Dr Emily Ng

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15/10/2026

Crooked teeth alone do not mean your child’s growth is off track.

But if they also snore, mouth-breathe, struggle to eat, seem tired or have difficulty concentrating, it may be worth looking deeper.

The first step is NOT choosing an appliance. It’s understanding what is happening and whether timing matters.

During an orthodontic assessment, I look at:

🦷 Breathing
Could nasal obstruction or enlarged tonsils or adenoids be contributing? Breathing difficulties can affect sleep, behaviour and concentration. If needed, I may refer your child to an ENT specialist.

🦷 The upper jaw
Is the jaw narrow, or are the teeth simply crowded or positioned inwards? A narrow upper jaw may benefit from expansion, which can also widen the base of the nose. Otherwise, teeth may be straightened now or later, depending on the situation.

🦷 The bite
Are there crossbites, deep bites or jaw shifts? Some problems are more time-sensitive. A crossbite that shifts the lower jaw may become more established over time. Earlier treatment may help address this, or a deep bite that interferes with comfortable jaw movement, while growth is available.

🦷 Muscle function
I assess tongue posture, lip seal, breathing patterns and whether the teeth prevent the lips from closing comfortably.

Orthodontic treatment is NOT a cure for every sleep, breathing, attention or feeding problem. But it may be part of the solution.

That’s why diagnosis matters.

After an assessment, you should understand:
• What have we found?
• Should we treat, refer or monitor?
• Would earlier treatment change the options?

Early assessment does not always mean early treatment. Sometimes monitoring is the right plan.

But when timing matters, it helps to know while your child is still developing.

Teeth can often be moved later. Jaw growth is more time-sensitive.

Comment GROWTH for my guide.

13/10/2026

Nasal strips or mouth tape for kids?
What if, instead of only helping the symptom, we asked whether we can improve the foundation while a child is still growing?

Adults vs kids: why timing matters.

For adults, facial growth is largely complete, so treatment often involves managing the airway we already have:
🦷 CPAP: keeps the airway open with positive air pressure
🦷 MAD: holds the lower jaw forward during sleep
🦷 Surgery: in selected patients, this may include jaw or nasal surgery, or hypoglossal nerve stimulation
For children, growth may give us additional options:
🔍 Expansion: if the upper jaw is narrow. The roof of the mouth is also the floor of the nose, so widening a constricted maxilla can affect the nasal airway.
🔍 Growth guidance: in selected growing children, we can posture the lower jaw forward, changing its environment to improve the opportunity for it to reach its genetic growth potential.
🔍 Early orthodontics: for problems such as very protrusive teeth, difficulty closing the lips comfortably, or a deep bite that may restrict the lower jaw.
🔍 Referral where needed: ENT, allergy management, speech or myofunctional therapy.

Sleep-disordered breathing, growth and development are complex and multifactorial.
We cannot say that early orthodontics will prevent future sleep apnoea. (Behrents et al., 2019)
But we can look at the different factors contributing to a child’s breathing and sleep.
Can we improve facial structure where indicated?
Why are they mouth breathing: is there nasal obstruction or inflammation that needs addressing?
Are allergies being managed?
Is the tongue functioning well?
Is the child getting enough good-quality sleep?

13/10/2026

Nasal strips or mouth tape for kids?
What if, instead of only helping the symptom, we asked whether we can improve the foundation while a child is still growing?

Adults vs kids: why timing matters.

For adults, facial growth is largely complete, so treatment often involves managing the airway we already have:
🦷 CPAP: keeps the airway open with positive air pressure
🦷 MAD: holds the lower jaw forward during sleep
🦷 Surgery: in selected patients, this may include jaw or nasal surgery, or hypoglossal nerve stimulation

For children, growth may give us additional options:
🔍 Expansion: if the upper jaw is narrow. The roof of the mouth is also the floor of the nose, so widening a constricted maxilla can affect the nasal airway.
🔍 Growth guidance: in selected growing children, we can posture the lower jaw forward, changing its environment to improve the opportunity for it to reach its genetic growth potential.
🔍 Early orthodontics: for problems such as very protrusive teeth, difficulty closing the lips comfortably, or a deep bite that may restrict the lower jaw.
🔍 Referral where needed: ENT, allergy management, speech or myofunctional therapy.

Sleep-disordered breathing, growth and development are complex and multifactorial.
We cannot say that early orthodontics will prevent future sleep apnoea. (Behrents et al., 2019)
But we can look at the different factors contributing to a child’s breathing and sleep.

Can we improve facial structure where indicated?
Why are they mouth breathing: is there nasal obstruction or inflammation that needs addressing?
Are allergies being managed?
Is the tongue functioning well?
Is the child getting enough good-quality sleep?

