You probably know that it's never too late to begin orthodontic
treatment—but when it comes to your youngster's teeth, did you know
that earlier may be better than later? According to the American
Association of Orthodontists, kids should have an initial orthodontic
screening at age 7. What makes early evaluation — and potentially,
early treatment — so important?
There are several ways that kids can benefit from seeing an orthodontist
at an early age. But it's important to recognize that early evaluation isn't
necessarily followed by early treatment; in most cases, if orthodontic
work is needed, we simply monitor your child's growth patterns until we
see that it's time for treatment to begin. This gives us an opportunity to
get the best results in the most efficient way, and to help prevent future problems.
Although every child's development is different, in most kids the first adult molars have typically started to emerge by around age six. This, along with other developmental markers, lets us get a handle on the basic alignment of the teeth, from front to back and side to side. It may also be possible at this point to determine whether there is adequate room in the mouth for all of the permanent teeth — and, if not, to take action.
When Earlier Treatment Is Better
Treatment for common orthodontic problems typically begins around age 9-14, when all of the baby teeth are gone and many of the permanent ones are in place. But there are some conditions that are much easier to treat if they're caught at an early age, when a child's natural growth processes are going full speed ahead.
One is severe crossbite, a condition where the upper teeth close inside the lower teeth. To treat this problem, a device called a palatal expander can be used, which gradually and painlessly widens the upper jaw; it's especially effective when the jaw itself hasn't fully developed. If we wait too long, a more complicated treatment — or even oral surgery — might be required to correct the problem.
Another condition that may benefit from early treatment is severe crowding. This occurs when the jaws are too small to accommodate all of the permanent teeth. Either palatal expansion or tooth extraction may be recommended at this point, to help the adult teeth erupt (emerge from below the gums) properly. Even if braces
are required later, the treatment time will likely be shorter and less complicated.
Early intervention may also be helpful in resolving several other problems. Protruding teeth, especially in front, can be prone to chipping and fractures; they may also lead to problems with a child's self-image. A severe underbite, caused by the lower jaw growing much larger than the upper jaw, can result in serious bite problems. Orthodontic appliances, including braces and headgear, can be successfully used to correct these problems at this stage, when the child's development is in full swing, thereby increasing the chances that surgery can be avoided.
Correcting Bad Habits
At one time or another, anyone may pick up a bad habit. But there are some situations where a youngster's parafunctional (detrimental to health) habits can actually influence the development and function of his or her teeth, jaws and mouth. Some examples of these are persistent thumb sucking, tongue thrusting and
The sucking reflex is natural in early childhood; it usually disappears between ages 2 and 4. But if it persists much later, the pressure of the digit on the front teeth and the upper jaw can actually cause the teeth to move apart and the jaws to change shape. This can lead to the orthodontic problem called “open bite,” and may impair speech. An open bite can also be caused by the force of the tongue pushing forward against the teeth (tongue thrusting).
Mouth breathing — an abnormal breathing pattern in which the mouth always remains open, passing air directly to the lungs — is related to alterations in the muscular function of the tongue and face. It may cause the upper and lower jaw to grow abnormally, which can lead to serious orthodontic problems. Although mouth breathing may start from a physical difficulty, it can become a habitual action that's hard to break.
Various orthodontic treatments are available to help correct these parafunctional habits — and the sooner they're taken care of, the less damage they may cause. But these potential problems aren't always easy to recognize. That's one more reason why you should bring your child in for an early orthodontic screening.
For many teens, braces are a rite of passage: They're one more example
of the changes adolescents go through at this time — along with growth
in stature, edgier tastes in clothes and music, and an increasing degree
of self-awareness. But is there any particular reason why orthodontic
appliances and teenagers seem to go together? In a word: Yes.
There are several good reasons why adolescence is the optimal time for
orthodontic treatment, though occasionally even earlier intervention
is called for. One has to do with the development of the teeth: There's
no set timetable for every kid, but generally by the age of 11-13 the
deciduous (baby) teeth have all been lost, and the permanent ones have
largely come in. This is the time when we can go to work correcting the
problems that cause a bad bite (malocclusion), improper tooth spacing
or poor alignment.
Orthodontic problems don't improve with age — they simply become harder to treat. It's easier to treat many orthodontic problems during adolescence because the body is still growing rapidly at this time. Whether we use standard braces, or appliances like palatal expanders, we can create an improved appearance and function in a short period of time. In later years, when the bones of the face and jaw are fully developed, many conditions become more difficult (and costly) to treat.
There's even a social element to getting orthodontic treatment in adolescence. If you need braces, you're not alone! Chances are you'll see some of your classmates in our office, and you may even make new friends as you go through the process together. When it's done, you'll have a smile that you can really be proud of, and benefits that will last your whole life.
The Orthodontic Treatment Process
What can you expect when you come in to our office for treatment? It all depends on what kind of treatment you need. The first time you come in, we will take pictures and radiographic (X-ray) images of your mouth, and possibly make a model of your bite. Then, we'll develop a treatment plan. It may involve regular braces, with or without elastics (rubber bands). We might also recommend that you use a specialized appliance for a period of time. Here are some of the most commonly used orthodontic appliances:
Metal Braces need no introduction. But you might be surprised to find they're smaller and lighter than ever. They may even offer some customized options, like colored elastic ties on the brackets.
Clear Braces feature brackets made of ceramic or composite materials which blend in with your teeth, making them harder to notice. They're suitable in many situations, but they cost a little more.
Clear Aligners for teens is a series of removable, clear plastic trays that gradually straighten teeth as they're worn
(for 22 hours per day). Formerly recommended only for adult patients, they now come with special features — like compliance indicators to tell how often you've been wearing them — that make them appropriate for teens in some situations. The advantage: they're practically invisible!
Lingual Braces offer the most unnoticeable form of orthodontic treatment because they are attached to the back (tongue side) of the teeth, where they cannot be seen at all.
Other orthodontic appliances may be recommended in some cases, where major tooth or jaw movement is needed. They can range from small devices that fit inside the mouth to external headgear. But don't worry: You'll get used to them, and they're temporary — but they provide a long-term benefit in a short time.
How Long Will I Wear Them?
There's no one answer that fits everyone: It all depends on what we need to do in your individual situation. Generally, however, the active stage of orthodontic treatment lasts 6-30 months. Afterwards, you will wear a retainer for another period of months. When your orthodontic treatment is complete, the new smile we've worked together to create will be yours for a lifetime.