How can parents know
what is right?

Vertical Growth Damages Faces	Horizontal Growth Improves Faces
This child’s face was damaged by vertical growth following orthodontic treatment. Vertical growth is associated with thick lips, receding chins, protruding noses, sloping foreheads and tired eyes.	This boy received Orthotropics®. Although his front teeth stuck out both jaws were encouraged to grow forward. Few other techniques achieve this because they pull the teeth back. Horizontal growers retain naturally straight teeth for a life time.

 

Many young children have beautifully straight teeth at the age of five or six but the teeth and face can quickly change if they leave their mouth open (see above).

What can be done to correct these problems?

The jaws of many children are too small to accommodate all the teeth. Orthodontic treatment corrects this by extracting some teeth so that the others can be correctly aligned with Fixed Braces (Train Tracks) but these can have some drawbacks, such as damage to the enamel and roots of the teeth.

Is there another way?

Some parents prefer more natural methods such as Orthotropics® which aim to guide the growth of the jaws so that there is room for the teeth without extractions. Success depends on good co-operation but the results can be dramatic.

Orthotropics® does not use ‘train tracks’ and works best with children under nine years old provided they wear their appliances as instructed. If they do there should be room for all 32 teeth avoiding the need for any extractions. However, it is a highly skilled treatment that requires patients to learn to keep their mouths closed which some children find difficult. Be cautious if your dentist or orthodontists tells you that they may use fixed ‘Train Tracks’ as this should not be necessary.

All orthodontists are legally obliged to tell their patients about alternative methods of treatment, especially if they are recommending irreversible procedures such as extractions or surgery. Unfortunately not all do so. If you were not told about all alternatives, you have a legal right to complain. The girl below was told she had to have four extractions and her teeth pulled back but she was not told there was any alternative.

How can a lay person know?

To be certain you should ask the orthodontist if there will be room for all 32 teeth and also check that the vertical growth will not be increased. If you don’t receive such an assurance, you might be wise to ask for a second opinion.

What is the best thing to do if the top teeth are behind the lower teeth?

Protrusive lower jaws need treating early or the patient may need to have surgery to cut and reposition them. Orthotropics can usually avoid the need for this (see below).

 

What is the best thing to do if the front teeth stick out?

You can take the top teeth back or bring the lower jaw forward (see below).

Orthodontics This boy’s front teeth stuck out so two side teeth were taken out and “Train Tracks” were used to pull the front ones back. By kind permission. Clark JD Kerr WJS and Davis MH. 1998 Dental Update 25:12-17.

Orthotropics This boy’s front teeth also stuck out but he had orthotropics to move both jaws forward. No extractions, no train tracks and no relapse.

 

Will surgery be necessary?

Severe over or under-growth can be corrected with appropriate Orthotropic® treatment, but the child will need to be young enough and learn to keep their mouth closed. Some orthodontists do not tell patients that surgery may be necessary until the patient is too old to avoid it, so it is wise to ask them first.

Research has shown that Orthotropics can achieve much greater changes to the shape of the face than any other method.

Changing the shape of the face can have a big influence on a child’s self confidence. This reticent boy with a retruded jaw, was treated with Orthotropics and subsequently became captain of his rowing team. Orthodontic treatment can not achieve results like this.

 

HOW CAN YOU MAKE THE RIGHT CHOICE?

It is very difficult to reduce vertical growth and you need a clinician who you can trust to achieve this. We suggest that you ask to see the best improvements your clinician has achieved, this is more important than looking at final results. Unfortunately it is not possible for us to advise individual patients and we suggest that if you have a problem you discuss it with your general dentist. If he or she is not familiar with the concepts discussed here, you could ask for a referral to a local orthodontist or alternatively go to ‘Where to get treatment’ on this page. Alternatively click on the flag of your nationality above and ask your national advisor for guidance.

 

Orthotropic clinicians are divided into different classifications.

A Master in Orthotropics. This is awarded to outstanding Orthotropists as determined by criteria set up by the Board.

Registered Members are dentists, who are fully trained in Orthotropics® as determined by criteria set up by the Board.

Provisional Members are dentists who are interested in Orthotropics but have not yet received full training. This category is limited to two years by when applicants must have attended a course and/or taken a written test as determined by criteria set up by the Board.

CAUTION. Before starting treatment it is wise to ask the following questions.

1. How many permanent teeth will be taken out initially and how many more may need extracting later. Most children who have “Train Tracks” and retractive treatment will lose four permanent teeth and about half of them will not have room for their wisdom teeth as well, leaving them with only 24 teeth. If the growth has been properly controlled while they were young there should be room for all 32 teeth.
2. If Train Tracks are suggested you should check that he/she has received training in Orthotropics because they should not be necessary and can severely damage the face if it is already growing vertically.
3. Will surgery be necessary? It will not be required following appropriate Orthotropic® treatment, but they will need to be young enough and learn to keep their mouth closed. If this decision is delayed it may be too late to avoid major surgery.
4. Ask your clinician if they feel confident of avoiding an increase in the vertical growth of your face? It is your right to be told about all types of treatment and be warned of likely problems. Insist on a photo of your face taken from the side before treatment and monitor the changes that follow (see above and below).

The changes in the patient below are quite frequent following Orthotropic® treatment but rarely if ever seen with other methods.

Showing how the face will continue to improve if the posture is corrected.
Orthodontic treatment can not achieve results like this.