01/10/2026

If you realise you’re on the wrong train, do you get off at the next stop, or wait until the terminal?

If something is steering your child’s growth off course, do we wait until they’ve finished growing to correct the result?

Not every problem needs early treatment.

If it’s mild and unlikely to cause harm, sometimes it’s completely reasonable to wait and monitor.

But there are situations where I’m more likely to recommend starting earlier:

🦷 The bite is shifting the jaw

For example, a crossbite causing the lower jaw to shift sideways, or a bite interference preventing the upper and lower jaws from developing harmoniously.

🦷 The bite is damaging the teeth or gums

When teeth are crowded or biting unevenly, some teeth may experience excessive wear. Teeth pushed outside ideal bone and gum support may also be more vulnerable to gum recession.

🦷 The front teeth are very protrusive

Teeth that stick out are more vulnerable to trauma. And if the lips cannot close comfortably around them, they also lose the normal support of the lips, which may allow the protrusion to worsen as the child grows.

🦷 The problem may become harder to correct with time

Children continue to grow and compensate around the problem. What starts as one imbalance may create secondary effects over time.

That’s why during a consultation, I’ll explain:

Should we start now, or can we wait?
What are the benefits of starting now?
What are the possible consequences of waiting?

Then parents can make an informed decision about whether they want to proceed.

Early treatment is about recognising the children where timing actually matters.

Because I would much rather tell a parent, “This is mild. Let’s watch it,” than have them come back years later and say:

“I wish I’d known we had an opportunity to do something earlier.”

Teeth can often be moved later.

Facial growth cannot be replayed.

Growth gives us opportunities, not guarantees.

Follow for orthodontics beyond straight teeth.

Comment GROWTH for my guide on what I look for by age.

Join me tomorrow for the Dyson Masterclass at ION Orchard 🦷I’ll be sharing some simple things that can make a big differ...
26/09/2026

Join me tomorrow for the Dyson Masterclass at ION Orchard 🦷

I’ll be sharing some simple things that can make a big difference:

Brushing
The 3 spots people often miss

Flossing
Why we do it, and how to do it well

And we’ll also talk about what happens outside those 2 minutes, twice a day:

Diet.
Clenching + grinding.
Mouth breathing.
Daily habits.

What stayed with me most from the CameraJet launch, where I was invited to speak, were the questions people asked.

The practical ones.

“Am I flossing properly?”
“Do I need to go under the gums?”
“What should I do if my gums bleed?”

Dyson Unveiled
Sun 27 Sept • 2–3 PM
ION Orchard, B4 Atrium

Thanks Dyson for putting oral health in the spotlight.

Because oral health is part of health + wellness.

Dyson Singapore Dyson

Any questions? Leave them in the comments ❤️

24/09/2026

Parents, if your child has these 4 signs, see an orthodontist around age 7–8.

Not every child needs early treatment. But these are signs I’d check sooner:

🚩 A narrow upper jaw or crossbite
Your child may shift their lower jaw sideways just to make their teeth fit.

🚩 Front teeth that stick out
They’re more vulnerable to chipping or breaking in a fall, and your child may struggle to close their lips comfortably.

🚩 Crowded adult teeth or no gaps between baby teeth
There may not be enough room for the adult teeth to come through properly. An assessment can tell us whether any teeth are at risk of getting stuck.

🚩 An underbite
When the lower front teeth sit ahead of the upper front teeth, checking while your child is still growing may give us more options.

The teeth are a clue.
I’m looking at how your child’s jaws and face are growing, not just whether their teeth are straight.

Growth is a runway.
An early check gives us time to guide development if needed. It does not mean your child needs treatment now.

The key is treating the right child at the right time.

Phase 1: If treatment is needed, we may be able to address a developing problem while the jaws are still growing. Sometimes the right next step is simply monitoring, or a referral to another specialist.

Phase 2: If needed later, focuses on the final position of the adult teeth and how the bite fits.

Comment GROWTH and I’ll send you videos exploring early orthodontic treatment options at different ages. 🦷

This is general education and is not a substitute for an in-person assessment or perso

17/09/2026

Jaw expansion isn’t new. But the way I do it, and what I look for, has changed.

🦷 Traditionally, making an expander could take 3 appointments:
1️⃣ Place separators between the teeth, which can be uncomfortable.
2️⃣ Fit stock metal bands by getting your child to bite them into place, followed by a traditional impression.
3️⃣ Come back to finally fit the expander.

🖥️ Now?

