The truth about children's orthodontics

“The Truth About Children’s Orthodontics The Benefits, The Costs and What to Avoid”

A special report by Dr Seth Newman

Hi there, and thanks for downloading our guide to children's orthodontics. This guide contains information on how you can help your child enjoy a confident smile with straight and healthy teeth, the guide also goes through some of the treatments we offer – fixed, invisible and rapid orthodontics. We then go on to answer the top 6 questions everyone asks about orthodontics.

As you read through it now picture your child’s teeth – see how the ideas we suggest could make the changes they want or need in how they look.

We offer these alternatives for straighter teeth for children:  

Fixed orthodontics with conventional metal brackets Fixed ‘Life Style Orthodontics’ with clear or ceramic braces

We’ll take each of these in turn so you can see which could be right for your child, we will also take a look at early intervention orthodontics in order to prevent problems later on in life.

So, take hold of the ideas in this guide and apply them to your own situation, would they make eating more comfortable, would they help you to feel better about your teeth and smile?

And as you read through this now, think about the way these concepts would specifically work for you and what would seem like the best logical choices in your own situation.

So prepare to find out more, see the benefits, seize the ideas, ask yourself those questions and on a final note enjoy finding out about smiling and laughing with straight teeth.

How soon should I bring my child to the orthodontist?

The key to achieving a great orthodontic result is to mention any concerns you have to your child’s dentist as soon as possible. Your dentist can then refer you to a specialist orthodontists, such as Newman’s Orthodontics. We prefer to see children at a very young age, sometimes as young as five years old. The reason for this is that there are very often preventive measures that we can take which are difficult to spot by a general dentist.

Preventive orthodontics is the process by which we work with the child's jaw development and growth to ensure that the teeth end up in the correct position. This is a very specialist area and once the jaw has finished growing clearly it is too late for this option.

If you are at all concerned about your child's tooth position, it really is never too early to have an initial chat. There have been many cases where people have brought their children to us in their early or mid teens only to find that the treatment is compromised.

We encourage the referral of children at the age of six to eight years, so that any abnormal tooth and jaw development can be detected early and treatment planned for the optimal time. Early treatment, when appropriate, can usually be carried out at an age when there is less schooling and social demands on the child, often making this an ideal time to be treated.

All too often, problems of a child’s teeth and jaws are left untreated until adolescence, when all baby teeth are lost. This makes treatment much more complex than it needs to be and may result in lengthy treatment, sometimes require the extraction of adult teeth and perhaps even surgery to give the desired results. Early treatment can alleviate many avoidable problems, often reducing the need for complex treatment later on, when all the adult teeth have developed.

Treatment at an early stage in development will be much simpler, easier and less demanding on school hours.

As adults we tend to think about orthodontics is just about straight teeth, it isn't.

Early intervention and “dentofacial orthopedics” is important because some parents get stuck on the visual of just their child’s straight teeth. Some parents think if their kid has a great smile then they’re in the clear. However, orthodontists look at more than just the smile and examine the movement and growth of the jaw (for under- and over-bites) and use panoramic xrays to look at tooth follicles checking for impacted, missing and overcrowded teeth.

5 Reasons Your Child May Need Early Orthodontic Intervention Thumb Sucking Beyond Age 5 Can Lead to Orthodontic Problems. Parents ask us all the time whether they should have their child evaluated for orthodontic treatment even though they still have baby teeth. Our answer is always YES! Why do we want to see children even as young as age six?

There are several reasons and here they are: 1. They have a persistent thumb, finger or tongue habit.

These types of habits should be eliminated by the time your child enters kindergarten. If left untreated, they could cause the teeth to be pushed out too far and the jaws to grow in the wrong direction. Furthermore, speech problems as well as eating difficulties are quite common in children with these persistent habits.

2. They have upper teeth that are behind the lower teeth (also called an under bite).

This is a very severe problem that should be treated at a young age while the child is still growing. The upper jaw in these cases is not growing at the same rate as the lower jaw. Often, these problems, if left to the teenage years, will result in extensive orthodontic work and even jaw surgery to fully correct.

3. They have teeth that protrude out too far.

This problem is commonly related to a thumb or finger habit, but can also be growth related. The lower jaw is not growing at the same rate as the upper jaw. The biggest problem in children with severely protruding teeth is that they can fall and break or crack a tooth, which will result in extensive dental work for the rest of their lives. It also can cause extreme wear of their back teeth and, even later in life, jaw problems.

