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Pediatric Dentistry
Orthodontics
A child's
appearance is very important to them and their parents, and a good self-esteem
is a critical component in child's social and psychological development.
Orthodontic treatment may be recommended for your child as early as 5 years
of age if they have an underbite or crossbite, but most orthodontic treatment
will begin at age 7 or older. The goal of orthodontics is to bring your
teeth, jaws, and lips into proper alignment and relationship by using braces
as well as dentofacial orthopedic appliances. Give your child a beautiful
healthy smile that is good for life. Beginning your child's orthodontic
treatment before all of the primary or baby teeth fall out is often a necessity
to avoid removal of permanent teeth during orthodontic treatment. Early
evaluation could possibly minimize your treatment time and costs at a later
age.
 Before
 After
Orthodontic Correction in Children
by Dr. Stephen R. Branam, D.D.S.
In the twenty years that I
have been a pediatric dentist and treating orthodontic problems in children,
I have observed some significant changes in orthodontic treatment, philosophy,
and methods. Years ago, orthodontic treatment was requested and performed
almost exclusively to align the patient's crooked or crowded teeth and
improve their appearance. Usually the braces were placed in the mouth
after all of the permanent teeth had erupted (age 12-14 years), and the
crowded teeth were quite obviously in need of alignment. Frequently, four
permanent bicuspids would have to be extracted, and the patient would
wear braces for two to four years and often times, full headgear would
be needed.
Headgear was worn to pull the
upper front teeth backwards to correct overbites and little emphasis was
placed on the soft tissue profile and temporomandibular joint (jaw joint)
position. The patient would be wearing their braces well into high school
and then be required to wear retainers for at least a year or more to
hold their teeth in their new position because the teeth were crooked
a long time prior to beginning their treatment.
The current treatment philosophy
and methods have changed significantly in recent years. It is usually
obvious that a child will need orthodontic treatment by 6-7 years of age
(when the upper and lower incisors begin to erupt). When treatment is
started depends on the overbite, the overjet, and the severity of crowding
present in the mouth. We know that eight percent of people who have a
large overjet (front teeth that stick out) actually have a small or underdeveloped
lower jaw which needs to be positioned more forward. Only about 20 percent
of patients need to have the front teeth pulled back. This type of correction
is done by wearing orthopedic appliance inside the mouth or by wearing
headgear daily, mostly while sleeping, if started between nine and eleven
years of age. It is also possible in about ninety percent of patients
to avoid extraction of permanent teeth, if the treatment is begun prior
to age ten years. In a growing child, we can usually use appliances to
develop the jaw to an adequate size to accommodate all of the permanent
teeth, but some patients will still need to have permanent teeth removed
no matter how early the treatment is begun. Moving younger and more immature
teeth is usually less painful than mature teeth.
With many adults having headaches
and jaw joint pain on a consistent basis, any orthodontic treatment regiment
should have a preventive component to eliminate or minimize these potential
problems. As a pediatric dentist, I have often seen adolescent children
who already have a pattern of headaches which are attributed to their
poor dental occlusion or bite. These headaches usually occur in the morning
when awaking or late in the school day. These headaches are also usually
directly related to stress or the tension of the child, therefore this
should be addressed during their orthodontic treatment.
By beginning orthodontic treatment
earlier and at the appropriate time, the child is often finished with
their braces by ninth grade at the latest. Many times by doing early treatment
you can make full braces optional or minimal and save yourself some significant
cost and still have a very nice smile and healthy mouth and jaw. Full
braces are still often needed but the wearing time is significantly shorter
in current treatment regiments making retainer wear shorter also.
Since patient cooperation is
a very significant factor in orthodontic treatment, younger patients are
usually more excited about appliance wearing which means a quicker result
and possible less costly treatment. Early orthodontic treatment with proper
treatment timing can give you an excellent result and be a positive experience
for your child, as well as building self-confidence in their appearance.
If you want more information, please feel free to contact us
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