Guided Orthodontic Growth Ages 6-10

Jaw Development Ages 6-10 An Overview

What is RAGGA?

Removable Anterior Guided Growth Appliance (RAGGA) is a non-invasive, safe orthopedic growth guidance appliance that fits like a simple upper retainer.  RAGGA is used in children ages 6-10 to develop the jaws and mid-face to their full genetic potential, without risky and expensive jaw surgery.

What should I look for in my child to know if an orthopedic growth evaluation is necessary?

  • Teeth crowding or crooked teeth
  • Misaligned bite
  • Teeth don’t meet correctly
  • Underbite or overbite
  • Facial asymmetry
  • Frequent headaches
  • Snoring
  • Open mouth breathing
  • Short attention span/ easily distracted

Benefits of Orthopedic Growth Guidance

RAGGA provides many benefits over traditional orthodontic techniques including remodeling of the jaws during the growth phase, alignment of teeth and functional bite within the ideal developed jaw position, improved facial structures, and improved overall posture.

Three months into orthopedic guided growth with RAGGA, this 8-year-old’s posture, head tilt, and facial symmetry has improved.

Because of the profound forward growth of the upper and lower jaws, RAGGA decreases and in most cases eliminates the potential for TMJ problems and airway issues in children.  1/3 of children wearing RAGGA will not need further orthodontic treatment. The other 2/3 of children wearing RAGGA will need Controlled Arch Braces later during adolescence to straighten and align the teeth in the space provided by orthopedic growth, but the duration will be much shorter (estimated 6-12 months) in braces than in children who do not have orthopedic growth with RAGGA prior to braces.

Jaw Development Ages 6-10 What to Expect

How does Orthopedic Growth Guidance using RAGGA work?

RAGGA is a simple, retainer-like appliance that is worn on the roof of the mouth.  The appliance is specifically designed to put pressure on a specific spot on the upper palate that stimulates a nerve to turn on the bone growth centers behind the upper jaw.  The RAGGA is also unique in that it has a small dimple that the child pushes on with his/her tongue as a myofunctional exercise (an exercise for correct tongue position) as well as applies pressure to this very important “spot”.   Stimulation of this spot creates a robust response of bone growth resulting in 3-dimensional remodeling of the entire mid-face forward, including the nasal sinus and upper jaw. This type of growth stimulation is unlike any other orthodontic appliance available.

Additionally, specially designed bite pads on the appliance allow the lower jaw to follow the forward growth, stimulating the lower jaw to also remodel and grow into the genetically intended physiologic position.  The result? Beautifully developed mid-face, upper and lower jaws and more than adequate space for the teeth to fully erupt.

For orthodontic treatment to be successful, the jaws must first be developed and positioned in the correct location in the face.  Only after that should the teeth be then aligned and straightened.

Guided Orthopedic Treatment: Real Patient, Real Results

8 year old with headaches developing deep overbite and retruded lower jaw.

Day of RAGGA insertion- deep bite unlocked and lower jaw allowed to come forward, decompressing the TMJs and opening up the airway.

2 months wearing RAGGA- Headaches resolved.  Upper jaw growing forward and lower jaw tracking forward on bite plates, further decompressing the TMJs and opening the airway.

raga device inserted

3 months in treatment, the upper jaw is developing forward 3 dimensionally, developing space to accommodate future adult teeth.


Jaw Development Ages 6-10 FAQs

Why are my child’s teeth crowded?

Many people think crowded teeth are a genetic trait.  This, however, is false. Also, it is not the result of large teeth.  It is, rather, the result of lack of forward growth of the nasomaxillary complex, including the mid-face and upper jaw. (More on why so many kids have underdeveloped nasomaxillary complexes, click here)  Develop the nasomaxillary complex to the ideal size and physiologic position using Orthopedic Growth Guidance and the teeth align beautifully with Controlled Arch braces.  

What is the best age for my child to begin orthodontic treatment?

 Many people think it’s not necessary to begin thinking about orthodontics until all the baby teeth have fallen out in the pre-adolescent years.  However, treating children earlier, around age 6-8 years old leads to the best results. The face and jaws are done growing by age 12. Trying to straighten teeth in a jaw that is under-developed can lead to undesirable compromises in function, esthetics, airway, posture and compressed TM joints.

Dr. Hughes philosophy is to harness a child’s growth, ideally between the age of 6-10, to maximize the full forward face growth potential.   A child will spend much less time in braces later on by starting them young and harnessing the growth potential using a non-invasive, safe, simple orthopedic growth appliance.  RAGGA treatment in children ages 6-10 will reduce the time in braces to about 6-12 months later on, far less than the 2 years that we typically see adolescents wearing conventional braces without any prior orthopedic growth guidance.

