In the next conversation of the Healthy LUDzik Club, we focused on a topic that often only comes up when a child already has permanent teeth – malocclusion. Are crooked teeth just a matter of genes? It turns out that they are not! Our interviewee, Dr. Izabela Cwalina-Sidor, a specialist in orthodontics, convinces us that as many as 80% of malocclusion problems have their source in environmental and functional factors that we can influence from an early age. What shapes our child's bite and face and how can we support their proper development? What habits can be harmful and when is it worth going for the first check-up with a specialist?

Genes or environment? What influences the development of malocclusion?

It is a common belief that malocclusion is inherited. Although genes play a role, Dr. Izabela Cwalina-Sidor emphasizes that the key factors are those that we can influence: "We now know that about 80% of this malocclusion and facial structure are the result of environmental factors," says the expert. The most important include:

• Breathing: Correct nasal passage versus harmful mouth breathing.
• Tongue position: Does it rest on the palate or lie low?
• Swallowing function: Is it mature or has the infantile type persisted?
• Habits: Thumb, finger, inappropriate pacifier sucking.
• Diet: Does it stimulate bone development through biting and chewing?

These elements, which have been in effect since birth, sculpt the developing facial skeleton of a child.

Thumb, pacifier, mouth breathing - what to watch out for?

Some habits and dysfunctions are particularly risky:

• Thumb sucking: Considered by the expert to be the most harmful. "The thumb really does a lot of damage to a child's facial development," she warns. The main problem is pushing the tongue to the bottom of the mouth and deforming pressure on the palate and teeth.
• Incorrect use of a pacifier: Although generally less harmful than the thumb, an ill-fitting pacifier (e.g. round, too large) or using it for too long can also perpetuate a low tongue position.
• Mouth breathing: Often associated with a low tongue position. It disrupts the development of the jaw (narrowing it), leads to malocclusions and incorrect head positioning, which can affect the posture of the entire body. "If a child breathes through the mouth and this tongue lies somewhere at the bottom (...) then a series of events happens like a cascade," explains Dr. Izabela Cwalina-Sidor, MD. The air entering through the mouth is not warmed, moistened and cleansed as when breathing through the nose, which can be associated with more frequent infections or ear problems (e.g. enlarged tonsils).
• Incorrect diet: Too soft, pulpy food does not stimulate muscles and bones to work and grow. A child needs hard foods to bite and chew.

Early check-up – the key to a healthy bite

So when should you go for the first check-up for bite development? Definitely before the appearance of permanent teeth!

"In fact, you can already (...) notice that something is wrong in the third or fourth year of life," says Dr. Izabela Cwalina-Sidor. "The fourth or fifth year of life is really the best time for this [first visit]. We already have all our baby teeth then. We (...) are able to see how this tongue functions, how this child breathes."

What will the specialist (pediatric dentist or orthodontist) assess?

• Symmetry and proportions of the face.
• Breathing pattern.
• Position of the tongue at rest and during speech/swallowing.
• Muscle tension around the mouth.
• Condition of baby teeth and development of dental arches.
• The presence of harmful habits.

Early detection of problems allows for the implementation of simple preventive or therapeutic measures, such as speech therapy exercises, elimination of habits, and sometimes the use of delicate devices supporting proper growth. "It is better to go prophylactically to correct something (...), than later have a really serious skeletal defect to treat" - emphasizes the expert.

The role of the parent: observation, support and cooperation

As parents, we have a huge impact on the health of our children's bite. The key is:

• Conscious observation: Pay attention to how the child breathes (is the mouth often open, especially at night?), how it eats, whether it sucks its thumb.
• Correcting habits: Gently but consistently eliminate thumb sucking; wean off the pacifier at the appropriate age (approx. 18 months), choosing an anatomical model in advance.
• Stimulation of biting: Give the child (appropriately to age) hard foods that require chewing.
• Collaborate with specialists: Don't postpone a visit to the dentist/orthodontist. The first check-up at the age of 3-5 is the perfect time. If necessary, cooperate with a speech therapist, physiotherapist or otolaryngologist - the development of the bite is related to the functioning of the entire body.

Remember that orthodontic treatment is often a long and expensive process. By investing time and attention in prevention at the earliest stages of development, we give our children a chance to avoid serious problems in the future.

Appeal to parents: Your awareness matters!

Dear parents, remember that taking care of your child's healthy bite is much more than just keeping an eye on brushing their teeth. It is a conscious observation of their development, correcting bad habits and early check-ups with specialists. Do not ignore the signals and remember - a healthy bite is not only a beautiful smile, but the foundation of correct pronunciation, breathing and the overall health of your LUUdzik.

The article was based on a conversation with Dr. n. med. Izabela Cwalina-Sidor, a specialist in orthodontics, conducted as part of the Healthy LUUdzik Club.