Facial growth guidance in Metairie, Luling and Destrehan
Facial growth guidance means watching how your child's jaws, face and airway are growing, and stepping in only when it helps. The goal is simple. We want the upper jaw wide enough for the teeth and the tongue, the lower jaw growing forward, and the nose doing the breathing.
It is not braces at age five. For many children, the right plan is to watch and check again in six months or a year. For others, a short, gentle phase of treatment while they are still growing can make room for adult teeth and support easier nasal breathing. Dr. Allison Hamada will tell you which group your child is in, and why.
Timing is the whole point. The American Association of Orthodontists notes that a palatal expander works best while a child is still growing, because the seam in the middle of the palate has not fused yet (AAO). The American Academy of Pediatric Dentistry also says that early diagnosis and treatment of developing bite problems can help children reach a stable, healthy bite (AAPD).
Who growth guidance is for
Most of the children we see for growth guidance are between about 5 and 10 years old. They still have a mix of baby teeth and adult teeth, and their jaws are still very responsive. Families usually come to us for one of these reasons:
- A parent noticed snoring, mouth breathing or restless sleep.
- A dentist, pediatrician, ENT or speech therapist suggested an orthodontic look.
- An older sibling needed extractions or a long round of braces, and the parents want to get ahead of it this time.
- The baby teeth are crowded, or the bite looks off, like a crossbite.
- A parent simply wants to know whether their child's growth is on track.
Teens and adults are not out of options. Growth slows, so the tools change. For adults with a narrow upper jaw, Dr. Hamada offers non-surgical palatal expansion for adults (MARPE).
More signs worth a closer look
The list above covers the signs we see most. Here are a few more that parents often mention once they know what to look for. None of them proves there is a problem. Many have other causes, like allergies or big tonsils. But each one is a good reason to have someone look at the jaw and the airway together.
At night
- Snoring most nights, gasping, or pauses in breathing
- Restless sleep or night sweats
- Sleeping with the mouth open
- Bed-wetting that starts again after a long dry stretch
During the day
- Waking up tired or cranky, even after a full night
- Trouble focusing, or acting hyper and impulsive
- A stuffy nose that never seems to clear
- Morning headaches
In the mouth and face
- Lips that rest apart instead of closed
- A tongue that pushes forward when your child swallows or talks
- Upper teeth that sit inside the lower teeth on one or both sides
- Crowded baby teeth, or adult teeth coming in twisted
Mayo Clinic lists snoring, mouth breathing, restless sleep, new bed-wetting, attention problems and hyperactivity among the signs of sleep apnea in children (Mayo Clinic). Cleveland Clinic notes that long-term mouth breathing in children can affect the shape of the face, including a narrow face and a receding chin (Cleveland Clinic). If your child snores often, please tell your pediatrician too. Sleep apnea is a medical diagnosis, and a physician makes it. We are glad to work alongside them. You can read more in our guide to why children snore and our article on mouth breathing and attention in kids.
What a growth and development visit looks like
The first visit is a free consultation. You do not need a referral. Dr. Hamada examines your child herself, and the airway is part of every exam.
- We listen first. Tell us what you have noticed at home: sleep, snoring, habits, speech, eating, focus. Bring any notes from your pediatrician, dentist or ENT.
- Dr. Hamada looks at the whole picture. She checks the teeth and bite, the width of the upper jaw, the profile, where the tongue rests, how the lips close, and how your child breathes.
- Digital records when they help. A quick 3D scan replaces messy impressions. Imaging is used when it adds something to the decision.
- A plain answer. You leave knowing whether your child needs something now, later, or not at all. If the answer is "not now," we set a time to check growth again.
- A clear plan if treatment helps. We explain what it will do and what it will not do. Our team checks your insurance and walks you through payment options before you decide anything.
Want more detail before you come in? Here is what to expect at your first visit.
The tools we use to guide growth
Palatal expansion
An expander gently widens a narrow upper jaw while it is still growing. That can make room for adult teeth, correct a crossbite, and give the tongue more room to rest where it should. Learn how a palate expander works for kids, or read what Metairie parents should know about jaw expansion.
Phase 1 (early) treatment
Phase 1 is a short, focused round of treatment, usually somewhere around ages 6 to 10. It targets one or two specific problems while your child is growing. Not every child who has a first phase needs a second. See our page on Phase 1 orthodontics in the New Orleans area.
