When is the right time to have your child fitted with braces?

By Dr. ArgiroKechagia, BDS, MFDS (rcsed), MSc

It is frequently difficult for parents to realize when their child needs orthodontic treatment since there are often malocclusions where the front teeth appear straight. In general, the orthodontic treatment takes place between 9-14 years old, when most or all of the primary teeth have been shed.

However, around the age of 7-8, the child has enough permanent teeth in order for the orthodontist to diagnose if there will be future malocclusion. The orthodontic examination at an early age can be very important, since in many circumstances the early diagnosis and prevention makes the future treatment easier for the patient and the doctor. This does not mean that all children need treatment at this age, but it does allow the orthodontist to determine whether your child could benefit from early intervention. 

More specifically, early orthodontic treatment can help avoid extraction of permanent teeth and better control of skeletal problems since the orthodontist can influence the skeletal growth if the patient is still growing.

After a very detailed examination of the face, the jaws and the teeth as well as an assessment of x-rays, photographs and molds of teeth, the orthodontist will assess whether the child or teenager requires treatment and will be able to formulate a suitable treatment plan.

There are different kinds of appliances that can be used depending on the patient’s situation. The most frequent appliances are:

·         Fixed Braces

Fixed braces are the appliances that cannot be removed during the treatment. These are the most common type of orthodontic brace. 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. They are placed in the upper and lower jaw, for arch expansion, movement of teeth or anchorage control. Sometimes rings called bands are also fitted around the back/molar teeth.  The orthodontist adjusts the fixed braces every 4-6 weeks.

·         Removable braces

Sometimes fixed braces are not the ideal appliances to bring about the required changes to the bite, and a removable brace has to be used. A removable brace simply clips onto the teeth, and can be easily fitted or removed. Its insertion or removal does not cause any pain. They are most commonly used in order to change the shape of the dental arch (i.e. expansion) as well as promote or modify growth of the jaws, adapt the soft tissues and muscles of the face to new positions, move whole groups of teeth at the same time or change the angulation of teeth. These appliances are used in pre-adolescence and adolescence age.

One other advantage of these appliances is that it can be removed when patients want to eat and brush their teeth. The major challenge is that their result depends on patient’s compliance.

·         Headgears

Headgears are being used less and less by orthodontists these days; but its use is still necessary in a small minority of cases. It is supported by the neck or the head of the patient and is worn to move the back teeth further back in order to create extra space; or to stop the back teeth from moving forwards and keep them in their present position, whilst the front teeth are being straightened. Headgear also helps you achieve the best possible bite between your upper and lower teeth.

Active treatment time with orthodontic braces typically ranges from six months to two years, but there is always some variability depending on the case. More particularly, the duration of treatment depends on the growth of the patient’s mouth and face, the individual’s biological response to the brace, the severity of the problem and the cooperation of the patient.

While orthodontic treatment requires some commitment, patients are rewarded with healthy straight teeth, proper jaw alignment and a beautiful smile that lasts a lifetime. Untreated orthodontic problems may contribute to tooth decay, diseased gums, temporomandibular joint problems and loss of teeth. Protruding teeth are more susceptible to accidental chipping and other forms of dental injury. Crooked teeth can also lead to a decrease in one’s self-confidence. Sometimes, the increased cost of dental care resulting from untreated malocclusion (bad bite) far exceeds the cost of orthodontic care.

It has been proven that improvements in personal appearance contribute to greater mental and physical well-being. Although treatment may sometimes seem lengthy, creating a beautiful smile is a reliable way of improving the health of your teeth as well as your self-esteem. In this way, orthodontic treatment can benefit social and career success, as well as improve one’s general attitude towards life.