Concerns About Pediatric Midline Deviation in Young Children

The philtrum of the infant is asymmetrical?

Hello, my son is currently 3 and a half years old.
The tip of his philtrum has been increasingly deviating to the left.
Since he was about 1 year old, his lower jaw tends to protrude unconsciously, resulting in a situation where his lower teeth overlap his upper teeth.
However, when reminded or during sleep when relaxed, it returns to normal.
Should I be concerned about his philtrum and lower jaw at this stage, or will it improve naturally as he matures? Thank you!

Ms. Wu, 30~39 year old female. Ask Date: 2020/10/05

Dr. Xiao Kaiwen reply Pediatrics

There are many possibilities in this situation, such as issues with the nerve control around the oral cavity, muscle coordination problems, malocclusion, dental misalignment, or temporomandibular joint (TMJ) issues.
It is recommended to consult a pediatric dentist for further evaluation.

Reply Date: 2020/10/05

More Info

Concerns about pediatric midline deviation, particularly in young children, can be quite common among parents. In your case, your son is showing signs of a midline deviation with the philtrum (the vertical groove between the nose and upper lip) shifting to the left, along with a tendency for his lower jaw to protrude, causing a dental occlusion where the lower teeth overlap the upper teeth.
First, it's important to understand that children's facial structures and dental alignments are still developing. At the age of three and a half, many children experience variations in their growth patterns, and it is not unusual for their dental and facial features to appear asymmetrical. This can be due to a variety of factors, including muscle tone, habits, and even the way they sleep or play.

The fact that your son’s jaw returns to a more normal position when reminded or when he is relaxed suggests that this may not be a fixed issue but rather a habit or a temporary developmental phase. Children often exhibit behaviors such as thumb sucking, mouth breathing, or unusual jaw positioning, which can influence their dental alignment and facial symmetry.
However, it is essential to monitor the situation. If the deviation becomes more pronounced or if you notice other concerning symptoms, such as difficulty chewing, persistent discomfort, or speech issues, it would be advisable to consult a pediatric dentist or an orthodontist. These professionals can assess his dental alignment and jaw positioning more thoroughly and determine if any intervention is necessary.

In many cases, as children grow and their facial structures mature, these issues can resolve on their own. The jaw and teeth often shift as the child grows, and many children will naturally develop a more symmetrical appearance as they reach their teenage years. However, early intervention can sometimes be beneficial, especially if there are concerns about the development of the jaw or teeth that could lead to more significant issues later on.

In summary, while it is understandable to be concerned about your son's midline deviation and jaw positioning, it may not be an immediate cause for alarm, especially if he is otherwise healthy and developing normally. Regular dental check-ups are crucial during this period to monitor his growth and development. If you have ongoing concerns, don’t hesitate to seek professional advice to ensure that your son receives the appropriate care and guidance tailored to his specific needs.

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