08/04/2026
Why timing matters: Skeletal Class 3
Did you know? Facial bones begin to solidify as children get older. This means early correction of skeletal discrepancies become less effective. Delaying care can worsen the skeletal discrepancy over time, and increases the chance of needing invasive surgery later.
Early orthopaedic correction also targets the underlying bony structures that support healthy breathing, which promote optimal sleeping patterns.
This 10 year old in mixed dentition (adult and baby teeth) presented with a skeletal Class 3 pattern, including:
· An under-developed maxilla (upper jaw)
· Anterior and posterior cross-bites (the upper teeth were locked in behind the lower jaw)
· A forward-rotated mandible (lower jaw), shortening the facial dimensions
Phase 1 early interceptive orthodontics was implemented, involving a fixed palatal expander with extra-oral facemask protraction for 8 months. This encouraged development of the maxilla, corrected the anterior and posterior cross-bites, and balanced facial proportions. A noticeable improvement in nasal breathing, and oropharyngeal space (lower airway) also occurred.
Phase 2 orthodontics will be the next step for this patient in a few years, to cosmetically straighten and align the adult teeth when they are older.
The takeaway: Early diagnosis and timely interception can make all the difference in managing Class III cases without surgery.
This content is for educational and general purposes only, and does not constitute personal dental or medical advice. A comprehensive assessment by a registered dental practitioner is required to determine your child’s individual needs, suitability for treatment, and appropriate care options.
Patient consent has been obtained for all images and videos, which are of real patients of registered dentists Dr Emily So (DEN0002001363) and Dr Alice Shan (DEN0001923772).
