Pediatric Dentofacial Deformities

Pediatric Dentofacial Deformities

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Summary

Pediatric dentofacial deformities can result from congenital (present at birth) conditions or conditions that occur after birth. They can lead to abnormalities in the jaw and roof of the mouth (palate), affecting the alignment and appearance of teeth.

Expanded Overview

Congenital conditions can affect the appearance of a child’s face and teeth. Some abnormalities may be evident at birth, and some may not be noticeable until later.

Other dentofacial deformities can result from conditions that occur after birth, such as thumb sucking and facial paralysis.

Types

Pediatric dentofacial deformities include: 

  • Abnormal tooth development – Can cause teeth to be small, discolored, crowded, delayed or prone to breaking. Some conditions can cause missing teeth.   
  • Cleft lip and palate – A child can have a cleft lip, cleft palate or both. A cleft palate occurs when the roof of the mouth doesn’t fuse completely as a baby is developing in the first trimester of pregnancy. A cleft lip occurs when the upper lip doesn’t completely join and leaves a gap.
  • Crooked smile – This can occur from crooked jaw or lower face asymmetry (uneven). It can also result from facial paralysis.
  • Excess gums – Some conditions can cause gums to grow over the teeth more than usual.
  • Jaw disorders – Jaw disorders can cause “malocclusions,” or misalignment of the teeth, including:
  • Underbite – Occurs when the lower jaw (mandible) sticks out farther than the upper jaw. This can be caused by a genetic condition, or it can be a symptom of other syndromes or conditions.
  • Open bite – Occurs when the upper and lower teeth do not neatly come together with the top teeth over the bottom teeth when the mouth is closed. This can also affect speech, as the tongue cannot press against teeth.
  • Overbite – Occurs when the upper jaw grows too large, or the lower jaw doesn’t grow enough.

Causes

Pediatric dentofacial deformities can occur because of many different conditions, including:

  • Amelogenesis imperfecta – A development disorder that causes teeth to be unusually small, discolored, pitted or grooved. Teeth can also be prone to rapid wear and breakage. It can affect primary (baby) and permanent (adult) teeth.
  • Apert syndrome and Crouzon syndrome – These syndromes occur when skull bones fuse too soon while the baby is developing in the womb, affecting the appearance of the face. Both can cause an underdeveloped jaw and crowded teeth. A cleft lip and palate are also a possibility with these syndromes.
  • Dentinogenesis imperfecta ­– Causes tooth discoloration; they can be blue-gray, yellow-brown or translucent. It can also weaken teeth, making them prone to rapid wear, breakage and loss. Problems can occur in primary teeth and permanent teeth.
  • Facial asymmetries – Can cause problems with jaw development. Craniofacial microsomia, for example, occurs when one side of the face and skull develops smaller than the other side. This can lead to underdevelopment of one side of the upper or lower jaw.
  • Hypohidrotic ectodermal dysplasia – Can result in abnormal development of the skin, hair, nails, teeth and sweat glands. Teeth can be absent, misshapen and look small and pointed.
  • Oculodentodigital dysplasia – Can affect the eyes, teeth and fingers. Teeth can be small, missing or weak, and prone to cavities and early loss.
  • Recombinant 8 syndrome – Recombinant 8 syndrome affects the heart, urinary tract, intellectual ability and face. Overgrowth of gums (gingival hyperplasia) and abnormal tooth development can also occur.
  • Thumb sucking – Thumb sucking should be discouraged by age 4, as it can affect the alignment of the teeth, cause an over bite and change the shape of the roof of the mouth. The intensity of sucking will determine the extent of changes in the mouth.

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