4. Not enough room for the adult teeth to come in.

This is common problem that we see daily. Often the parent tells us that their child lost baby teeth months ago and there is no sign of any adult teeth. They get worried. Most of the time there is a crowding problem and the jaws are too small and narrow. Early intervention with expansion-type appliances can make room without the need for extractions.

5. Mouth breathing, snoring, teeth grinding.

All of these can be associated with a bad bite, narrow arches, crowding and habits. Early intervention can provide a solution for your child to help them breathe better and sleep better too. Studies show that many children who do not sleep well at night have problems focusing at school and experience excessive daytime sleepiness.

We are pleased to offer you and your child a complimentary 45 min consultation which will include :     

Welcome tour Panoramic evaluation (a complete digital scan of your child's teeth) Photographic and video graphic records of your child before treatment begins A full treatment plan Communication with your insurance partner

What is the best age to get braces?

As we have previously mentioned it is best to bring your child to the orthodontist as early as possible, so that if need be, we can work with the development of the jaw. It is however standard practice to begin orthodontic therapy to move teeth when the patients draw has finished growing, typically around 14 years old.

Dependent upon the particular situation sometimes surgery or other interventions are required, and this can be started at an early age so that by the time the bone development has finished orthodontics can be started.

What are fixed braces?

Most patients require the use of fixed orthodontic appliances (‘train tracks’) to have really straight teeth, and achieve the best possible improvement of their smile. Small precisely designed metal or ceramic buttons called brackets are stuck/bonded to each tooth. Sometimes metal rings called bands are also fitted around the back/molar teeth. The brackets are then connected to each other using a thin metal wire, called an archwire. The wire is held in place with small elastic rings called modules, or with very thin wires called ligatures. Modules come in a variety of colours to customise your brace. The wires are adjusted at regular intervals to straighten the teeth and correct the bite.

Modern brackets are quite small, and they cover a relatively smaller area of each tooth, making braces more attractive than they used to be. With fixed braces, there is no plastic in the roof of the mouth. This means speech is unaffected and the flavour of food can be enjoyed fully. As the appliance cannot be removed, it acts full-time, and so it is very effective. Fixed braces are very good at achieving fine detail, and making the smile look really perfect!

How do fixed braces work?

Fixed appliances, by definition, cannot be removed by the patient. The simplest way to think of each bracket is as a handle with which it is possible to control each tooth individually and precisely.

As we have already mentioned, in the early part of treatment, a thin archwire is fitted to link up all the brackets.

Because the teeth are irregular, the wire has to bend up and down or in and out between the teeth. This is the clever bit: the wire, a bi-product of NASA research, has perfect shape memory and will gradually return to its original shape, bringing the teeth with it.

As treatment progresses, stiffer wires are fitted and these act as a monorail. At this time, tiny springs and elastics are also used to guide the teeth in the desired directions.

What are the limitations of fixed braces?

Fixed braces are not very good at major alterations to the bite. For this, other appliances are used either before or at the same time as the fixed braces. Examples include changing the relationship of the jaws with a functional/orthopaedic appliance, or moving the upper teeth back to improve bite with headgear. Very occasionally specialist surgery needs to be used in conjunction with brace treatment to achieve the ideal result.

How are fixed braces fitted?

Depending on your treatment, fixed braces can be fitted either in a single appointment or over several appointments.

Sometimes small blue elastic rings called ‘separators’ are fitted between your back teeth a few days before your braces are fitted. This is to enable the fitting of ‘bands’ around the molar teeth. Bands are like rings that fit around the back teeth. Not everybody needs to have bands as part of their fixed braces.

Before braces are fitted, your teeth are cleaned and conditioned. For those who need bands special glue is used to stick them to the teeth. The brackets themselves are square-shaped metal or ceramic components that are glued to the teeth.

The fitting of fixed braces is completed by connecting the bands and/or brackets with a thin piece of wire that is held in place using small elastics called modules. These come in different colours to make the wearing of braces more fun.

Will it hurt my child?

Fitting their fixed braces will not hurt: they are simply glued to their teeth. No injections are required, and they certainly do not need to go to sleep for fixed braces to be fitted, what a shame you might say!

For the first 4-5 days after their appliances have been fitted, and for a day or two each time they are adjusted, they may experience some discomfort and slight toothache. Their teeth may feel loose and quite tender.

Parts of the brace may rub on their lips, cheeks or tongue. They may also notice increased saliva flow, and a minor temporary effect on their speech. This is normal, and soon they’ll get used to wearing their brace and their speech will go back to normal.

Stick to a softer diet for the first few days.