Myofunctional therapy
Some children need help with the muscles, not just the bones. Myofunctional therapy uses simple exercises to train the tongue to rest on the roof of the mouth, the lips to close, and the nose to do the breathing. We work with trained therapists, such as Bloom Therapy Group, a local practice that focuses on this kind of care. Read more about our myofunctional therapy and TMJ care.
Teamwork with your child's doctors
Big tonsils, adenoids, allergies and tongue ties are medical issues. When we see signs of them, we point you to your pediatrician, an ENT or a sleep specialist. Dr. Hamada also founded The Airway Exchange Group, a study club in New Orleans where dental and medical providers share what they are learning about airway health.
Watching and rechecking
For many children, the best tool is time. We take a baseline, then check growth at regular visits. If something changes, we act at the right moment instead of guessing.
What growth guidance can and cannot do
We would rather be honest than oversell. Early care can make room for adult teeth, correct a crossbite, and lower the chance of extractions or more complex treatment later. In some children, widening a narrow upper jaw may also make nasal breathing easier.
But orthodontics does not diagnose or cure sleep apnea. The research on expansion and children's sleep is still growing, and the results are mixed. The AAO's updated white paper on sleep-disordered breathing asks orthodontists to screen for it and work with physicians, not to treat it on their own (AAO white paper update, AJO-DO). That is how we work. Results vary from child to child, and Dr. Hamada will tell you what is realistic for yours.
Three offices, one approach
Every office offers the same airway-focused exam with Dr. Hamada:
- Metairie office: 123 Metairie Rd, Metairie, LA 70005. Close for families in Elmwood, River Ridge, Harahan, Kenner and New Orleans.
- Luling office: 118 Lakewood Dr, Luling, LA 70070. Serving Boutte, Hahnville, Paradis, Des Allemands and the rest of St. Charles Parish.
- Destrehan office: 131 Ormond Center Ct, Destrehan, LA 70047. Serving St. Rose, Norco, Montz and New Sarpy.
We are open Monday through Thursday, 8:00 AM to 4:45 PM. Call 985-725-0509 to book a free growth and airway consultation.
Growth and development FAQs
What is facial growth and development guidance?
It is orthodontic care that watches how a child's jaws, face and airway are growing, and steps in only when it helps. That might mean a palate expander, a short phase of early treatment, myofunctional therapy, or simply checking again in a few months.
What age should my child first see an orthodontist?
The American Association of Orthodontists recommends a first orthodontic check by age 7. Dr. Hamada likes to see children by age 5 or 6, and sooner if you notice snoring, mouth breathing or a bite that looks off.
Does an early visit mean my child will need braces early?
No. Many children who come in early do not need any treatment yet. We take a baseline, check growth over time, and tell you plainly if and when treatment makes sense.
Can a palate expander help my child breathe better?
It may, for some children. Widening a narrow upper jaw can make room for the tongue and may make nasal breathing easier. The research is still mixed, so we never promise it will fix a breathing or sleep problem. Sleep apnea is diagnosed and treated by a physician, and we work alongside your child's doctors.
Is early treatment worth it if my child may need braces later anyway?
Often, yes. Guiding growth while the jaw is still developing can shorten or simplify later treatment, and in some cases it helps avoid extractions or jaw surgery. Not every child who has early treatment needs a second phase. Dr. Hamada will explain the trade-offs for your child.
My child snores. Should we see the pediatrician or an orthodontist first?
Start with your pediatrician, because frequent snoring can be a sign of sleep apnea, which is a medical diagnosis. An orthodontic exam can add useful information about jaw width and growth. We are happy to share what we find with your child's doctor.
Is it too late if my child is already 10 or 12?
No. Growth slows with age, so the options change, but there is still a lot we can do. Teens still respond well to many treatments, and adults with a narrow upper jaw may be candidates for non-surgical palatal expansion.
Does insurance cover early orthodontic treatment?
Many dental plans include orthodontic benefits that can apply to early treatment. Coverage varies by plan. Our team checks your benefits and explains your payment options before treatment begins.
Do I need a referral for a growth and airway consultation?
No. You can book a free consultation at our Metairie, Luling or Destrehan office without a referral.
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