Narrow Upper Jaw

A narrow upper jaw is a condition where the upper jaw is not wide enough horizontally compared to the lower jaw. In this case, the jaw closes in such a way that the upper jaw teeth are inside the lower jaw teeth.

The narrow upper jaw is a problem that needs treatment in childhood. This problem may be hereditary or may occur later. Children with a narrow upper jaw often have a tired facial expression. Their faces tend to elongate.

Signs and Symptoms

A narrow upper jaw causes some orthodontic problems. The most common of these is the occurrence of crooked teeth. Since the upper jaw is narrow, the new teeth that will erupt in the upper jaw cannot find a place in the jawbone and come out as crooked teeth.

In the case of the narrow upper jaw, the teeth do not fully close. Accordingly, the jaw cannot fully perform the chewing function.

In cases where the jawbones cannot close completely, the lower jaw tends to slide to the right or left to complete the closure. This leads to an abnormal appearance of the jaw during the child’s growth period.

Causes of Narrow Upper Jaw

Mouth Breathing

The main reason for the formation of the narrow upper jaw is that when the child is in the developmental period, starts to breathe through the mouth, not through the nose, and makes it permanent. And mouth breathing causes dry mouth, which triggers bad breath. In this case, the use of some oral care products (eg, ADA-approved mouthwash such as Biotene Dry Mouth Oral Rinse or as a different choice: TheraBreath Dry Mouth Oral Rinse) may be beneficial to the person. 

This condition usually develops due to tonsils, adenoids, crooked nasal bone, or any obstruction of the upper respiratory tract. Respiratory problems become chronic if left untreated for a long time. In this way, the child makes a habit of mouth breathing. This case also adversely affects the upper jaw and teeth. Over time, very serious changes and abnormal appearance of the jaw may occur.

We can often see the characteristic ‘adenoid face’ type in mouth-breathing individuals. In these individuals, a long and narrow face, short upper lip, narrowed upper jaw, opening between the anterior lower and upper teeth, and a lower jaw growing downward and backward are common.

Pacifier and Thumb Sucking

Habits such as a finger, lip, or prolonged pacifier sucking can cause a narrow upper jaw. It is very common, especially in children older than 2 years of age who still use pacifiers or suck their thumbs. Pacifiers and thumb-sucking put pressure on the palate. Thus, it causes the palatal bone to deepen upwards. This, in turn, narrows the edges of the upper jawbone by pulling it inward over time.

The narrow upper jaw can also occur due to genetic reasons.

Diagnosis

Because of its negative consequences, a narrow upper jaw is a problem that needs diagnosis and treatment at an early age. If the child has trouble breathing through the nose, sleeps with his/her mouth open at night, snores, and has tooth and jaw disorders, it is necessary to consult a dentist.

Sometimes, the dentist can tell that the child has a narrow upper jaw even by looking into their tired eyes. In the examination, the dentist checks the child’s mouth and jaw structure. During the examination, there is usually no need to use a device. However, dentists sometimes use various measurements or imaging tests to confirm the diagnosis.

Treating Doctors

Orthodontists, who are kind of dentists, undertake the treatment of the narrow upper jaw. However, in the treatment process, otolaryngologists, child psychologists, gastroenterologists, and sometimes even dietitians can also participate. For example, otolaryngologists deal with situations that make it difficult to breathe through the nose (adenoids, tonsils, nasal bone deviations, etc.). Or, if families find it difficult to overcome the child’s obsession with using pacifiers and thumb-sucking, then it would be best to consult a child psychologist.

Narrow Upper Jaw Treatment

It is important what the child’s narrow upper jaw originates from. That cause must be eliminated so that the same situation does not happen again. These reasons are generally adenoid, long-term use of pacifiers, thumb sucking, and mouth breathing. The most common of these factors is mouth breathing.

Removing any obstruction on the respiratory tract (such as adenoid or tonsil removal surgery) has been shown to have healing effects in the expansion of the upper jaw dental arch and the change of the growth direction of the lower jaw. In this respect, the transition from mouth breathing to nasal breathing in the early period provides an improvement in the upper jaw and facial structures without requiring any other intervention.

In terms of orthodontic treatment, the most appropriate age range to treat a narrow upper jaw is 6-8 years. Dentists can successfully treat this disorder with removable palate expanders and plaques if diagnosed at an early age. Since movable palate expanders cannot be used in the treatment of children aged 12-14, fixed expanders are used instead.

Expanding the Upper Jawbone

In the case of the narrow upper jaw, the main desired treatment is an expansion of the upper jawbone. In this treatment, the rapid palatal expander applied to the upper jaw ensures the expansion of not only the teeth but also the bone of the upper jaw. With this method, the dentist can achieve expansion in patients whose jawbone growth continues.

In certain periods, the dentist expands the palatal expander to the sides, and that stretches the upper jaw bone. During this process, the front teeth separate from each other, and gaps form between them. This is exactly what the dentist expects and wants. The separated bones will already fuse correctly. After a while, the crooked teeth straighten on their own and fill those gaps. Thus, a beautiful appearance of the teeth forms.

In adult patients whose jaw bone growth and development has stopped, it is not possible to expand the upper jawbone with the above method alone. So, these situations require additional surgical treatment to provide expansion of the upper jawbone. In this respect, age is of great importance in the treatment of orthodontic problems.

Dental Expansion in the Upper Jawbone

This treatment does not provide expansion of the upper jawbone. The dentist treats narrowness by correcting the slopes of the upper teeth. Dentists apply dental expansion mainly in cases of sightly narrow upper jaws. With this method, milder conditions in adult patients where the upper jawbone cannot be expanded are treated.

If Narrow Upper Jaw is Left Untreated

The child may have hearing problems, as the deep palate, which occurs as a result of prolonged pacifier use or thumb-sucking habits, can block the Eustachian tube. The inability to breathe through the nose causes the jawbone structure to deteriorate, and the deterioration of the jawbone structure causes the inability to breathe. All these are factors that constantly interact negatively with each other.

A child who can’t breathe properly can’t get enough oxygen either. This, in turn, can result in poor body and brain development. If the narrow upper jaw is left untreated, chewing functions will also be impaired. Because the food cannot be ground completely, digestive problems will occur in the individual.