Upper Jaw Deficiency in Children: Symptoms, Causes & Treatment Options
- Dr Srinivasa Rao Bogavilli
- 2 days ago
- 5 min read
Introduction
A well-developed upper jaw (maxilla) is crucial for facial harmony, proper breathing, and a healthy bite. When the upper jaw does not grow as expected, it may result in a condition known as upper jaw deficiency or maxillary hypoplasia. Left untreated, it can lead to functional, aesthetic, and even psychological challenges.
Early diagnosis and intervention are key — especially during the growing years to guide the jaw’s natural development and avoid more complex treatments later.
What is Upper Jaw Deficiency?
Upper jaw deficiency, also called maxillary deficiency, refers to underdevelopment of the maxilla in size, position, or width. It may appear as:
A narrow dental arch
A retruded midface (flat cheeks)
Posterior or anterior crossbite
Crowded upper teeth
An open mouth posture
This condition is more than just an orthodontic issue — it affects facial structure, speech, breathing, and self-esteem.
Causes of Upper Jaw Deficiency
Several factors can contribute to poor upper jaw growth in children:
Genetic predisposition
Prolonged mouth breathing due to nasal obstruction
Thumb-sucking or pacifier use beyond age 3
Tongue thrusting or improper swallowing patterns
Cleft palate or craniofacial syndromes
Lack of proper muscular stimulation during growth
Common Symptoms and Signs
If your child shows any of these, an orthodontic evaluation is highly recommended:
🔹 Narrow smile and Narrow Arch
🔹 Posterior or anterior crossbite
🔹 Difficulty breathing through the nose
🔹 Frequent mouth breathing during sleep
🔹 Crowded upper front teeth
🔹 Flat cheeks or sunken midface
🔹 Snoring or sleep-disordered breathing
🔹 Low tongue posture
Complications if Left Untreated
Upper jaw deficiency can lead to long-term problems like:
Chronic mouth breathing
Obstructive sleep apnea risk
Difficulty in chewing, swallowing, and speaking
Jaw joint (TMJ) pain
Midface hypoplasia
Social challenges due to facial imbalance
Treatment Options for Upper Jaw Deficiency
The goal of treatment is to stimulate jaw growth, create space for teeth, and restore facial balance. Treatment depends on the child’s age and severity of the deficiency.
1. Palatal Expanders
Palatal expanders are commonly used between ages 7–12, when the maxillary suture is still open. These devices:
Gradually widen the upper jaw
Correct crossbites
Create space for erupting teeth
Improve nasal airflow
Types include:
Hyrax expander
Haas expander
Quad-helix
2. Face Mask Therapy (Reverse Pull Headgear)
Used in growing children to bring the upper jaw forward, especially in Class III malocclusion cases. Often combined with a palatal expander.
3. Growth Modification Appliances
Functional appliances like the Frankel appliance or Protraction facemask help redirect growth in the upper jaw during mixed dentition years.
4. Braces (post-expansion)
Once enough space is created and the jaw is in position, braces (Metal Braces or Ceramic Braces or Damon braces or Lingual braces even Invisalign aligners) are used to align teeth into proper bite relationships.
5. Orthognathic Surgery (Adults)
If upper jaw deficiency is diagnosed after growth completion, surgery like SARPE (surgically assisted rapid palatal expansion) or Le Fort I osteotomy may be needed.
Ideal Age for Upper Jaw Deficiency Treatment
The best results come when treatment begins during the growth phase (ages 7–12). Early intervention:
Takes advantage of natural bone flexibility
Prevents worsening of crossbites or crowding
May eliminate the need for surgery later
An orthodontic evaluation is recommended as early as age 7, especially if your child shows any of the signs mentioned above.
Real-World Success Story:
Correcting Upper Jaw Deficiency Transformed Aarav’s Life
Aarav, a 15-year-old student, had always struggled with chronic mouth breathing, frequent sinus infections, and a noticeably concave facial profile. His parents noticed he avoided smiling in photos and often complained of poor sleep.
Upon evaluation, Aarav was diagnosed with maxillary hypoplasia (upper jaw deficiency). Due to his age and completed growth, we recommended a two-phase surgical and orthodontic approach:
Phase 1: Surgically Assisted Rapid Palatal Expansion (SARPE) to widen the upper arch and improve nasal breathing.
Phase 2: Le Fort I osteotomy to advance the maxilla and align his bite.
Post-treatment, the results were life-changing:
Aarav’s facial profile became more harmonious and confident.
His nasal breathing significantly improved.
He began sleeping better and felt more energetic throughout the day.
Most importantly, his self-esteem skyrocketed—he even gave a speech at school with a big, confident smile.
FAQ
1. What is upper jaw deficiency and how can I know if I have it?
Upper jaw deficiency, or maxillary hypoplasia, is a condition where the upper jaw does not grow forward enough. This can cause a sunken midface, crossbite, open bite, or breathing issues. Common signs include flat cheeks, mouth breathing, and a concave facial profile.
2. What causes upper jaw deficiency in children or adults?
Upper jaw deficiency can be genetic or developmental. It may occur due to:
Family history of jaw imbalance
Habitual mouth breathing
Early loss of baby teeth
Cleft palate or craniofacial syndromes
3. Can braces fix upper jaw deficiency?
Braces alone may not be enough if the problem is skeletal. For growing children, functional appliances or face mask therapy can help guide jaw growth. In adults, surgical treatment like Le Fort I osteotomy may be required for complete correction.
4. What is Le Fort I osteotomy and when is it needed?
Le Fort I osteotomy is a surgical procedure to move the upper jaw forward. It’s commonly recommended when upper jaw deficiency is diagnosed after growth has completed and orthodontic appliances alone can’t fix the bite or facial profile.
5. Is upper jaw deficiency related to breathing problems or sleep apnea?
Yes. A retruded upper jaw can narrow the airway, leading to chronic mouth breathing, snoring, and in some cases, obstructive sleep apnea. Treating the jaw deficiency often improves breathing and sleep quality.
6. How is upper jaw deficiency treated in children?
In children, growth modification techniques like:
Palatal expanders (SARPE)
Face mask therapy (reverse pull headgear)
Functional appliances (e.g., Frankel, twin-block)
...can be used to guide proper jaw growth without surgery.
7. Can upper jaw deficiency affect facial appearance?
Absolutely. A deficient upper jaw can make the face look sunken, give the appearance of a protruded lower jaw, and affect the harmony between the nose, lips, and chin. Correcting it significantly improves facial balance and smile aesthetics.
8. Is surgery for upper jaw deficiency safe and effective?
Yes. When done by a qualified oral and maxillofacial surgeon, Le Fort I osteotomy and SARPE procedures are very safe and deliver predictable results. They’re often combined with braces for complete orthodontic correction.
9. What age is ideal for treating upper jaw deficiency?
Best age (non-surgical): 7–14 years (growth phase)
Best age (surgical): After growth completion (~16–18 years for girls, ~18–21 for boys)
Early diagnosis by an orthodontist is key to choosing the right approach.
10. How long does treatment for upper jaw deficiency take?
Non-surgical orthodontic treatment may take 12–24 months
Surgical orthodontic treatment (pre-surgical braces + surgery + post-surgical braces) may take 18–30 months
Your orthodontist will customize a plan based on your age and jaw structure.