Medically Reviewed by Dr. Catherine Murphy, DDS, MSD on September 28, 2026
Orthodontic treatments create more space for permanent teeth in growing children by widening a narrow upper jaw with a palatal expander, holding open the gap left by a baby tooth that was lost too early, and guiding jaw growth while the bones are still developing. When a child’s permanent teeth begin to emerge and the jaw does not have enough room to accommodate them, crowding, shifting, and misalignment can follow, and those issues tend to grow more complex over time. Orthodontic treatment during childhood, before the jaw fully matures, gives dentists a meaningful window to guide growth in a healthier direction.
At Floss & Co., Dr. Catherine Murphy and Dr. Martha Silva work closely with young patients and their families to assess jaw development and determine when to intervene. Their approach goes beyond straightening teeth. Our orthodontic consultations include an airway assessment, because how a child breathes and sleeps is just as important as how their smile looks.
Why Growing Children Run Out of Room for Permanent Teeth
Permanent teeth are larger than the baby teeth they replace, and they arrive over several years. If the upper jaw is narrow, if baby teeth are lost too early, or if the teeth are simply large for the arch, there may not be enough space for every permanent tooth to come in straight. Our overview of the life cycle of your teeth explains how this transition from baby to adult teeth unfolds.
Habits can play a role as well. Thumb sucking beyond age five, ongoing mouth breathing, and a tongue that rests low in the mouth can all influence how the upper jaw develops. When a baby tooth is lost early to decay or injury, neighboring teeth can drift into the empty space and block the path of the permanent tooth that was supposed to fill it.
Why Timing Matters in Children’s Orthodontic Treatment
Children’s jaws are still developing, which makes early intervention particularly effective. Unlike adult bone, a child’s jaw responds readily to gentle, consistent pressure, allowing orthodontic appliances to guide growth rather than force correction after the fact. This is the core principle behind Phase 1 orthodontics, also called early interceptive treatment.
The American Association of Orthodontists recommends that children see an orthodontist by age seven. An evaluation at that age does not mean treatment will start right away. In many cases, it simply lets our team monitor development and step in at the right moment if a problem appears.
What Phase 1 Orthodontics Addresses
Early orthodontic treatment typically takes place between the ages of 6 and 10, while a child still has a mix of baby and permanent teeth. The goal is to create the space those incoming teeth will need. Common issues treated at this stage include crossbites, underbites, severe crowding, and narrow arches. By treating these conditions early, we aim to reduce the likelihood of more involved treatment later and, in many cases, make future treatment shorter and more straightforward.
Treatments That Create Space for Permanent Teeth
Not every child needs the same approach. The right tool depends on whether the problem is a narrow jaw, a missing baby tooth, or teeth that are already starting to crowd. The table below summarizes the most common options used during Phase 1.
| Treatment | What It Does | Often Used When |
|---|---|---|
| Palatal Expander | Gradually widens the upper jaw to add room along the arch | The upper jaw is narrow, crowded, or in a crossbite |
| Space Maintainer | Holds open the gap left by a baby tooth lost too early | A permanent tooth is still years from coming in |
| Limited Braces | Aligns a few front teeth to make room or correct position | Front teeth are crowded, protruding, or in crossbite |
| Monitoring | Tracks growth and eruption with periodic checkups | Development looks on track, or treatment is best timed later |
How Palatal Expansion Works
One of the most common tools in early orthodontics is a palatal expander, a device that gently widens the upper jaw over a period of months. Because a child’s palate has not yet fused, gradual pressure can actually expand the bone itself, not just shift the teeth. A 2024 study published in PubMed Central found that early intervention with palatal expansion was effective for correcting maxillary crowding, with shorter treatment duration and greater improvement than late orthodontic treatment, reinforcing the value of intervening during the growth window. Once the jaw has widened, newly erupted teeth have the room they need to come in properly.
How Space Maintainers Protect Room for Permanent Teeth
Baby teeth do more than help a child chew. They also hold space for the permanent teeth developing underneath. When one is lost early, a space maintainer, a small custom appliance, keeps the neighboring teeth from drifting into the gap. That preserved space gives the permanent tooth a clear path when it is ready to erupt, which can prevent crowding that would otherwise need correction later.
Signs Your Child May Benefit From an Early Evaluation
Some space problems are easy to spot at home, while others only show up on imaging. These are a few of the signs that are worth mentioning to our team.
