bad bite big problems anterior open bite maxillary constriction thumb sucking

A Bad Bite Can Lead to Big Problems

I recently had a chance to catch up with an orthodontist friend of mine, Dr. Derek Hoffman at Peden and Hoffman Orthodontics. Of course, we talked about teeth! The best part was I was able to ask questions from a mom perspective because I was thinking about you. ­čÖé

Dr. Hoffman reminded me of issues, that if left uncorrected, can cause big problems long term. I have learned about these things when I was in dental school, but not as in-depth as an orthodontist.

My friend pointed out some common problems that lead to a bad bite that is helpful to correct sooner rather than later. Now I want to pass this information on to you.

I don’t want to turn into an orthodontist, but I do want you to be able to identify issues with your child’s teeth so that you can prevent bigger problems in the future.

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Problem #1 – Lost a baby tooth early

Losing a baby tooth early usually happens in two ways:

  1. The baby teeth are so close together that when the permanent tooth comes in, instead of replacing one tooth it replaces two.
  2. The baby tooth has a really bad cavity or infection and the tooth could be saved so it had to be removed prematurely.

Kids typically have a full set of teeth around age 3. They begin losing their baby and getting their adult teeth around age 6. It is important to make sure to take your child the dentist regularly not just to check for cavities. The dentist is also checking to make sure the teeth come in at the proper time and will help identify if your little one doesn’t have enough space for all of the adult teeth to come in.

Many times I will explain to parents that their child needs to have a silver cap on a tooth. Usually, it is because the cavity got pretty big and the silver cap will help maintain the tooth long term until it is time for it to come out.

The first question that I usually get is “why can’t you just pull it? it’s just a baby tooth, right?” Yes, it is a baby tooth and eventually, it will come out. However, if the tooth comes out too early it can lead to the problems.

Baby teeth help guide the permanent tooth into the right place. Without the baby tooth or teeth their … well, let’s just say it can get pretty interesting.

It’s like they say, pay now or pay later. In this case, its pay now or pay a whole bunch later to your local orthodontist.

The biggest orthodontic problem with losing a baby tooth too early is that it can cause a midline drift or an impacted tooth.

If your child has a tooth pulled before the permanent tooth is ready to come in, it is crucial to talk to your dentist about having a space maintainer.

What is a space maintainer?

A space maintainer is a device that is either cemented in place or comes out like a retainer that prevents the movement of the teeth on either side of the missing tooth from tipping. This helps prevent the tooth or teeth from becoming impacted. There are different types of space maintainers depending on the tooth or teeth that are missing.

If your child had a space maintainer, double check that it is still in there. If it is not, have it replaced because it may save you an even bigger bill later.

Problem #2 – Sucking thumb or fingers for too long

Many times parents will think it is cute when their baby’s suck their thumb. Trust me, there is nothing cute about a kid that sucks their thumb that you have to pay a nice chunk of change to fix their teeth later.

If at all possible have your child stop this habit by age 6 or 7 or once the permanent teeth start coming. This will help prevent issues from progressing as your child gets older. Many times if the habit is stopped early the teeth will spontaneously correct themselves.

The biggest problem with a thumb or finger sucking habit is that it leads to maxillary constriction and/or anterior open bite.

Maxillary constriction

Maxillary constriction is a result of the thumb being pushed on the roof of the mouth and the cheeks squeezing on the teeth during the sucking motion.

This leads to several problems including difficulty chewing, eating, speaking and can lead to mouth breathing, which leads to a whole bunch of problems.

Anterior open bite

An anterior open bite is the common look of someone that sucks their thumb or fingers. As a result of the thumb or finger being in between the teeth, there is space between the teeth that make it extremely difficult to bite into foods. Imagine trying to the bite into an apple … when you bite down your front teeth are still open.

Other problems with an anterior open bite in addition to difficulty biting foods are:

  • difficulty pronouncing words correctly
  • sensitive teeth
  • TMJ pain

There are ways to help your child stop their thumb or finger habit. I have worked with some very persistent kids who have had parents try everything to get their child to stop.

Your child’s dentist can make appliances that are cemented inside the mouth that make it uncomfortable or almost impossible to suck their thumb or finger. This discourages the habit and eventually, the child stops the habit.

Remember, to talk to your child’s dentist when they go in for their checkup if you need help with getting your child to stop this habit.

Problem #3 -anterior crossbite

Ideally, you want to have your top teeth in front of your bottom teeth when you bite down. When it is reversed, especially on the front teeth it can cause what dentist and orthodontist like to call an anterior crossbite.

You may think this innocent looking bite is nothing to worry about. The problem is that it can cause some harmful long-term effects on your child’s teeth.

One of the biggest problems is that anterior crossbite can lead to abnormal wear on the tooth. Remember, teeth are the only hard tissue in the body that can’t be replaced. Over time, because the teeth are not in the proper position, you may notice the enamel with wear away. Once that enamel is gone … it’s gone.

Another problem with anterior crossbite is that it can lead to receding gums. When the gums recede the roots of the teeth are more exposed which can lead to sensitivity.

Lastly, anterior crossbite can put harsh forces on the teeth which can cause tooth pain or even the tooth to get loose.


Remember to watch when your child starts losing teeth. If they lose a tooth early for whatever reason check with your dentist to see if they will need a space maintainer. Have your child stop sucking their thumb by age 6 or 7 or once the permanent teeth start coming.

I know that I shared a lot with you, but I don’t want you to be the mom that says “no one ever told me that.” If you see something that looks a little off with your kid’s teeth, bring it up with your dentist or orthodontist.

The American Association of Orthodontist recommends children have an orthodontic evaluation at the age of 7.

The most orthodontist will do a complimentary consultation. That means no money out of your pocket! So, talk to your local orthodontist and hear what options your child has to correct their bite. If you don’t feel comfortable with your orthodontist, it is okay to get a second opinion.

With lots of love,
Dr Toni

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