Early Orthodontic Intervention
Why your child may need treatment sooner rather than later
Parents often come into my practice and ask, “why does my child need braces so young?” This is a valid question because several decades ago children weren’t getting braces until they were teenagers. However, advances in research have proven that some orthodontic interventions are often more effective in younger age ranges when the jaws are undergoing a rapid period of growth. By starting treatment at an earlier age (specifically between the ages of 7 and 10) the child’s natural growth is used to correct a variety of different problems.
Although early orthodontic intervention is not right for every child, there are certain irregularities that orthodontists can easily correct in younger children. These irregularities include crowding, underbites (where the lower jaw is further forward than the top jaw), open bites due to thumb-sucking habits and crossbites.
Children with crowding often have small dental arches. Before permanent teeth come in it may be possible to help them emerge through the gums into a better position. A device called an expander can gently widen the jaw so that all of the permanent teeth can eventually fit. Decades ago, we would extract permanent teeth to make space and move other teeth into place; but this is often a thing of the past.
Early treatment is also beneficial for children with underbites, where the lower jaw is too big or the upper jaw is too small. We often see this in children between the ages of 7 and 8, and it is easy to address with early intervention involving fixed appliances that comfortably guide the jaws into a more harmonious relationship. Children who don’t receive treatment for this type of bite at a young age often have to have jaw surgery when they are teenagers or adults.
Children with open bites are also excellent candidates for early intervention. An open bite often occurs in children who have sucked on a pacifier or thumb beyond the age of two. The front top and bottom teeth don’t meet when the child bites down. There is a retainer-type of device that helps to stop the thumb or pacifier sucking habit and simultaneously get rid of the open bite. Similar to an underbite, the only way to correct an open bite after the jaws stop growing is with jaw surgery in conjunction with braces.
Sometimes a child may be genetically prone to missing an adult tooth or teeth. If this is caught early the orthodontist can guide the eruption of other teeth into the space, thus decreasing the need for implants or bridges to replace the missing teeth in the future. For example, a common tooth for people to be missing is the lateral incisor–the teeth next to the two front teeth. We will often guide the canines and all teeth behind them into the space where the incisors are missing. It is impossible to tell that the child once had a missing tooth and long term, the patient will not need to address the missing front teeth with dental work.
Early orthodontic treatment can correct significant problems, prevent more severe problems from developing and simplify future treatment. The final alignment of the teeth is often not corrected until all the permanent teeth have erupted. Typically a short phase of braces is needed around the age of 12. However in some circumstances this second phase may not be needed.
Parents may feel overwhelmed by the financial burden of treatment. Most orthodontic offices will assist families by reviewing the proper timing of enrollment for dental benefits that provide orthodontic coverage, assisting with health savings account plan information and offering in-office payment arrangements that make treatment affordable.
Young children may often be a bit fearful about the idea of visiting an orthodontist. Like adults, this is often due to a slight fear of what is unknown; therefore, it is important to foster open communication with your child before the first appointment with an orthodontist. Talk about what he or she may already know about braces or expanders (perhaps a friend or family member has them), visit the website or Facebook page of your orthodontist to see fun photos and videos of children their age who are undergoing treatment, and know that most orthodontists will assist you in allaying any fears that your child may have by continuing this dialogue once in the office.
Tina Reed, MD Bio
Dr. Reed was raised in Pittsburgh and received her undergraduate and dental degrees from the University of Pittsburgh. She then completed an advanced orthodontic residency and Masters of Science in Oral Biology at the University of California – San Francisco.
In 2002, after practicing in Redwood City, CA, Dr. Reed and her husband returned to Pittsburgh. In a Pittsburgh Post-Gazette article she addressed the question of why Pittsburgh?" Her answer was, "Why not?! My family appreciates everything Pittsburgh offers: strong arts and culture, rich history, quality education, affordable housing, great food and restaurants, diverse outdoor activities and a strong sense of community."
She is a member of the American Association of Orthodontists, the Western Pennsylvania Society of Orthodontists, the Great Lakes Association of Orthodontists and the American Dental Association. She was the founder of the Bay Area San Francisco Pitt Alumni Club, and an active supporter of the local chapter of the Crohn's and Colitis Foundation, Pittsburgh Parks Conservancy and the Riverlife Task Force.