Tweens and Early Orthodontia
I remember clearly the day my daughter’s dentist said it was probably time for her to get braces. “She’s only 9-years-old! Braces are for teenagers!” I objected. “They start kids earlier now and usually do two phases of treatment,” he said.
Was it all just a big orthodontic racket or had dentists figured out some things since my teen years? To get to the bottom of the early-orthodontia concept, I asked the professionals some questions that you may have too.
Why are braces necessary?
Most importantly for function, when our teeth are properly aligned, they fit together in a way that helps us chew adequately and doesn’t wear teeth down unevenly. Also for the protection of teeth that would otherwise protrude and, of course, for appearance.
Why start early?
Early orthodontics (and the possible two phases of treatment) is not new but has become more prevalent in the last 15 years. The American Association of Orthodontists recommends children be evaluated by an orthodontist by age 7 to serve as a baseline from which the child’s dentofacial growth and development can be monitored.
“[This] is a time of exchange of baby teeth for permanent teeth, and is opportune for intervening to intercept problems that may worsen with age,” says Lee Graber, DDS, MS, PhD, and president-elect of the American Association of Orthodontists.
“Most orthodontic problems respond nicely to treatment started around the time all the permanent teeth complete their eruption (usually 10-12 years),” says William Berlocher, DDS. “However, there are several conditions (crossbite, severe crowding and severe overbite), that benefit from early treatment.”
Why are two treatment phases necessary?
The first phase of treatment is often done to “set the stage” correcting the position and shape of the upper and lower jaws to allow existing and incoming teeth to fit better in the mouth while doing some alignment. The second stage is for refinement and final alignment. There could be several months to several years between phases.
Are there benefits?
Although there is still some debate as to all the benefits of early treatment, the industry agrees most upon the following:
• Correction of problems both dental and skeletal that if left untreated could adversely affect facial growth and development and could potentially require surgery.
• Creation of space in crowded cases to allow for new teeth to come in, in a more acceptable position. This may prevent the need for pulling those teeth.
• Correction of protruding teeth in the “danger zone” for being hit and broken,
especially in sports situations.
• Correction of teeth that may be deemed socially unacceptable during the important developing years for self-esteem and self-confidence.
Is early treatment more expensive?
Orthodontists explained that the misconception is that the two-phase treatment means that their child is being treated twice for the same thing. Each phase has specific goals and objectives. Phased treatment may mean more expense in some patients, but with others the expense is actually less. Orthodontists generally use phased treatment when there is true benefit to the patient. As with other healthcare situations, a second opinion is recommended if parents have concerns.
When to see the orthodontist
Besides following the recommendation of seeing an orthodontist by age 7, there are several signs to look for that indicate the need for orthodontic check up including:
• Crowding of the teeth.
• An open bite (where there is a gap between the top and bottom teeth when the jaws are closed).
• Ectopic eruption (where an adult tooth protrudes from the gum over the baby tooth it is replacing).
• An underbite or overbite (when one jaw sticks out farther than the other).
• Obvious crookedness or a gap between the front teeth.
• Oral habits such as thumb/finger sucking.
In addition to these indications, it’s also important to consider the child’s emotional readiness. Orthodontics can sometimes be uncomfortable, require special attention to the types of foods that can be eaten, oral hygiene and maintenance (like wearing head-gear at night). Children (and parents) need to be committed to the process for the sake of the end result – a functional and beautiful smile.
Courtney Drake-McDonough is a writer for Dominion Parenting Publications.
