Summer can be a time of fun and enrichment for children. It’s also a great time for parents to check things off of their to-do lists without having to schedule around school. This includes making your son or daughter’s dentist appointments and, depending on his or her age and needs, orthodontist appointments, too. Getting a jumpstart on braces—if your child needs them—will save loads of time once class is back in session. Key words: If your child needs them. So how do you know if your kiddo does?
If it seems like your child’s teeth are a little off or every kid in the class is flashing a new set of braces, you probably have plenty of questions. You probably also have plenty of preconceived notions about braces.
If you’re basing everything you know about braces on your personal experiences from middle or high school, stop. The truth is, a lot has changed in childhood orthodontics since you were growing up. That includes the rise of braces that you can’t even see.
Advances in teeth straightening technology
“The biggest change has been the rise of Invisalign and similar companies that use a sequence of clear plastic aligners instead of metal braces to straighten the teeth,” says Eric Baugher, DDS of Central Virginia Orthodontics in Lynchburg. “Many people are drawn to this idea of treatment because you can avoid the look and feel of traditional braces. But compliance is the key to successful treatment with Invisalign since the trays need to be worn 22 hours per day.”
The prevalence of Invisalign isn’t the only change in orthodontics since you were a tween. Traditional braces themselves have been modernized, too.
“Advances with traditional braces include super-elastic wires that make treatment more comfortable for the patient is more protective of the roots of the teeth compared to treatment decades ago,” continues Dr. Baugher.
Another advance is simply making traditional braces smaller.
“The bracket technology has created smaller braces that have a prescription for each tooth in order to provide a more efficient and comfortable patient experience,” says Mark Blanchette, DDS, MS of Blanchette Orthodontics in Lynchburg. “We now have smaller, esthetic brackets that can help those patients who are concerned with the appearance of the appliances.”
Other advances in bracket technology have come along, as well. Take thermal technology, for instance.
“Thermal wires are activated by the temperature of the mouth,” explains Dr. Blanchette. “This can speed initial alignment and leveling of the arches.”
Even the way patients are fitted for braces has changed.
“As opposed to taking impressions, today we use a digital scanner, which scans the patient’s teeth and creates an immediate computer model,” says Dr. Blanchette.
The list of advances does not end there.
“Other advances are self-ligating brackets, which help minimize friction during treatment and lingual brackets which hide traditional braces on the other side of the teeth next to the tongue,” says Dr. Baugher.
At what age should my child be evaluated for braces?
Hearing of these advances may remove your hesitation to take your child to the orthodontist this summer, but if you’re still wondering, wonder no more. A check-up can do no harm. Your child may be too young for braces, but a first or second-grade child isn’t too young for a check-up. Early planning can save a lot of angst down the line.
“The American Association of Orthodontists (AAO) recommends that all children have a check-up with an orthodontic specialist no later than age 7,” says Dr. Baugher. “The AAO does not advocate comprehensive orthodontic treatment at age seven, but interceptive—Phase I—treatment may be appropriate for some specific dental problems. Just a few examples of dental problems that may need early orthodontic treatment include: severe crowding, anterior crossbite, deep bite, and problems with the eruption of permanent teeth.”
Age seven may sound startlingly young, far younger than you remember. It may seem that children are now able to get braces earlier than they were in decades past, but that may not actually be the case. What’s different is how ubiquitous braces are these days.
“Braces are definitely much more common now than they were 30 years ago,” Dr. Baugher. “This is partly due to braces being more affordable today with many dental insurance plans covering a portion of the cost. Also, more people want a ‘perfect smile’ and are willing to invest in orthodontic treatment to achieve a healthy smile that will last a lifetime.”
Even with the assurance that orthodontic technology has advanced and an early check-up is a sound idea, actually putting your child in braces can be a difficult decision. How do you know if your son or daughter is ready?
“There is no exact age that applies across the board for kids to begin orthodontic treatment,” says Dr. Baugher. “An early evaluation by an orthodontist will help ensure that treatment begins at the correct time to give the greatest possible result. Many children will not be ready for orthodontic treatment until most of their permanent teeth are in or close to erupting.”
He adds, “Dental health also plays a big part in determining when someone is ready to begin orthodontic treatment. If teeth and gums are not absolutely healthy without braces on, then it is best to delay the start of treatment and work on improving oral hygiene first.”
Puberty should be another consideration.
“For most adolescents, the proper time to start is when most of the primary (or baby) teeth have exfoliated,” says Dr. Blanchette. “This can reduce the amount of time that the appliances are needed. There are times when it is appropriate to initiate treatment earlier if there is a disharmony in growth, if there are impacted teeth, or if the child has a habit such as thumb-sucking or tongue-thrusting. Occasionally it is appropriate to initiate treatment if the child is having self-esteem issues due to the alignment of their teeth.”
When genetics come into play
Some kids are pre-disposed to needing braces, regardless of thumb sucking and other childhood habits.
“Genetics play a role in tooth number, size and shape, as well as jaw size,” says Dr. Baugher. “If a child has parents that, as children themselves, both had braces with permanent teeth removed due to severe crowding, then the child is much more likely to also have dental crowding requiring orthodontic treatment. Likewise, a parent that still has a primary (baby) tooth present where a permanent tooth never formed is more likely to have a child with a missing permanent tooth. So, just like all the other traits we inherit from our parents, dental problems and malocculusions can be passed on also.”
Of course, not every child is genetically predisposed to needing braces. But there isn’t a lot that parents can do to prevent the need for them, either.
“Many issues, such as crowding, crossbites, and overbites, are pre-programmed in the individual based on the growth and development of their teeth and jaws,” says Dr. Baugher.
There is one thing you can do, though: discourage thumb and finger-sucking habits.
Dr. Baugher says, “The earlier such habits are stopped will help minimize their negative effects on the teeth and bite.”
Braces in stages, or all at once?
You may think that you want your child’s braces done in stages instead of all at once. For most children, that is not an option.
“Most orthodontic treatments are comprehensive, which means that teeth in both the top and bottom arches have braces during treatment,” says Dr. Baugher. “This is usually necessary to ensure that the bite fits together well after the teeth are straightened. Some people that have a good, stable bite but are not happy with their smile due to a little spacing or crowding around the front teeth can get a partial set of braces to fix that one issue.”
Even if, medically, it made sense, doing braces in stages doesn’t make financial sense.
“Occasionally, children need braces on only one arch,” says Blanchette. “It is unusual to place braces on one arch and then later correct the other arch. This would not be very cost and time efficient.”
Consult with a professional to make the most informed decision
With so many advancements in orthodontic care available today, identifying which direction is best for your child can be challenging without advice from a dental health professional. Speak with your child’s dentist or schedule an appointment with an orthodontist for more information.
~ Mark Blanchette, DDS, MS of Blanchette Orthodontics in Lynchburg
~ Eric Baugher, DDS of Central Virginia Orthodontics in Lynchburg