Dr Aya El Hamalawy

08/10/2026

She didn’t need to wait for all her adult teeth to come through. 🦷✨

This patient was still in mixed dentition, with significant upper crowding and an anterior crossbite — where the upper front teeth bite behind the lower teeth.

Why does that matter?

An anterior crossbite can sometimes cause a child to shift their lower jaw to find a comfortable bite. If that functional shift is left during growth, it can contribute to an altered closure pattern, uneven tooth wear and uneven loading of the jaw joints and muscles.

By intervening during growth, we were able to create space, correct the crossbite and establish a much more favourable bite while her adult teeth are still coming through.

And importantly, this doesn’t mean every child needs orthodontic treatment early.

Sometimes “wait and see” is absolutely the right approach.
Sometimes timing matters.

Early assessment doesn’t always mean early treatment — it means knowing what can safely wait and what may be better addressed during growth. 🦷🌱

05/10/2026

“They’re only baby teeth… let’s just wait and see.” 👀

Sometimes, that’s exactly the right approach.
But sometimes, timing matters.

These are 3 signs that would make me look a little closer rather than automatically waiting for all the adult teeth to come through:

1️⃣ Mouth breathing / open-mouth posture
Persistent mouth breathing can be associated with nasal or airway obstruction and altered tongue and lip posture. I’m interested in why a child is mouth breathing, not just whether their teeth are straight. Depending on the findings, this may mean working alongside ENT or other appropriate clinicians.

2️⃣ A significant anterior crossbite
When the lower teeth sit ahead of the upper teeth, particularly where there is an underlying jaw discrepancy, I don’t like to simply assume a child will grow out of it. In selected growing children, early assessment can help us decide whether interceptive treatment may be beneficial while growth is still on our side.

3️⃣ Significant crowding / a very narrow arch
Crowding isn’t always simply about “not having enough room for the teeth.” I’m looking at the width and shape of the dental arches, eruption space and underlying jaw development to understand why that crowding is happening.

And this is the important bit:

Early assessment does NOT mean every child needs early orthodontic treatment.

Sometimes my recommendation genuinely is to monitor.

But I’d rather make “wait and see” a clinical decision than make it the default. 🦷✨

If something doesn’t look quite right with your child’s bite, getting it assessed early can tell you whether it needs treatment now, later, or simply monitoring.

23/09/2026

Everyone’s talking about palatal expansion… but are we focusing too much on width? 👀

A narrow upper jaw and lack of space for developing teeth can absolutely be reasons to consider expansion in a growing child.

But the jaws don’t grow in just one direction.

They grow in 3 dimensions and sometimes creating more width is only part of the treatment goal.

In certain developing Class III or underbite patterns, we may also need to consider the front-to-back relationship between the upper and lower jaws. This is where treatments such as maxillary protraction, sometimes using a Delaire facemask alongside expansion, may be considered.

The important question isn’t simply:

“Does my child need an expander?”

It’s:

“What are we trying to correct, and why?”

Because an expander is a tool.
The diagnosis should always come first. 🦷

22/09/2026

Have you noticed the lips?
Not just the teeth… look at the difference in the lips.

In the before photo, the upper front teeth were positioned further forward, making it difficult for the lips to meet comfortably when the face was relaxed.

This is what we call lip incompetence — when the lips don’t naturally come together at rest without effort.

Why does that matter?

Ideally, the lips should be able to rest together comfortably. Lip closure is part of a balanced resting oral posture, helping to maintain moisture around the lips and mouth. When the lips remain apart frequently, it can contribute to an open-mouth posture and mouth-breathing pattern, and we may also see dry or cracked lips.

After treatment, the teeth are better aligned and the upper incisors are in a more favourable position. But look beyond the teeth: the lips can now meet much more comfortably at rest, with noticeably less dryness around them too.

This is why, particularly in growing children, orthodontics isn’t always just about straightening teeth.

We’re looking at tooth position, the bite, lip competence, oral posture and the developing jaws — and how they all work together as a child grows.

Sometimes the changes you notice outside the mouth are just as important as the ones inside. ✨

22/08/2026

“Can we try expansion first? I really want to avoid surgery.”

I hear this from parents a lot.

And I completely understand it. The thought of your child having surgery or a general anaesthetic can be frightening, so when expansion is presented as something that might help, it’s natural to want to try that instead.

But there’s an important distinction.

Jaw expansion and ENT surgery are not interchangeable treatments.

Expansion can address a narrow jaw, create space and support dental and skeletal development. But if there is a significant airway obstruction, expansion does not automatically remove the cause.

And this is where my role has limits.

As a dentist, I can assess the jaws, teeth and developing occlusion. I can recognise signs that make me concerned about the airway and refer appropriately.

But I cannot be the person deciding whether your child does or doesn’t need ENT surgery. That decision needs to come from an ENT specialist after assessing your child.

Sometimes expansion is appropriate.
Sometimes ENT treatment is needed.
Sometimes myofunctional therapy has a role.
And sometimes a child genuinely needs more than one of these.

So the goal should never simply be “How do we avoid surgery?”

It should be:

“What does this particular child actually need?”

Because treating the jaw while leaving a significant obstruction unaddressed isn’t the outcome any of us are looking for.

MyofunctionalTherapy

22/08/2026

20/08/2026

Sometimes it’s not just about crooked teeth — it’s about recognising when there isn’t enough space for the adult teeth to come through properly. 🦷✨

This young patient presented with:

• Narrow upper and lower arches
• Significant lower crowding
• A deep bite tendency
• Limited space for the developing adult teeth

By intervening during growth, we’ve been able to develop the arches, create more space and improve the alignment of the erupting teeth, while working with his natural growth.

And we’re not finished yet. This is Phase 1 treatment, where the aim isn’t simply to straighten teeth — it’s to create a better environment for the adult teeth as they erupt and support the developing bite.

Early orthodontics is about recognising the right problem at the right time. 🤍

16/08/2026

Parents apologise to me all the time.

For the fillings.
For the brushing battles.
For the dummy that stayed a little longer than planned.
For their child being nervous, crying, or simply not wanting to cooperate.

But none of these things tell me whether you’re a “good” parent.

Parenting is hard, and there is rarely a perfect way to do it. My job isn’t to judge what’s happened before. It’s to understand what’s going on, support you and your child, and work out what we can do next. 🤍

So if you’ve ever walked into a dental appointment already preparing to say “sorry”… you probably don’t need to.

Save this for your next mum or dad guilt moment 🤍

09/08/2026

I decided to join the “kinda chic” trend… dentist edition 🤍

But these are actually things I genuinely love seeing in the parents I meet every day.

Parents who ask questions. Who trust their instincts. Who notice the little things. Who keep looking for answers when something doesn’t quite feel right.

Whether it’s feeding difficulties, toothbrushing battles, mouth breathing, snoring, dental health or how their child’s jaws are developing, sometimes there’s more to the story than we first realise.

You don’t have to know everything. You don’t have to spot everything early. And you definitely don’t have to get everything right.

Being curious, asking questions and learning along the way?

Kinda chic, if you ask me. 🤍

07/08/2026

This patient’s orthodontic treatment focused on more than aligning teeth.

By guiding growth at the right time, we improved the bite, created a more balanced smile, and achieved a healthier long term result.

Every child is different. That’s why an early orthodontic assessment can be so valuable.