My discussions with parents sometimes come around to the topic of pediatric dental appliances. I’ve noticed that the word “appliance” makes some parents think I’m about to recommend an orthodontist.  In fact, dental appliances and orthodontic appliances are not the same thing. I work with dental appliances. Since my patients are children, they’re pediatric dental appliances. Let’s go over the types I most often use in my practice.


I recommend mouth guards for two purposes.  One is to manage tooth grinding, sometimes called “bruxing”.  About 30% of all children get into this behavior at some point. Grinding commonly happens at night during deep sleep. Most kids grow out of it, but we want to minimize the risks of complications until it does. In addition to enamel wear, grinding can cause serious issues like TMD. The other reason for mouth guards is preventing trauma. Getting a tooth knocked out or chipped is certainly never good, not even a baby tooth. Therefore, kids playing sports or doing anything that risks dental trauma should wear mouth guards. You can read up on the types of guards, fitting, and costs here. Mouth guards are the pediatric dental appliances I recommend the most.


We’ve discussed some of the issues around the thumb-sucking habit here. As with bruxing, this behavior is common and commonly goes away on its own. Our aim with thumb sucking to discourage and “train away” the habit. If the more conservative approaches don’t work, I can install an appliance. It looks a little like an older kid’s retainer.  It stops the child’s thumb from reaching the “sweet spot”, the roof of his or her mouth. Thus, the habit is less rewarding and more likely to fade away.


Kids may need space maintainers when they lose a baby tooth prematurely. Baby teeth are nature’s space maintainers. That is, they hold places for permanent teeth until they’re ready to erupt. Premature loss of a baby tooth opens the door to dental and later orthodontic complications we want to avoid.  Pediatric space maintainers come in two types, fixed and removable.  Fixed maintainers assure constant pressure, and don’t get lost. In contrast, removable maintainers are easier to clean and offer the comfort option of taking them out.


Expansion devices are installed to stretch and widen the upper arch. This provides space for upper teeth to realign properly, and in some cases prepare the jaw for surgery. In contrast, bionators correct certain abnormalities in jaw development.

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