Experts Say: Help with Teeth

Worried about your child’s teeth? Read on.


My daughter who is three has buck teeth while the teeth on the bottom row are a little twisted and crooked. She sucks her thumb and I am worried that may affect her permanent teeth. Do I need to look at getting her braces once her permanent teeth are in?


Prolonged thumb sucking and other sucking habits e.g. pacifier use can cause crooked teeth. Having ‘buck teeth’ where the upper front teeth flare out is a common finding. This is due to the forward pushing forces of the sucked finger on the upper front teeth. As the finger also rests on the lower front teeth, it is not uncommon for these teeth to recline backwards, resulting in the crooked alignment that you have observed. Apart from teeth, extended sucking habits can also cause changes to jaw development. The upper jaw can become narrower as the sucking forces mould the upper jaw inwards, around the thumb. The reduced space in the jaw can further worsen the crowding of the teeth.


Orthodontic treatment may be necessary if any teeth and jaw issues persist as the permanent teeth erupt. Orthodontic braces use wires and little attachments (called brackets) that are glued onto teeth to improve alignment. These are not removable. Correction of a narrow jaw may require separate treatment such as wearing an orthodontic appliance which may resemble a retainer. This aims to improve the growth of the narrowed jaw.  Very flared upper incisors are 4 times more likely to sustain dental injuries due to trauma. Children may be teased about their teeth and this can have an impact on their psychosocial wellbeing. Hence, for some children, we consider starting correction early.


Correction can commence as early as 7 years of age. This is a targeted treatment, designed with a focus on improving any jaw issues as well as the alignment of the front teeth. However, orthodontic braces are no longer the only way to correct the front teeth. Some children feel more conscious of their teeth when braces are put on. These children may be more suitable for a newer treatment called Myobrace, which resembles a sports mouthguard and is removable. The Myobrace system harnesses the strength of her own facial muscles to realign the teeth naturally. A big advantage is that this can be worn in the comfort of her home, without the need to wear it to school.


Fortunately, your daughter is still young and her teeth and jaws still have the ability to self-correct with the cessation of the habit. This means her ‘buck teeth’ have the potential to line up nicely in the jaw once she stops sucking her thumb. 


Consider starting with gently bringing awareness to the sucking habit. Many books have been written depicting how another child or animal character is trying to kick the habit. Reminders to keep her finger out of her mouth may also come in the form of motivational reward sticker charts. Other parents have tried putting a band-aid or bitter tasting solutions on the thumb but results are varied. Commercially available thumb guards or special dental appliances can be used as reminders to wean off the thumb habit. Your paediatric dentist will be able to discuss which option is best suited to your child’s needs. 



Questions answered by:

Dr Tabitha Chng

Paediatric Dentist

Thomson Specialist Dentistry

Thanks for sharing!