tweens

c2c tweens

ages 8-12

Is It Time for Braces?

By REID MontInI, DMD, Ms, Pa

While braces can improve a smile at any age, timely evaluation can optimize the orthodontic result and limit the time and expense of orthodontic treatment.

uWhat is the best age to schedule an orthodontic consultation? The American Association of Orthodontists recommends that an orthodontic consultation should take place at the first sign of problems or no later than age 7.

uDoes this mean all 7-year-olds need braces? Seeking an orthodontic evaluation does not always translate into a need for orthodontic treatment at this early age. However, early evaluation provides the orthodontist the opportunity for timely diagnosis of problems and the opportunity to aid in the guidance of growth and development. In addition, early evaluation may aid in the prevention of more serious problems.

uWhat kinds of issues should parents be looking for when assessing the need for treatment? • Crowded or crooked teeth • A crooked face or chin • Lower teeth that stick out beyond upper teeth when the bite is closed • Large overjet or "buck teeth" • Large space • Thumb or finger habit lasting past the age of 6 • Front teeth that do not overlap vertically • Narrow jaws • Early loss of baby teeth • Delayed or uneven eruption of adult teeth

uWhat damage can occur if treatment is not started at the right time? Damage can occur in two ways. The most obvious is physical damage. When lower teeth stick out beyond the upper teeth, the gum tissue of the lower

teeth can become compromised and the upper teeth can wear abnormally. Severe crowding can be problematic and lead to damage. Problems caused by crowding can include but are not limited to: delayed eruption, damage of adjacent teeth and gums, impacted teeth and ectopic tooth growth. Also, a narrow upper jaw can lead to uneven growth of the lower jaw. Left untreated, this unevenness can require jaw surgery to correct it as an adult.

The second type of damage is psychological and can be equally problematic. Excessive overjet (buck teeth), severe crowding and crooked teeth can have a negative effect on self-image and social development in the preteen years. Many scientific studies have shown the positive effects of orthodontic treatment on self-image and confidence.

uAre there any problems where early intervention is not advantageous? Several studies have shown that overjet (buck teeth) correction is just as effective during teen years as it is at a young age. Therefore, it is usually best to wait to correct this problem until all the adult teeth are erupted. The exception to this rule is when social problems or teasing occur as a result of the upper teeth sticking out. The significance of the social problem, at times, determines the course of action.

uWhat is the bottom line regarding timing of orthodontic treatment? Each patient is evaluated on a caseby-case basis. If parents are unsure as to their child's orthodontic needs, it would be advisable to schedule a consultation with an orthodontist. In many cases, consultations are complimentary.

I typically recommend annual or semi-annual evaluations starting at age 7. In most cases, waiting to place braces until all the adult teeth, other than wisdom teeth, have fully erupted is standard practice. Exceptions to this philosophy include cases where damage, either physical or social, can occur due to a lack of action.

Your orthodontist should present the risks and benefits of all options in a way that parents and patients can understand. After discussing the recommendations, you can make an informed decision about your child’s treatment and feel confident in that decision. 

Dr. Montini graduated with honors from the harvard school of Dental Medicine in 2002 and completed his orthodontic residency at the university of Florida in 2005. he and his wife, Karin, have been married since 1998 and have two children.