Namine had an orthodontist appointment, but this was no ordinary visit. Today we discussed the upcoming dental work she will need.

In preparation of getting braces, Namine had to have a dental impression of her teeth. She had to do the same thing when she got the palatal prosthetic, but that was five years ago. Unlike then, she had to do it for the top and bottom teeth.

For at least two years, Namine’s orthodontic doctors have been telling us that she will need a jaw expansion. Now, this is no longer true. First, let me catch you up on what Namine has had so far.

Namine was born with Pierre Robin Sequence, which resulted in micrognathia (small/regressed lower jaw), cleft palate (not to be confused with cleft lip), and ankyloglossia (being tongue-tied).

Namine had several procedures to correct these defects: a tracheostomy tube to allow her to breathe; a palate closure; a jaw distraction to bring her lower jaw forward; decannulation (getting rid of the trache tube) and a partial frenectomy (tongue clipping) to improve her speech. (In the interest of full disclosure, I also have to mention Namine’s g-tube, which she needed to be able to eat. Due to her jaw and palate, she couldn’t swallow food without aspirating.)

As Namine’s adult teeth came in, they’ve been impacted — rubbing against each other due to the lack of room. We understood (as it was explained to us by doctors) that this was because of her small jaw. To fix this, she would need braces and one more major procedure: a jaw expansion. The expansion differs from the distraction she had by a matter of axis: the distraction elongated her jaw, but the expansion would widen it.

After seeing the dental team, however, we now know that Namine does not need a jaw expansion at all. Her jaw is small, but neither the upper or lower is out of alignment; widening it would not benefit her. She will, however, require four teeth to be pulled, in addition to having braces.

Namine has two baby teeth in her bottom jaw that have no adult teeth behind them. Because they have no adult teeth to push them out, they would never fall out on their own. Pulling them is the only recourse, and doing so will also make room for the remaining adult teeth.

The two teeth in the upper jaw which will be removed are out of alignment. They’re actually blocking the canines. Of the two types of teeth, the canines are more important; therefore, the two other teeth will be pulled.

After these four teeth are pulled, Namine will have braces to realign all her teeth.

This post is part of the timeline: Jaw Expansion – an ongoing story on this site. View the timeline for more context on this post.