins to exhibit more self-confidence as their smile is corrected.”

Dr. Medina insists that it is important to bring your child in to have them looked at around the age of seven when they begin to get their first permanent molars. “Parents need to know that it’s important not to wait,” she adds. “Bring them in for an evaluation. Many problems are not readily visible but are still very important to address.” Of course, you should bring your child in at an even younger age if a noticeable problem exists. “A cross-bite is a good example", Dr. Medina says. “Often this can be detected during a regular dental check-up.”

Two of the most common problems Dr. Medina sees are crooked teeth and narrow arches. The arch is the curvature of bone where the teeth sit and includes the roof of the mouth. An underdeveloped arch will have a narrow shape, and, in consequence, the teeth will be crowded or may even be blocked. “The most common cause of narrow arches is mouth breathing. For example, when a child grows up with allergies or asthma or maybe the tonsils are too big, then the upper airways are affected. This keeps the arch from developing properly.

I asked her if having narrow arches is why orthodontists often pull teeth. “I generally don’t pull teeth,” she said. “Only in some rare instances. It’s better to develop the dental arches to accommodate all of the teeth. Also, if teeth are removed so that the remaining teeth fit in an underdeveloped arch we might just be treating a symptom and not addressing the problem. The problem is the underdeveloped arch; the symptom is the overcrowding of the teeth. Fix the problem, which is the arch, and then the teeth will fit”


(Interview published in 2009 by Whole Kids® magazine)

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