Your Baby’s Gap-toothed Smile: Should You Worry?

Your baby’s front teeth have begun to grow in, and there’s a gap between them. Should you be worried? In a word: No. A gap is a favorable occurrence because it gives adult teeth more space to grow in. Children whose teeth are closer together are more likely to suffer from a phenomenon called “crowding” that enhances the chance that the adult teeth will grow in too close to each other and become misaligned.

Believe it or not, your baby is born with his or her baby teeth already developed, hiding just below the gum line. The spacing between them has more to do with their role as placeholders for adult teeth than for their function as primary teeth. Frequently, as your child grows older and other teeth, especially the canines and molars, start to grow in, the front teeth will slowly grow together and the gaps will decrease until the teeth are aligned properly.

There are circumstances where gaps between baby teeth can be a problem. Sometimes, a gap persists because primary teeth simply refuse to grow in. This can lead to permanent teeth growing in improperly because their way has not been “paved” the way they would be if the baby tooth had grown in as expected.

As for a gap between your child’s adult front teeth? That’s usually just a cosmetic issue and probably nothing to worry about. In fact, the eruption of molars farther back in the jaw will often help crowd the gapped front teeth together. If your child is self-conscious about a gap between his or her front teeth, a veneer slightly wider than the tooth can be bonded to each tooth’s surface. Other options involve a removable appliance, such as a retainer and a fixed appliance composed of brackets and rubber bands that apply pressure to pull the teeth together.

Despite our reassurances, you should not hesitate to bring up this issue with us. Your child will one day lose his or her baby teeth, but that doesn’t mean they don’t serve an important role. Tooth problems don’t always occur all at once, and issues you or your child might not notice can be obvious to a trained eye. Bring your child to our office; we can fill in the gaps in your dental health care knowledge.

Mouth Breathing: Why It Matters

Let’s say your child has a stuffy nose for a few days and you notice that, understandably enough, he or she is breathing mostly through the mouth rather than through the nostrils. No long-term harm will result from that temporary change.

But if a child breathes through the mouth as a matter of course, week in and week out, cold or no cold, that is a cause for significant concern.

Here’s why. If left untreated, chronic mouth breathing can cause:

o    abnormally elongated facial development
o    crowded, crooked permanent teeth that are prone to decay
o    a “gummy” smile (gums more prominent than in the average smile)
o    frequent upper respiratory infections
o    poor school performance due to sleep deprivation caused by snoring or apnea
o    possible erroneous diagnosis of ADHD (attention deficit hyperactivity disorder)
o    bad breath, chronically chapped lips and abnormally fibrous gums

Mouth breathing almost always has a physiological cause rather than being a “habit.” The most common causes include chronic nasal obstruction, enlarged adenoids and/or tonsils, and allergies. If the underlying cause can be successfully treated, the mouth breathing will likely subside, with no or few permanent effects. If still breathing through the mouth by age 7, your child should see our orthodontist, who may recommend palate expansion to correct misaligned teeth and abnormal facial development. We will help your child by working in conjunction with your other medical professionals, including an ear, nose and throat doctor, an allergist and, of course, an orthodontist.

If you are not sure whether your child is a mouth breather, look for these signs:

o    frequently has his or her mouth open at rest, especially while sleeping
o    dark circles under the eyes
o    subtle changes in facial shape
o    tends to be more tired and listless than others the same age

When in doubt, err on the side of caution. Bring your concerns to us and to your pediatrician. Make appointments for evaluations and get your questions answered. Sadly, mouth breathing is often underreported and undertreated. But diligent observation and action can keep your child from suffering any long-term effects from mouth breathing.