Brace Yourself – What You should Know About Your Child’s Dental Care

It’s always a surprise when you see an adult with braces, but it can be equally jarring to see them on children who are not yet teenagers.

Seeing such young children with braces may raise a few questions, why are young children having orthodontic work done? Is it necessary? Is this something parents of younger children should have on their radar?

The American Association of Orthodontists says that the best age for children to start seeing an orthodontist is 7. There are a number of practical reasons for starting this early.

Dr. Derek Bock of Forest Orthodontics and Pediatric Dentistry, points out that a visit at this age “doesn’t mean that a child is ready for orthodontic treatment at age 7, but rather it’s a great time for an orthodontic specialist to evaluate and monitor the growth and development for the ideal time for that child. Every child is different”

Part of the reason for this is because, by age 7, children will usually have at least 4 permanent molars and 4 permanent incisors. The term “6-year molars” refers to the fact that this is usually the age these permanent teeth come in.

However problems can arise right around this crucial time, for example, if there are additional or missing teeth it may lead to crowding, over-spacing, or other alignment problems for teeth coming in properly.

Much of the early detection solution lies in providing checks and balances to the way in which permanent teeth are correctly, or incorrectly, replacing primary teeth.

Brian Laski BSc (Hons) DDS, MSc, FRCD(C) of Laski Ortho Smiles, says that when necessary, “Orthodontic correction can occur while a child has baby teeth. It is beneficial to complete certain orthopedic movements while many of the primary teeth are still in place, such as widening the upper jaw in order to make room for crowded permanent teeth to erupt into place at the appropriate time. Often times, this prevents the need for permanent teeth to be extracted in the future, which is a trend that the orthodontic profession is moving away from.”

Things to watch for during this time period, under special orthopedic care, include tooth loss and eruption issues. An orthopedic specialist can decide if early removal of a primary tooth might be called for in one case. Or in another case where a tooth has been lost prematurely, maintaining that space may help prevent issues down the line, and remedy teeth trying to emerge into a crowded space.

Some other situations that may need to be addressed in adolescent orthodontics include underbites, overbites, crossbites, open bites, and deep bites.

Anterior underbites may not be able to be corrected completely until later into the teenage years, but some attention and work can be done to assure that there is not damage done to the front teeth.

With a posterior crossbite, which can create crowding, an expansion can be done to assure the jaw doesn’t incur shifting.  As Anil J. Idiculla D.M.D, of i-Orthodontics, points out, “We are not just aligning teeth.  We are aligning jaws as well.”

Alignment is an important area to look at a young age, because although it can be corrected later, the alignment will affect how the teeth interact and can cause uneven wear and impact, even to the point of compromising the integrity of gum tissues.

Also, it is easier to correct these issues at a younger age rather than have to address them closer to the teenage years where crooked teeth may have social implications.

At an earlier age, habits are formed in chewing and jaw motion overall, and with problematic alignment, these habits reinforce further damage that only escalates during these years of intense physical growth and change.

Protrusive front teeth, for example, can be something to be addressed for more than simply cosmetic reasons, as they often cross over into the realm of a safety concern if they continue to become progressively exacerbated over time.

At the important, aforementioned age of 7, deep bites and anterior open bites can also be diagnosed. If the bites don’t have enough of an overlap (open bites) whether, from natural or habit-related causes (thumb or finger sucking), these are better to be looked at early for correction. Crowding and spacing issues can also happen if teeth just happen to be too small.

As mentioned, actually taking pre-emptive action, rather than simply getting an early age consult, may not be needed in most cases. But to avoid potential trouble down the road in other situations, these early orthodontic measures may be in order.

“Some patients with significant problems of their jaws or of the development of their teeth may benefit from breaking orthodontic treatment into two parts, says Dr. Jamie B. Reynolds DDS, MS of Northville Orthodontist.  

Dr. Reynolds continues, “The first part typically referred to as an ‘interceptive phase’ or ‘phase 1’, is a shorter burst of treatment aimed to help make room for developing teeth or help develop the jaws. Devices such as expanders and space maintainers are used in combination with braces to accomplish this phase. Most interceptive phases are done with many baby teeth still in the mouth and many times will require final straightening of the permanent teeth when they grow in later. These two-phase treatments are typically reserved only for the more complicated treatments. In our practice, about 80-85% of all patients we see can wait and have treatment in one phase when all the teeth are in. The remaining 15-20% benefit from dividing treatment into two phases with the first phase beginning around age 7 or 8.” 

Some of the solutions, for example, for crowding, may utilize tooth removal, or expanding arches to support more space for teeth. These types of procedures and the others mentioned above can be explained by your orthodontist and can be non-invasive and non-traumatic for the young patient.

Based on all of the reasons mentioned above, it’s a good idea to start screening children at the age of 7, in order to locate and diagnose these problems, if they do exist, while it is early enough to take proactive measures.

Whether or not it can wait until a later day, interceptive treatment can help your child face less time wearing braces, and also may spare them the need for longer term braces during their more impressionable years in later adolescence. We highly recommend that if you have a child around the age of 7 or a little older, that you set up a screening appointment with a board-certified orthodontist, to ensure their oral health today and into the future.