1️⃣ 3D scan your child’s teeth.
After diagnosis and treatment planning, I design the expander around your child’s teeth, stage of development and what we need to achieve.
It’s then 3D printed with customised bands designed to fit your child’s unique tooth shape.
No separators. No biting in stock bands. No traditional impressions.

2️⃣ Next appointment: fit the expander.
But the biggest change isn’t the expander.
Expansion used to focus mainly on widening a narrow upper jaw to make space for crowded teeth.

Now I’m also asking:
👃 Does your child mouth breathe?
😴 Do they snore or sleep poorly?
🧠 Do they have attention, hyperactivity or ADHD-like symptoms?

Because I’m not just thinking about their teeth. I’m thinking about their growing face, breathing and sleep.

⚠️ And expansion may not be enough. If mouth breathing and poor tongue posture continue, some of the factors that contributed to the narrow jaw may still be there, increasing the risk of relapse.
The expander creates the space. Better breathing and tongue function can help support the result as your child continues to grow.

💬 Comment AIRWAY for my parent guide on the link between teeth, jaws, breathing and sleep.

💬 Comment LOWER to find out what happens to the lower jaw when we expand the upper.

Did you or your child have an expander?

What was your experience like? Share below 👇

Medical disclaimer: For general education only. Please seek professional advice for recommendations specific to you or your child.

11/09/2026

Sometimes the reason I keep showing up here is the reason I started looking beyond straight teeth: my own child.

I’m Dr Emily Ng, a Specialist Orthodontist in Singapore treating all ages, with a special interest in growing children, facial growth, breathing & sleep.

I share what I know so families can spot clues earlier, ask better questions & find the right help.

To the 16,000 of you here, thank you ❤️

Follow for orthodontics beyond straight teeth.

10/09/2026

“If you widen my child’s upper jaw, what happens to the lower jaw?”

🚫 The lower jaw cannot be expanded like the upper jaw.
The upper jaw has a suture in the middle that can be gently opened while a child is growing.
The lower jaw doesn’t, so we can’t widen it skeletally in the same way.

So what happens to the mismatch?

1️⃣ Sometimes a narrow upper jaw is actually holding the lower jaw back.
Once we widen the upper jaw and clear that interference, the lower jaw may be free to sit and grow further forward while growth is still happening.
We’re not making the lower jaw grow.

🟢➡️ We’re trying to clear interference, restore function and give growth a better trajectory.

2️⃣ The lower teeth may change too.
↘️ 👅 ↙️
When the upper jaw is narrow, the lower teeth may compensate by tilting inwards towards the tongue.

↖️ 👅 ↗️
After expansion, some may upright naturally.

3️⃣ If they don’t, we can guide them.
Elastics, aligners or removable appliances can improve the position of the lower teeth.

🦷 These move the teeth. They do not skeletally expand the lower jaw.

🚌 Think of growth like being on a bus.
If you realise you’re on the wrong bus, get off early rather than waiting until the last stop.
That’s why timing matters.

Save this if your child is having expansion, and share it with another parent who’s wondering what happens to the lower jaw. 🦷

Disclaimer: This post is for general information only and does not replace professional dental advice. Every child is different, and treatment should be assessed and recommended by a qualified dental professional.

04/09/2026

Fixed or removable expander: Which is better? 🦷

There is no single “best” option. It depends on your child 👇

🔒 Fixed expander
• Stays attached and works 24/7
• Usually provides more predictable, skeletal expansion
• Parent turns the screw nightly for about 1 month
• Requires extra cleaning
• Avoid sticky or acidic foods

🧼 Removable expander
• Easier to clean, with fewer food restrictions
• Must be worn consistently
• Often suits younger children
• Parent turns the screw every 1–3 days for 1–2 months
• Can be misplaced — or ineffective if not worn 😅

😁 Invisalign Palatal Expander
• No screw turning
• Child changes to a larger expander every 1–3 days for 1–2 months
• Must be worn full time, except for brushing
• May take practice to insert and remove

🤔 Which is better?

It depends on:
👧 Age
🦷 Dental needs
🙋 Ability to follow instructions
👨‍👩‍👧‍👦 Family preferences and routine

Expansion has 3 phases:

1️⃣ Active expansion | 1–2 months
Creates more space.

2️⃣ Stabilisation | 3–6 months
Allows new bone to form and the expansion to settle.

3️⃣ Function | Lifelong
👄 Lips together
👅 Tongue up
👃 Breathe through your nose

Changing the structure is only part of treatment. Improving function helps maintain the result long term 💡

But what about the lower jaw? 👀

Follow for Part 2!

Disclaimer: This post is for general information only and does not replace professional dental advice. Every child is different, and treatment should be assessed and recommended by a qualified dental professional.

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