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Making Room for Adult Teeth

April 5, 2023

In this lecture clip, Dr. Rebecca Bockow explains how when a child's jaw doesn't have enough room for their adult teeth, many orthodontists will recommend removal. But Dr. Bockow has a different perspective. As the mother of one of her patients said, "There has to be a different way!"

Dr. Rebecca Bockow is a dual-trained board-certified orthodontist and periodontist – one of only a handful in the country. She lectures nationally on periodontics, orthodontics, interdisciplinary orthodontics, airway, and skeletal growth and development.

"This young man came to us once again, age six, and the mom said, "Dr. Bockow, I don't think we have enough room for all four lower teeth." And she's right. We don't. Once again, a lot of orthodontists in the area said, "Well, why don't we start taking out teeth?" And she said, "There has to be a different way." So we did upper and lower expansion. And we created more space for the teeth.

"How many incisors do we have here? Four lower incisors – the teeth are still upright and centered in the bone, and so we see plenty of space now, and we see plenty of space for the upper teeth. Now, here's where it gets really exciting, if it isn't exciting enough yet, but we follow these kids over time.

"And so this is a - this is called a lip bumper. He's using it as a nighttime retainer. And what I love is to see that there's plenty of room for the adult teeth to come in. Notice that these teeth are centered in the bone. There's plenty of soft tissue support. We can now load these teeth along their long axis of occlusion.

"So it's not just about airway. This is about dental health. This is about bone health. This is about soft tissue health. So, following these kids over time six, eight, twelve. Now, he's ready for phase two orthodontics. Right? And Mom says, "Well do we really need to do anything", and it really becomes more about alignment."

Dr. Bockow loves to create beautiful smiles for her patients, setting them up for a lifetime of dental and airway health.

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