Growth Modulation In Orthodontics & Paediatrics

What Is Growth Modulation?

Illustration of Growth modification

Growth modulation is a procedure where dental appliances are used to sculpt and mould the bone and faces of children. It is done to modify or manipulate a child’s jaw into a more natural, favourable position. When done early, growth modulation can correct deformities like underbites and overbites and perhaps even prevent the need for orthodontic treatment like braces or even surgery down the road.

Who needs Growth Modulation?

Many kids in Singapore can benefit from growth modulation so they can have beautiful, problem-free smiles as they grow older, and this procedure is especially recommended for children who show potential to develop serious underbites or overbites. This includes those with genetic tendencies in their families to develop serious underbites, which can lead to chewing or esthetic issues. It would be great to catch these developmental tendencies early so facial growth can be controlled and guided with a certified paediatric dentist.

What Can Growth Modulation Treat?

Growth modulation can effectively treat dental malocclusions in children, including:

  • Crowded/Crooked teeth 
  • Overbite or “bugs bunny teeth” or “protruding upper jaw” - Top front teeth extend beyond the bottom front teeth, resulting in abnormal tongue placement.
  • Underbite or “protruding lower jaw” - Lower jaw juts out past the top front teeth, affecting facial shape and impeding speech.
  • Open bite - The top and bottom anterior teeth don’t touch each other when the mouth is closed
  • Cross bite - Upper teeth fit inside of lower teeth, impacting facial symmetry.

What Happens If Malocclusions In Children (Eg. Overbite, Underbite) Is Not Treated?

Dental malocclusions in children can result in a serious array of problems, such as:

  • Speech problems 
  • Tooth decay 
  • Gum disease 
  • Mouthbreathing 

While dental malocclusions can certainly be treated with orthodontics, we can attempt to guide jaw formation and teeth eruption to decrease the need and length of orthodontic treatment. Growth modulation can help spot and correct such bite problems in children.

With that said, growth modulation cannot always entirely prevent malocclusion. It can, however, reduce the severity of the condition and hence simplify treatment. For example, a problem that might require corrective surgery in future can be treated in a much more non-invasive and gentle way.

When Is The Best Time To Do Growth Modulation?

It is best to bring your child in for an assessment before the age of 9, just before he/she enters puberty. At that age, we are already able to assess how the jawbones are growing in relation to your child’s teeth. Guidance of jaw growth is best carried out during puberty when the bones grow rapidly during their growth spurt. The best times to guide jaw growth would be 8 to 15 for girls and 9 to 16 for boys.

How Is Growth Modulation Carried Out?

You will first meet for a consult with Dr Nicole Ann Lee to give you an idea of what can be done. It depends on whether your child has a tendency for an underbite, overbite or has a very narrow arch. For children with bugs bunny teeth with a narrow arch, an upper removal appliance can be worn. The palate is expanded sideways with a plastic device, while the upper front teeth are retracted with a wire. This guides the eruption of this child’s teeth and prevents the occurrence of a traumatic bite.

Palatal expander for growth modulation
Little boy with mouthguard

Is Growth Modulation For Children Painful?

While this procedure may sound scary, growth modulation treatment should not be painful or uncomfortable at all in the hands of a trained pediatric dentist. Our paediatric dentist, Dr Nicole Ann Lee, works especially well with children, including children with special needs.

In order for treatment to be successful, however, patient compliance is extremely important.

With the correct treatment protocol, children can enjoy several advantages of growth mod treatment such as:

  • Better facial symmetry and alignment
  • Straighter teeth, overall harmonised jaw and smile
  • Correction of malocclusions such as overbite, underbite, crossbite
  • Decreased need for invasive treatments later in life
  • Better self confidence!


We look forward to answering any questions you may have in your pursuit of health, beauty and mind. Feel free to drop us a message right here.
International Building (Next to Lido)
360 Orchard Road #03-06/07
Singapore 238869

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    International Building (Next to Lido)
    360 Orchard Road #03-06/07
    Singapore 238869
    Mon to Fri: 9am to 5pm
    Sat: 9am to 1pm
    Closed on Sun & PH
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