If necessary, they may wish to take mild painkillers such the ones you would normally take for headaches. Please read the instructions on the packet regarding how much they should take.

We will supply you with some orthodontic wax. If any part of the brace is rubbing against their lips or cheeks, tear off a small piece of wax, roll it into a small pea-sized ball between your fingers, and gently mould this over any part of the brace that feels sharp. This acts as a cushion, keeping their lip or cheek away from the brace components.

If they continue to have discomfort beyond the first few days, contact the practice so that an emergency appointment can be arranged as soon as possible to adjust their fixed brace.

We are pleased to offer you and your child a complimentary 45 min consultation which will include :     

Welcome tour Panoramic evaluation (a complete digital scan of your child's teeth) Photographic and video graphic records of your child before treatment begins A full treatment plan Communication with your insurance partner

You may need to ensure that they stick to a softer diet only for the first few days of having their braces if there teeth feel a little tender. After that they should generally be able to eat normally.

Having said that, we recommend that they totally avoid certain foods to avoid damage to your teeth or your braces. These include sticky, chewy or hard sweets (such as toffee, boiled sweets and wine gums). Avoid chewing gum or bubble gum. Do not bite directly into very hard food with your teeth.

Keep the consumption of fizzy cola drinks to a minimum, and generally keep these to meal times.

Cut up harder fruit and vegetables (e.g. crisp apples, carrots) into smaller pieces before eating them. Be very careful with crusty bread, nuts, spare rib, corn on the cob and stones in fruit.

Above all think about what you eat and be careful.

Biting fingernails may result in damage to their brace. Do not let your children touch, play with, or pick at their brace. Do not allow them to bite pens or touch their braces with them. Do not use their teeth as DIY or household tools! The more you look after their braces, the sooner their treatment will be completed.

If despite all your careful attention part of the brace becomes dislodged or damaged, contact the practice as soon as possible so that an appointment can be arranged either to repair the brace or to relieve any discomfort. Damage to the braces can prolong treatment. If appliances are repeatedly damaged and no progress is being made, treatment may have to be terminated.

Your friendly orthodontic team

We will provide you with a free pack containing what you need to look after your children's braces. From now on you will need to spend more time ensuring they clean their teeth. Neglect will cause swelling and bleeding of the gums, tooth decay and marking/staining of the teeth around the brackets.

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Brush after each meal.

Make sure the gum margins are also brushed even if they bleed when you brush them.

Change the brush every three months.

Use the interdental toothbrush supplied for getting in between the brace components and the tooth surface.

Use the fluoride treatment we provide regularly.

It may also be useful to use disclosing tablets occasionally to check that you are removing all the plaque from your teeth.

This usually takes anywhere between 9-24 months but can vary according to how severe your case is. Failed and cancelled appointments or repeated breakages of the brace will add to the overall treatment time.

Once the active phase of the treatment has been finished, it will be necessary to wear a retainer. This may be removable or it may be fixed behind their front teeth. The length of time this has to be worn can vary.

You will need regular appointments during treatment for the brace to be adjusted, typically around every 5 weeks or so.

Yes. It will be important your child still has check-ups with your regular dentist throughout orthodontic treatment so that your teeth can be checked for decay.

We will provide you with a mouthguard free of charge. Wear your mouthguard for any sport or activity where accidents may cause damage to your teeth.

If your child plays a wind instrument, then fixed braces may initially make things more difficult. You will need to discuss this with their music teacher.

If the fixed braces become damaged, or a component is digging in your child’s lips or cheeks, or if you are concerned that the fixed braces are continuing to be uncomfortable or troublesome beyond what is normally expected for the first few days, then telephone the practice for advice and/or an emergency appointment. Where possible, do not try and adjust the appliances yourself, as this may damage them.

Straighter teeth are known to be healthy teeth as they are easier to clean.

Would it make a difference to the life of your son/daughter if they had straighter teeth?

Newmans orthodontics offer you:     

Open days so that you can sit next your kids ensuring they remain engaged in the process too Insurance excepted from most major schemes Games for the kids to play whilst they wait keeping your visit stress free Movies and Xbox available in the patient lounge Choice for every treatment option, and NO pressure to choose any option, simply go with what you feel is best.

Please call us today on 516.626.2060 and book for a FREE initial assessment, we can discuss your concerns, prepare a fully costed treatment plan, liaise with your insurance provider and find out which orthodontic system would suit your child best.

This means this is a low risk and no cost way to finding out more – call us to book your appointment today …

We look forward to seeing you soon,

Dr Seth Newman