At what age should my child be seen by an orthodontist?
The American Association of Orthodontists recommends that all children be seen by an orthodontist by age 7. This does not mean that all children need treatment. In fact, I find that most young children do not need intervention at this age. However, for those that do need early treatment, or Phase I treatment, the timing is highly sensitive.
What are the reasons a young child (average age 7-10) might need Phase I treatment? Phase I treatment is not the same as a full set of braces. Phase I treatment is generally performed for 3 reasons:
1) If there is a jaw or bone discrepancy that can be corrected or improved.
2) If there is a dental safety issue.
3) If the patient is extremely self-conscious about the way that their front teeth look.
Let’s discuss each of these reasons in a little more depth.
1) Jaw/bone discrepancy: Children who have a narrow upper jaw or palate may need a palatal expander to widen their upper jaw into a proper bite. The upper jaw, or maxilla, is one fused piece of bone in an adult or older child. In a young child who has not yet reached puberty, the maxilla has not yet fused and is still in 2 pieces. These 2 pieces can be moved apart, and new bone forms in between, thus permanently widening the palate. Many parents wonder if this process is very painful. For young children, this process does not cause much discomfort. Since the bone is not fused, the most common reaction is pressure under the nose or the feeling of a sneeze. There are other jaw/bone discrepancies that can also be addressed at an early age such as an underbite, but I have found a narrow palate to be one of the most common issues.
2) Dental safety issue. There are various dental issues that can come up in young children, but I will mention a couple of common ones. Some children have deep impinging overbites. This means that their top teeth cover the bottom teeth vertically so deeply that their bottom teeth are touching or in some cases cutting or tearing the palatal tissue. When a bite is this deep it can cause recession of the gum tissue behind the upper teeth. For a case such as this, I will often prescribe a bite plate, which is a special kind of retainer with a thick area of acrylic. The child wears this appliance for a number of months and it helps to open the bite, bringing the teeth into a safer positon away from the gum tissue. Another dental issue that can come up is if a front adult tooth is hitting directly into a lower tooth. In this case, significant wear and damage can occur on the teeth. For these cases, there are a few treatment options, one being a short course of a few braces to move the tooth into a safe poisiton.
3) Self-conscious. Some young children who have very misaligned teeth get teased at school or become so self-conscious that they refuse to smile. In these kind of cases, it can be a huge boost to the patient’s self-esteen and emotional well-being to place a short course of braces to align teeth.
For children who do not need Phase I treatment, it is recommended to get observed by an orthodontist at least yearly so that dental growth can be monitored. Sometimes an orthodontist can ‘catch’ something as the patient grows and this can have a tremendous beneficial effect on their later development. Here at Hocking Orthodontics, our younger patients are part of a Junior Observation program and are monitored as a courtesy.
At what age should my child have a full set of braces?
Most children area ready for braces at 11 ¾ years. This is just an average, and can vary a lot! Some children who are only 9 may have a full complement of adult teeth, and may be ready sooner for braces. On the other hand, many children hang on to baby teeth until well into their teens and may not be ready for orthodontic treatment until much older. In order to have comprehensive braces or Invisalign (full treatment), the patient needs to have most or all of the baby teeth out. The tremendous variation in dental development is one of the reasons we recommend to be seen by an orthodontist for “Observation”. The orthodontist will be able to let you know the best timing for treatment.