Brace options for your tween, teen

[Parenting NH Administrator]

By Wendy Thomas

As parents it’s almost a given that our kids will at some point need to get orthodontic braces. We all know a straight-toothed smile is important both for health reasons and for providing self-confidence, but what we may not know is how to get started in taking care of our children’s teeth orthodontic health. How do you know a child needs braces, how old he should be, and what type of braces should he get?

According to the American Dental Association, ideally, all children should be evaluated by an orthodontist at around age 7. During the evaluation, the orthodontist will inspect the child’s mouth, jaw, and teeth and will then take a panorexx-ray (panorama x-ray picture of entire jaw in one shot.) Molds of the teeth may also be taken, along with photographs of the teeth and the child’s profile.

This information will then be evaluated to see if there are potential problems like missing teeth, underbites, or cross-bites that might impact the health or welfare of the child. After all the information is evaluated, the orthodontist will have a discussion with the parents letting them know what he has found and what suggestions he may have going forward.

It’s important to note that while some offices charge for this initial consult, there are others who do not, instead considering it to be part of the overall treatment plan. Be sure to ask first about cost before making any orthodontic consultation appointment.

Most children will not need braces until they have their permanent teeth – typically around age 12, however, in certain cases early treatment (referred to as Phase I or Interceptive treatment) may be indicated.  

Some of the most common reasons for early treatment include jaws that don't line up properly, impacted teeth (teeth that are stuck and unable to erupt naturally on their own), missing teeth and oral habit correction.  In most cases, early treatment involves placing an appliance to expand the upper jaw or to guide jaw growth (which can only be done while the child is still growing).  Sometimes a few braces may be placed, as well, to help move teeth into a more ideal position while waiting for full comprehensive treatment.

In severe cases, explained Wendy Maylone, Office Manager of Eilliot Orthodontics, Merrimack, it’s imperative you start early to move the bone before the growth is completed.

If braces are recommended for your child, there are a few options from which to choose.

Traditional braces –The most common kind of brace and it’s typically what we think of when we think of braces in general. This type of brace consists of either metal or porcelain brackets that are glued onto the front of teeth. Wires and bands (often in colors that the child chooses) are added to move the teeth into proper position.  Traditional braces are the most inexpensive method.

Invisalign braces – This type of brace treatment consists of clear thermoplastic aligners that are individually created for each person. They look like very thin mouth guards. Invisalign braces are typically used for kids and adults who might be self-conscious of having a “metal-grill.” “One thing to keep in mind with this type of treatment is that it’s a big commitment and you have to be sure the patient is ready and is responsible enough to take care of them,” Maylone said. “Clear aligners have to be worn full time and are only taken in and out when eating. “

Invisaligns do have some treatment limitations and are not used to correct severe problems.

Lingual braces –These braces are worn on the inside of the teeth and are typically used by people who don’t want any braces to show, for example, child models or older adult patients. Lingual braces are customized to the patient and as a result may take a little longer for treatment completion and may also cost a bit more than the other brace options.

In most cases brace treatment plans take about 21 months, with severe problems (jaws that need to be moved or widened) taking a bit longer. Once braces are started it is important for the patient to maintain proper care and this includes good flossing and brushing. “We recommend Sonicare toothbrushes and supply each of our patients with one as part of the treatment plan,” Maylone said. “And we advise our patients to change their toothbrushes every two to three months because the braces will wear down the bristles faster.”

Once brace treatment is started, the child will be instructed on what foods to avoid, (chewy and hard foods, candy, and gum are out) and how to watch out for problems like broken wires or swollen gums. It is also important for the child to continue seeing their dentist on a regular basis to ensure that proper dental health is maintained throughout brace treatment.

When a child initially gets braces, and each time thereafter when the braces are adjusted, his mouth will be sore and often he will need to go to a soft diet. The pain passes within a few days and in the end, if asked, there aren’t too many people who wouldn’t say with a smile that the pain and perceived aggravation of having braces was, in the end, worth it.

INFO BOX

Does my child have an orthodontic problem?

It’s not always easy to tell when your child has an orthodontic problem. Even teeth that look straight may be hiding a problem. According to the pamphlet, “Early Orthodontic Treatment,” early treatment for braces should be considered for the following problems.

• An unbalanced profile
• An overbite, underbite, crossbite, gummy smile, deep bite or open bite
• Overlapping or crowded teeth
• Difficulty chewing
• Open-mouth breathing
• Tongue-thrusting (pushing the tongue against the teeth when swallowing)
• Thumb or finger sucking after age 4
• Jaw joint problems

 “Following an initial evaluation, it is recommended that children be monitored every 6 to 12 months. If the child's teeth are developing normally and early treatment is not necessary then yearly check-ups are indicated,” said Maylone. “If braces are recommended by the orthodontist, make sure you have a clear understandable reason of why treatment is being offered and don’t be afraid to get a second opinion if you feel at all uncomfortable.”

Wendy Thomas is a freelance writer and mother of six from Merrimack.