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Stephen Fox D.M.D. | Member American Academy of Pediatric Dentistry

What's the Best Time for Ortho Treatment

TREATMENT TIMING

Dr. Fox provides orthodontic treatment for adolescents and children depending on the severity of the malocclusion. In some cases our office will refer you to an orthodontist who will work with us in caring for your child.

1. WHAT IS THE BEST TIME FOR ORTHODONTIC TREATMENT?

Developing malocclusions, or bad bites, can be recognized as early as 2-3 years of age. Often, early steps can be taken to reduce the need for major orthodontic treatment at a later age.

By age 7, enough permanent teeth have come in and enough jaw growth has occurred that the dentist or orthodontist can identify current problems, anticipate future problems and alleviate parents’ concerns if all seems normal. The first permanent molars and incisors have usually come in by age 7, and crossbites, crowding and developing injury-prone dental protrusions can be evaluated. Any ongoing finger sucking or other oral habits can be assessed at this time also.

The timing of your treatment is VERY important; a consultation will allow us to better understand your needs. Please contact our office if you have any questions.

Some signs or habits that may indicate the need for early orthodontic examination are:

  • early or late loss of baby teeth,
  • difficulty in chewing or biting,
  • mouth breathing,
  • thumb sucking,
  • finger sucking,
  • crowding, misplaced or blocked out teeth,
  • jaws that shift or make sounds,
  • biting the cheek or roof of the mouth,
  • teeth that meet abnormally or not at all, and
  • jaws and teeth that are out proportion to the rest of the face.

2. WHAT ARE THE BENEFITS OF EARLY TREATMENT?

For those patients who have clear indications for early orthodontic intervention, early treatment presents an opportunity to:

  • guide the growth of the jaw,
  • regulate the width of the upper and lower dental arches (the arch-shaped jaw bone that supports the teeth),
  • guide incoming permanent teeth into desirable positions,
  • lower risk of trauma (accidents) to protruded upper incisors ( front teeth),
  • correct harmful oral habits such as thumb- or finger-sucking,
  • reduce or eliminate abnormal swallowing or speech problems,
  • improve personal appearance and self-esteem,
  • potentially simplify and/or shorten treatment time for later corrective orthodontics,
  • reduce likelihood of impacted permanent teeth (teeth that should have come in, but have not), and
  • preserve or gain space for permanent teeth that are coming in.

3. WHAT IS A SPACE MAINTAINER?

Baby molar teeth, also known as primary molar teeth, hold needed space for permanent teeth that will come in later. When a baby molar tooth is lost, an orthodontic device with a fixed wire is usually put between teeth to hold the space for the permanent tooth, which will come in later.

4. WHY DO BABY TEETH SOMETIMES NEED TO BE EXTRACTED?

Removing baby teeth may be necessary to allow severely crowded permanent teeth to come in at a normal time in a reasonably normal location. If the teeth are severely crowded, it may be clear that some unerupted permanent teeth ( usually the canine teeth) will either remain impacted ( teeth that should have come in, but have not), or come in to a highly undesirable location. To allow severely crowded teeth to move on their own into much more desirable positions, sequential removal of baby teeth and permanent teeth ( usually first premolars) can dramatically improve a severe crowding problem. This sequential extraction of teeth, called serial extraction, is typically followed by comprehensive orthodontic treatment after tooth eruption has improved as much as it can on its own.

After all the permanent teeth have come in, removing of permanent teeth may be necessary to correct crowding or to make space for necessary tooth movement to correct a bite problem. Proper extraction of teeth during orthodontic treatment should leave the patient with both excellent function and a pleasing look.

5. HOW CAN A CHILD’S GROWTH AFFECT ORTHODONTIC TREATMENT?

Orthodontic treatment and a child’s growth can complement each other. A common orthodontic problem to treat is protrusion of the upper front teeth ahead of the lower front teeth. Quite often this problem is due to the lower jaw being shorter than the upper jaw. While the upper and lower jaws are still growing, orthodontic appliances can be used to help the growth of the lower jaw catch up to the growth of the upper jaw. Abnormal swallowing may be eliminated. A severe jaw length discrepancy, which can be treated quite well in a growing child, might very well need corrective surgery if left untreated until a period of slow or no jaw growth. Children who may have problems with the width or length of their jaws should be evaluated for treatment no later than age 10 for girls and age 12 for boys.

6. CAN MY CHILD PLAY SPORTS WHILE WEARING BRACES?

Yes. Wearing a protective mouthguard is advised while playing any sports. Your Pediatric Dentist/Orthodontist can recommend a specific mouthguard.

7. WILL MY BRACES INTERFERE WITH PLAYING MUSICAL INSTRUMENTS?

Playing wind or brass instruments, such as the trumpet, will clearly require some adaptation to braces. With practice and a period of adjustment, braces typically do not interfere with the playing of musical instruments.

8. WHY DOES ORTHODONTIC TREATMENT TIME SOMETIMES LAST LONGER THAN ANTICIPATED?

Estimates of treatment time can only be that- estimates. Patients grow at different rates and will respond in their own ways to orthodontic treatment. Dr. Fox has specific treatment goals in mind, and will usually continue treatment until these goals are achieved. Patient cooperation, however, is the single best predictor of staying on time with treatment. Patients who cooperate by wearing rubber bands, headgear or other needed appliances as directed, while taking care not to damage appliances, will most often lead to on-time and excellent treatment results.

9. WHY ARE RETAINERS NEEDED AFTER ORTHODONTIC TREATMENT?

After braces are removed, the teeth can shift out of position if they are not stabilized. Retainers provide that stabilization. They are designed to hold teeth in their corrected, ideal positions until the bones and gums adapt to the treatment changes. Wearing retainers exactly as instructed is the best insurance that the treatment improvements last for a lifetime.

10. WILL MY CHILD’S TOOTH ALIGNMENT CHANGE LATER?

Studies have shown that as people age, their teeth may shift. This variable pattern of gradual shifting, called maturational change, probably slows down after the early 20’s, but still continues to a degree throughout life for most people. Even children whose teeth developed into ideal alignment and bite without treatment may develop orthodontic problems as adults. The most common maturational change is crowding of the lower incisor (front) teeth. Wearing retainers as instructed after orthodontic treatment will stabilize the correction. Beyond the period of full-time retainer wear, nighttime retainer wear can prevent maturational shifting of the teeth.

11. WHAT ABOUT THE WISDOM TEETH ( THIRD MOLARS) – SHOULD THEY BE REMOVED?

In about three of four cases where teeth have not been removed during orthodontic treatment, there are good reasons to have the wisdom teeth removed, usually when a person reaches his or her mid-to-late teen years. Careful studies have shown, however that wisdom teeth do not cause or contribute to the progressive crowding of lower incisor teeth that can develop in late teen years and beyond. Dr. Fox can determine what is right for you.