Pediatric Bite and Occlusion Assessments in Lexington, KY

During an occlusion evaluation, we check whether the jaws have room for the permanent teeth and tongue, and whether the face is growing in balance:

• Jaw width, so the front permanent teeth fit without crowding
• Jaw depth, so the permanent molars have room at the back
• Jaw height, so the tongue rests in the mouth, not the throat
• Facial balance across the cheeks, nose, jaws, and chin
• How the teeth meet, including any shift when your child closes

We weigh all of this against your child’s age, because a bite that looks fine at 4 can be a concern at 9.

A good time for a first bite check is once all the baby teeth have come in, usually between ages 2 and 3. We can screen at any age, though. Early checks matter because the upper jaw does much of its growing in early childhood. If we notice a narrow palate or a lower jaw that’s falling behind at age 3, there’s a long stretch of growth ahead to guide it. You may have read that orthodontists recommend a first visit by age 7. It’s still a sound milestone, but your child doesn’t need to wait that long for a first look.

Malocclusion simply means a bad bite, where the teeth or jaws don’t line up the way they should. In kids, it can look like rotated or crowded teeth, teeth that aren’t symmetrical side to side, or upper and lower teeth that don’t close together comfortably. Malocclusion in children affects more than appearance. It can be a sign that a child’s oral posture is off, such as the tongue resting low or the lips staying apart, which can put a child at risk for airway issues. That’s why we always ask what’s causing the crooked teeth.

Most bite problems in kids involve crowded teeth, jaws out of harmony, or teeth meeting in the wrong direction. Common ones include:

• Crowding, where teeth come in rotated or out of position for lack of room
• An upper or lower jaw that sits too far forward or too far back
• A crossbite, where lower teeth close outside a narrow upper jaw
• A deep overbite, where the upper front teeth cover too much of the lower ones
• An open bite, where the front teeth don’t meet when the back teeth close

Orthodontists usually sort these into seven common bite patterns, from crowding to protrusion, and many children have more than one.

An excessive overbite, also called a deep bite, often happens when the lower jaw is held too far back, so the upper front teeth end up covering too much of the lower ones. Some overlap is normal. The concern is when it’s deep. Other causes we look for include:

• Mouth breathing instead of nose breathing
• Where the tongue rests in the mouth
• Muscle movements during chewing and swallowing that aren’t working properly
• An imbalance between the pressure from the tongue and the cheeks

Several of these are habits or posture rather than tooth position, so the cause we find shapes what we recommend.

A crossbite is when some lower teeth close outside the upper teeth instead of inside them, and it’s a common sign that the upper jaw is underdeveloped. Treatment depends on your child’s age and what’s behind the narrow jaw. A crossbite in children rarely fixes itself, and it can make the lower jaw slide to one side every time they bite. Some kids just need monitoring. Others do better with growth-guided care while the jaw is still developing, which is usually simpler than correcting it later.

An open bite is when a child closes their back teeth together and the front teeth don’t touch or overlap. One of the most common causes is a soothing habit, like thumb sucking or a pacifier, that keeps pressing the front teeth apart. Tongue thrusting during swallowing and mouth breathing can play a part too. When the cause isn’t obvious, a careful look at posture, swallowing, and jaw growth helps sort it out. If a habit is involved, we’ll talk with you about gentle ways to help your child let it go at a comfortable pace.

Yes. The tongue signals the upper jaw to grow broad and forward. When it rests up against the roof of the mouth, the upper jaw gets that cue and develops with room for the teeth. A low tongue posture removes the signal. The jaw then tends to grow narrow and sit lower than it should, which can lead to crowding, a crossbite, or an open bite. It can also make breathing harder. An underdeveloped upper jaw usually means less space behind the nose, so nasal breathing gets more difficult, and a child who struggles to breathe through the nose often breathes through the mouth instead. That habit keeps the tongue low and the cycle going. Mention these at your child’s visit:

• Sleeping with the mouth open
• Snoring or noisy breathing at night
• Lips that stay apart during the day

Because these signs overlap with airway health, a bite check here often turns into a bigger conversation about breathing and sleep.

After the assessment, we explain what we found and talk through the path that fits your child, whether that’s routine monitoring, habit or posture support, or a closer look at treatment. Many kids simply need a recheck at future visits. If a habit or tongue posture is involved, we start there. When jaw growth needs guidance, we’ll walk you through our early orthodontic treatment options and the timing that fits your child. You’ll never be rushed into a decision, and you’re welcome to call with questions later.

A bite check here looks at breathing, posture, and growth along with tooth position. Dr. Kevin White is a Diplomate of the American Board of Pediatric Dentistry and served as Chief Resident during his pediatric dental residency at Ann & Robert H. Lurie Children’s Hospital. What that means for your child:

• Bite screening that starts in the toddler years
• Findings tied to airway, tongue posture, and sleep, so we treat the cause
• A prevention-first approach that favors monitoring when that’s enough
• Plain explanations at every visit

Bite checks also connect to the rest of our pediatric dental services, from cleanings to airway and sleep assessments, all under one roof.