Noticing one of these signs does not always mean your child needs treatment. It does mean an evaluation can help you understand what is happening and whether early care makes sense.
How Palate Expansion Can Improve Breathing and Sleep in Children
One detail that often surprises parents is how closely jaw structure is tied to breathing. A narrow upper arch does not just crowd teeth. It can also restrict the nasal airway, contributing to mouth breathing, snoring, and disrupted sleep in children. This is why airway-focused orthodontics is at the heart of what we do at Floss & Co.
When we expand the palate and create more room in the upper jaw, we are also widening the floor of the nasal cavity. Many children who complete early orthodontic treatment breathe more freely as a result. For families who have noticed signs of pediatric sleep apnea or poor sleep quality in their child, this connection is worth exploring with our team. Our post on how airway expansion can improve your child’s breathing goes into more detail.
What the Early Treatment Process Looks Like
Every child’s plan is different, but most families move through the same general stages from the first visit to the end of Phase 1.
If you would like to know what that first visit involves, our guide to your first orthodontic consultation walks through it in detail.
What to Expect After Phase 1
Most Phase 1 treatment plans last approximately 12 to 18 months, depending on the issues being addressed, followed by a resting period during which we monitor the development of the remaining permanent teeth. Some children will need Phase 2 treatment, such as braces or clear aligners, once all permanent teeth have erupted. However, Phase 1 can often reduce the complexity and duration of the second phase.
Here are some of the outcomes families commonly see after early orthodontic treatment:
- More space: Permanent teeth have room to erupt without crowding or twisting
- Improved bite: Crossbites and underbites are corrected while the jaw is most responsive
- Better breathing: A widened arch supports improved nasal airflow
- Shorter Phase 2: With space already established, later orthodontic treatment is often simpler
Completing early treatment gives a child’s smile a much stronger foundation to build on in the years ahead.
Start Your Child’s Smile Off Right at Floss & Co.
Orthodontic treatment for growing children works best when it starts at the right time, and our team is here to help you figure out when that is. Dr. Murphy, who completed her orthodontic residency at Indiana University School of Dentistry and focuses on expansion over extraction, and Dr. Silva, who works well with children of all ages, take the time to understand each child’s development before recommending any treatment. Floss & Co. also offers flexible financing options, including CareCredit, making it easier for families to move forward.
If you are wondering whether your child could benefit from early orthodontic care, we would love to take a closer look. Reach out to our team to schedule a consultation and take the first step toward a healthier, more confident smile for your child.
Frequently Asked Questions About Creating Space for Permanent Teeth
At what age should my child have their first orthodontic evaluation?
The American Association of Orthodontists recommends a first orthodontic visit by age seven. At that point, a mix of baby and permanent teeth is present, so our team can spot crowding, bite problems, or a narrow jaw early. Many children simply need monitoring, while some benefit from starting Phase 1 treatment.
Does a palatal expander hurt?
Most children feel pressure rather than pain, usually in the first few days after the expander is placed or adjusted. Some notice tightness across the roof of the mouth or near the nose. Soft foods and over-the-counter pain relief approved by your pediatrician can help, and the sensation typically fades as your child adjusts.
What is a space maintainer and when is one needed?
A space maintainer is a small custom appliance that holds open the gap left by a baby tooth lost earlier than expected. It keeps neighboring teeth from drifting into that space, so the permanent tooth has room to erupt when it is ready. It is usually removed once the permanent tooth begins to come in.
Will my child still need braces after early orthodontic treatment?
Some children do and some do not. Phase 1 focuses on creating space and guiding jaw growth, and some children still benefit from Phase 2 treatment with braces or clear aligners once all permanent teeth are in. When it is needed, Phase 2 is often shorter and simpler because the groundwork has already been laid.
Can early orthodontic treatment help with mouth breathing or snoring?
It can in some cases. Widening a narrow upper jaw also widens the floor of the nasal cavity, which may support easier nasal breathing. Snoring and mouth breathing have several possible causes, so our team includes an airway assessment during orthodontic consultations and may coordinate with your child’s physician when needed.
About the Author
Dr. Catherine Murphy, DDS, MSD
Orthodontist, Floss & Co.
Dr. Catherine Murphy earned her Doctor of Dental Surgery from Indiana University School of Dentistry and her Master of Science in Dentistry through an orthodontic residency at the same institution. She has taught as adjunct clinical faculty, co-created the Take3ForMe self-care movement, and brings a holistic approach to orthodontic care with a focus on expansion over extraction.