When it comes to jaw alignment issues, I tell parents that treatment is not always necessary at a young age, but it is important to get evaluated early.
A common problem I see in teenagers and adults is that their upper and lower jaws do not line up properly, from front to back, side to side, and, to some degree, up and down. Most of the skeletal structures are well established by the time you are a teenager, so if the jaw is in the wrong position you have to decide if you want to correct the jaw-to-jaw relationship—often through surgery—or camouflage it. However, if the jaw alignment is evaluated at a young age, I can recommend different types of preventative treatments before the jaw is, so to say, “set in stone” to the altered position.
The most common problem is when the upper jaw is too narrow, and since the lower teeth cannot sit inside the arch of the upper jaw, they tend to slide to one side. This issue can be treated with an expander to address the resultant asymmetry before it happens. In other cases, where not only is the chin off center but one side of the face is taller than the other, it is very complex to treat later in life. However, in a young child we can position the jaw symmetrically and hold it in that place, similar to how curved spines are treated in children with scoliosis.
Depending on each case, I use either dental appliances that are removable or some that are glued in to hold the jaw in the correct position.
Other jaw alignment problems are the result of breathing issues due to tonsils and adenoids, so if that is the case I refer them to a specialist in otolaryngology (ear, nose and throat). If you cannot breathe through your nose, you tend to drop your jaw down to open up the airway or push it forward, which can cause open bites and underbites.
By screening for these problems when a child is three to six years old, you can correct the underlying problems and avoid more issues later in life.