Topic Overview

Growth modification (early treatment) is part of the first phase of
two-stage orthodontic treatment of children with
malocclusion (poor bite). Growth modification is only
possible when bones are still growing. It is most effective during children’s
growth spurts.

Orthodontists use growth modification devices (appliances) to change
the position, shape, length, or width of the jawbone(s). Some common devices

  • Headgear, an appliance that uses pressure to
    guide teeth and jaw growth.
  • Herbst, an appliance attached to the
    upper and lower molars that corrects overbite caused by a small lower
  • Bionator, a removable appliance that guides teeth and jaw
  • Palatal expander, an appliance that corrects cross bite by
    widening the upper jaw.

What to think about

Ideal timing of treatment varies depending on what the condition is, when
adult teeth come in, and how much growth is needed to correct the
malocclusion. Many children who begin growth modification in second or third
grade are finished with orthodontic treatment before they begin high

Children are often more cooperative than teenagers when it comes to
wearing their appliances for a certain number of hours a day. And children don’t
seem to mind closer parental supervision as much as teens do. But the
parent and the health professional must also beware of “burning out” the child
on treatment before the second stage of treatment-braces-begins.

Because the jaw continues to grow during childhood and adolescence,
growth modification doesn’t always last. Some teens and adults keep their new
jaw structure and size, while others have short-lived improvement. Relapse can also occur after treatment with braces alone.

Related Information


ByHealthwise Staff
Primary Medical Reviewer Adam Husney, MD – Family Medicine
Specialist Medical Reviewer William F. Hohlt, DDS – Orthodontics

Current as ofMay 7, 2017