Does RAGGA expand the upper jaw?

RAGGA is a growth appliance that stimulates the upper jaw and mid-face to develop 3-dimensionally. This orthopedic jaw appliance stimulates remodeling of the entire mid-face and maxilla (upper jaw).  If arch expansion is needed to correct narrowness of the dental arches after RAGGA treatment, then FRLA (fixed-removable lingual arch) expansion wires are placed on the upper and lower dental arches during the Controlled Arch Braces phase.

How long is the RAGGA growth appliance typically worn?

 RAGGA is a functional appliance and is worn 24 hours a day/ 7 days a week.  It is taken out of the mouth only long enough for the child to brush their teeth and clean the appliance.  The child must eat and sleep with it in for optimum results. The growth phase of treatment time is typically 8-10 months.

Will my child need braces after RAGGA?

30% of kids wearing RAGGA will likely NOT need braces during their early teen years.  For the 70% of kids who will need braces after RAGGA, it will be a much shorter duration of time in braces due to the space created by the orthopedic growth guidance which makes Controlled Arch protractive braces very efficient.

I was told my child will need teeth extracted for braces to make enough room for the other teeth to be straightened.  Should I consider my child having extractions of permanent teeth?

NO!  Do NOT extract any adult teeth for the purpose of making space for orthodontics.   Extraction of the bicuspid teeth, followed by retraction orthodontics, will compromise your child’s airway, compress the TMJs and affect the facial profile significantly.  Children with permanent teeth extraction have less room in their mouth for their tongue, are predisposed to the collapse of the upper airway during sleep, and most often develop obstructive sleep apnea at a later age.  With advancements in Orthopedic Growth Guidance using RAGGA, adequate space is created for all the permanent teeth. Dr. Hughes will make every effort to avoid extracting bicuspids for braces, which is usually not necessary in her clinical opinion.

My child is developing an underbite, will surgery be necessary to correct the underbite?

 Jaw surgery, although an excellent treatment option in very extreme, complex cases, is not necessary in most cases to correct an underbite in adolescents (and adults for that matter!).  With jaw development orthodontic treatments using RAGGA, the growth appliance develops the mid-face and upper jaw forward to a corrected posture in relation to the lower jaw. If you have been told your child needs jaw surgery, please seek another opinion with Dr. Tracey Hughes who is trained to use non-surgical Orthopedic Growth Guidance appliances and Controlled Arch braces to correct underbites.

My child is developing an overbite, will surgery be necessary to correct the overbite?

 Jaw surgery, in most cases, is not necessary to correct an overbite in adolescents (or adults for that matter!)  With Orthopedic Growth Guidance using RAGGA, the growth appliance allows the lower jaw to grow in 2 ways. Growth centers in both the condyles and ramus are activated to stimulate bone growth in underdeveloped lower jaws.  Additionally, the flat bite pads on the appliance allow the lower jaw to move forward into its more ideal, physiologic position. If you have been told your child needs jaw surgery, please seek another opinion with Dr. Tracey Hughes who is trained to use non-surgical Orthopedic Growth Guidance appliances and Controlled Arch Braces to correct overbites.

Do children experience TMD (temporomandibular joint dysfunction) symptoms and OSA (obstructive sleep apnea)?

 Absolutely yes!  

Many children with underdeveloped jaws and a bad bite experience TMD symptoms such as headaches, jaw clicking and pain, ringing in their ears, neck tension and ear symptoms just like adults.  

Dr. Hughes’ own daughter developed bite related headaches at the age of 7.  Orthopedic Growth Guidance eliminated 100% of her headaches and TMD symptoms the first month in treatment and enlarged her upper airway, all non-surgically.

Underdeveloped jaws and enlarged adenoids and tonsils all contribute to causes constriction of the upper airway and obstructive sleep apnea in children.  Getting the best sleep in terms of quality and quantity is now recognized as one of the top 3 most important factors in long term health and disease prevention.   Fixing the root cause of the problem with a jaw growth appliance and Controlled Arch braces can prevent a lifetime of TMD suffering and OSA in children.

Dr. Tracey Hughes

Why choose Boulder Valley Dental Center?

Dr. Tracey Hughes and the dedicated team at Boulder Valley Dental Center provide personalized dental care in Louisville, CO. Dr. Hughes is an experienced dentist who remains committed to continuing education in order to ensure the highest standard of care for your oral health needs and cosmetic goals. Dr. Hughes is trained in the LANAP procedure and offers comprehensive care for complex problems including gum disease.

Relationship dentistry is the hallmark of our practice where we place great emphasis on getting to know and understand our patients as a member of our extended family. We have designed our dental office to be welcoming, relaxing and a place that you look forward to visiting as you maintain, restore or enhance your natural smile.