By Dr. Catharine Borders
Orthodontics have come a long way in the 20 or so years since many of us had braces ourselves. The experience our kids have with braces is very different from ours, but in an exciting way. Now, there are many more options in addition to metal braces, such as clear aligners, ceramic braces (tooth-colored brackets that look more natural), and lingual braces (braces on the back of the teeth). New advancements in the brackets and wires themselves also allow for less pain and potentially shorter treatment times.
Due to orthodontic treatment being very different from their own, or not having had treatment themselves, we often get lots of questions from parents. To help ease your mind and to brace you for bracing your kids, we’ve answered some of the mostly commonly-asked questions we get from parents.
Who should I take my child to for orthodontic treatment?
First and foremost, all orthodontists are dentists but not all dentists are orthodontists. Both are doctors who help patients with oral hygiene and matters related to the teeth. However, orthodontists attend an additional 2-3 years of training, where they focus solely on complex issues related to the mouth, such as jaw alignment, teeth straightening, malocclusion, improperly spaced teeth and more.
Any type of tooth movement- from the most simple to the highly complex- requires you to see a specialist who has received additional training beyond dental school. Your orthodontist is a specialist and has attended an additional 4,000 – 6,000 hours of intense training to become certified to fix the following problems:
• Crooked smile or teeth
• Misaligned jaws
• Improper bite and chewing
• Underbite or overbite
• Braces, retainers or other corrective devices
Although you don’t want to see your dentist for straightening your child’s teeth, dentists are still an important part of your child’s oral care, and regular dental cleanings will still be necessary during orthodontic treatment. Both your dentist and your orthodontist will work together to make sure your child has a healthy smile, but it is a patient’s job to make sure they are receiving the best possible care for their oral health. While seeing your dentists for orthodontic work may seem convenient or appealing, you should only trust your child’s smile with a certified orthodontic specialist.
How can I tell if my child needs braces?
If your child is showing any of the following signs, you will want to make sure to schedule an orthodontic exam with a certified orthodontic specialist:
• Early or late loss of baby teeth
• Difficulty in chewing or biting
• Mouth breathing
• Thumb sucking
• Crowding, misplaced or blocked-out teeth
• Jaws that shift or make sounds
• Speech difficulties
• Biting the cheek or the roof of the mouth
• Teeth that meet abnormally, or don’t meet at all
• Facial imbalance
• Jaws that are too far forward or back
• Grinding or clenching of the teeth
• Snoring or other signs related to sleep apnea
At what age should I bring my children into the orthodontist?
It is important to assess your child’s orthodontic health early, and it is the recommendation of the American Association of Orthodontists that your child see an orthodontist by age 7. This may seem early to most, but assessment and monitoring early on may reduce the time and extent of treatment once they are ready for braces or other orthodontic appliances.
These are some of the issues we look for in 7-year-old patients:
• Crowding—Monitoring the eruption process (losing baby teeth and growing new permanent teeth) is done during these formative years. Taking appropriate action at the right time can dramatically simplify things later.
• Overbites and underbites—These bite problems can cause the gums to recede on the front teeth if left untreated. Teeth can even become loose and fall out later.
• Narrow upper jaw or posterior crossbite—Some studies have shown that a narrow upper jaw can cause uneven jaw growth if preventative measures aren’t taken early on. More recent studies have shown that expanding the upper jaw can improve the airway and cure sleep apnea.
• Impacted teeth—If left unmanaged, impacted teeth can cause damage to the roots of adjacent teeth
• Upper and Lower Jaw relationships—Can be managed with appliances and could potentially minimize the need for surgery later on in life.
• Oral habits—Harmful oral habits like thumb sucking can cause a bad bite and a narrow upper jaw.
• Improve Appearance—Orthodontic treatment has shown to have a psychological and social benefit. Beyond immediate orthodontics remedies for mouth health, research shows that it can help with self-perceptions and quality of life for your children.
Having your kids see an orthodontist at the right time could help identify any problems that may affect your child’s health and function early on. Secondarily, it could also save you time and money. An early orthodontic appointment will give your orthodontist time to spot current and incoming problems for children and allow them to plan appropriately.
Once permanent teeth have arrived, or if a patient has passed a certain period of growth, it can potentially take more time to treat a given condition. Most orthodontists perform their initial consultations as a courtesy to you so there are generally no charges associated with this first visit. Please ask your orthodontist about their specific policy on fees.
Should I wait to see an orthodontist until my child is referred by their dentist?
Take your child’s oral care into your own hands and don’t wait for a referral from your dentist, as a referral isn’t needed to see an orthodontist. However, before you call the first number you find online for an orthodontist, look for a list of orthodontists in your area. Some orthodontic specialists have even more distinct sub-specialties, so make sure to do your research. Orthodontists who are members of the Texas Association of Orthodontists (TAO) are committed to community service and innovation.
The TAO website, texasortho.org, is a great resource to start your search. After that, a deep dive into the offices’ websites, along with referrals from family and friends, is a great way to make your choice. You should choose the orthodontist that you and your child will be most comfortable with because a good patient-doctor relationship is essential to successful orthodontic treatment.