6 min read

How We Treat Asymmetrical Growth and Midline Deviation

When you think of the perfect smile, you probably think of perfectly aligned, white, evenly spaced teeth and a pleasing curve to the mouth. When you think of a young child about six or seven years of age, do you usually find that perfect smile described above? No! By the time they start to lose their baby teeth, you may see teeth of all different sizes, shapes, and positions as their permanent teeth erupt through their gums. While this is an ordinary sign at this age, you may also begin to see misalignment of the teeth such as asymmetrical growth or midline deviation.

What is a Midline Deviation?

To understand a midline deviation in the teeth, think of the space between the two front top and bottom teeth not lining up. Have you ever noticed the asymmetrical smile of Tom Cruise? Early in life, he suffered a hockey injury and had his right upper front tooth capped. It now sits in the middle of his upper mouth, with the two upper front teeth shifted to his left, no longer aligned with his nasal septum. While this midline deviation has become something for which he is known, your child may not want the same notoriety in the future!

What is Asymmetrical Growth?

Facial asymmetry is a difference in the size or observation of the right and left sides of the face. The lower half of the face is often more affected than the upper face. Every individual has some asymmetry, but our orthodontists can correct the more apparent deviations in the mouth and jaw.

At your child’s regular dental exams, we track the growth of the new teeth and identify any asymmetry (uneven development) that may need treatment in the future. This includes attention to the facial structure, which may show a jaw shift or more fullness on one side or the other.


Asymmetrical growth and midline deviation of the mouth can be from multiple causes:

  • genetics
  • severe crowding
  • missing teeth
  • trauma to the jaw or soft tissues in the mouth
  • jaw alignment problems
  • prolonged thumb sucking or pacifier use
  • nail biting
  • teeth grinding
  • Temporomandibular Joint Dysfunction (TMJ)


Managing facial asymmetry or midline deviation of the mouth begins when the patient, parent of the child, or our dentists first note it. Early detection and treatment can start when the child or adult patient is first seen and can minimize further complications. Difficulty chewing food, uneven wear on teeth, jaw-related issues, and headaches are a few of the adverse effects of poor dentition. The first line of defense is preventing misalignments like midline deviation due to preventable causes (prolonged thumb sucking or pacifier use, nail-biting, teeth grinding, injury, or loss of teeth due to cavities). Although we cannot do anything about genetics, most of the other causes can be addressed before creating lasting damage. Younger children's mouths are still developing, so early treatment is more manageable and can prevent greater misalignment from developing. So, the American Dental Association recommends beginning treatment between 8 to 14 years of age, but adults can also successfully complete treatment.


Treatment options will be addressed and thoroughly explained. Custom treatment plans will be created depending on what treatments are necessary to create a healthy alignment, and we will take into account your goals, finances, and lifestyles.

Early in the intervention process, our team will take the necessary diagnostic tests and review them to conduct a comprehensive smile analysis. For children, the development of more significant orthodontic problems can be curbed with a conservative approach to treatment, and guidance to stop harmful habits such as prolonged thumb sucking and grinding of the teeth. These practices can change the shape of the teeth and jaws as they grow.

As the need for correction becomes apparent, our staff can discuss the many orthodontic options that meet your budget, needs, and lifestyle:

  • Metal Braces

    This option has long been used and can correct your bite, help asymmetrical growth, midline deviation, and improve the function of the teeth. The advantage of the self-ligating bracket system used by Jungle Roots is the need for fewer appointments for placement of the braces, fewer orthodontist visits for adjustments, and shorter treatment times because the teeth move efficiently. Also, these braces have a low profile which provides increased comfort for the wearer.

  • Clear Braces

    An alternative to metal braces is the option of having clear braces. They deliver the same treatment benefits and provide maximum discretion. The clear braces are also self-ligating and all of the same advantages as metal braces are available. The difference is their color. They are designed to match your teeth' color and shade and are undetectable from a distance. Clear braces won't be nearly as visible in photographs!

  • Invisible Braces

    Our practice also has the latest in clear aligner "invisible" braces to offer our patients. A great alternative to brackets and wires, clear aligners can achieve the same great results as the treatment options of metal or clear braces for many patients.

  • Rubber Bands

    Elastic (rubber) bands may need to be worn with the braces to apply tension to one or more of the teeth. This will allow them to move in ways that the braces alone would not. They have connection points on the upper and lower jaw or in between the teeth on the same level, to create precise movement of the teeth. This is used to help individual teeth to move and has often been used for correction of overbite, underbite, or midline shift. Our orthodontic professionals will fit the elastics to create the exact force necessary to move your teeth where they need to be. Removable elastics (inter-arch) attach to the hooks connected to the brackets on the teeth. They come in different sizes that each exert a specific amount of force, and can be removed before eating and then replaced by the wearer or a parent after they finish the meal. It is best to remove them only for 30 minutes or less. You can choose your favorite colors to wear!

  • Palatal Expanders

    Another treatment option that some patients will need is a palatal expander. This is attached to the teeth and expands the entire upper jaw from its position in the roof of the mouth. A key is used to widen the appliance when adjustment is done by the orthodontist. The expander holds this position so that the person wearing it (and the teeth!), can adapt to their new position. Usually, this is worn from four to nine months.

With braces and palatal expanders, there may be a period of soreness after they are placed or adjusted. It is important to wear them constantly for your mouth to get used to them. The discomfort usually subsides within a week’s time. Eating soft foods will help, and drinking cold smoothies will soothe the mouth without having to chew!

Surgical Treatment

Education for our patients and the parents of our patients is our number one priority. Preventative treatment is always encouraged when seeing young children and followed up with orthodontic procedures if needed. Because our staff takes a conservative approach to treating any issue in the mouth, surgical options are always avoided unless absolutely necessary.

Extraction of teeth may occasionally be necessary prior to the application of braces. Removing specific teeth can allow spacing for teeth to be manipulated by the orthodontist, and the braces can pull or push the teeth into the correct alignment. Should extraction or surgical treatment be required, our dental professionals will thoroughly discuss what this entails and answer all concerns directly.

Summing it Up

When they have teeth erupting, a child's oral health should be as important as physical well-being. As they mature and their baby teeth fall out, alignment of a child's jaw and permanent teeth are examined at every appointment at Jungle Roots. Our staff will observe any asymmetrical growth and midline deviation and address any issues as soon as they are identified. Preventative techniques will be encouraged when a harmful habit is recognized, and hopefully, these measures can deter any misalignment of the growing child's teeth. When a child's permanent teeth are in place, we can discuss and provide any orthodontic treatment needed, such as metal or clear braces, clear aligners, or even a palatal expander.

Whether you or your child are seeking correction for asymmetry or midline deviation, we'll explain the options thoroughly, and a comprehensive treatment plan will be created to meet the goals for your optimal oral health, keeping budget and lifestyle in mind. Feel free to contact our office at any time to set up your or your child's complimentary orthodontic consultation. We love to help our patients create their healthiest smile!

At Jungle Roots Children’s Dentistry & Orthodontics, we strive to provide the highest comprehensive pediatric and orthodontic dental care in a unique, fun-filled environment staffed by a team of caring, energetic professionals. We believe the establishment of a “dental home” at an early age is the key to a lifetime of positive visits to the dentist.

Call Us - (480) 759-1119

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