When to Start Using Braces
Why do kids need braces?
Kids can need braces for any number of reasons, including crooked, overlapping, or overcrowded teeth, or a "bad bite" (known as malocclusion).
Malocclusion is when there's a difference in the sizes of the upper and lower jaws. When the upper jaw is bigger than the lower jaw, it's called an overbite. When the lower jaw is bigger, it's called an underbite.
Sometimes tooth and jaw problems can be caused by losing baby teeth too soon, accidents, or habits like thumb sucking. But often they're inherited, so if you or someone in your family needed braces, it's likely that your kids will, too.
Often, your child's dentist will be the first to notice problems during a regular visit and recommend that you see an orthodontist (a dentist who specializes in correcting jaw and/or teeth alignment problems).
The orthodontist can decide whether your child does indeed need braces and which devices would be best.
There's no set age for a child's first orthodontist visit — some kids go when they're 6, some kids go when they're 10, and some go while they're teens. Even adults can need orthodontic treatment. Many orthodontists say kids should see an orthodontist once their permanent teeth start coming in, around age 7. At this age, issues such as uneven bite and overcrowding will become apparent.
Starting the process early doesn't mean a child will get braces right away. It just means the orthodontist will be able to find problems and decide the best time to start treatment.
The First Orthodontist Visit
During the first visit, the orthodontist will thoroughly examine your child's teeth, mouth, and jaw. He or she may ask your child to bite the teeth together and may also ask questions about whether your child has problems chewing or swallowing or has ever had clicking or popping of the jaw.
The orthodontist may take X-rays of the mouth and teeth to see how the teeth are positioned and whether any permanent teeth still need to come in. He or she also may make a mold (or impression) of your child's teeth by pressing a tray of gooey material into the top and bottom teeth. When the mold is removed and the material hardens, the result is a replica of your child's teeth that will allow the orthodontist to decide which treatment options are best.
Types of Braces
Braces correct alignment problems by putting steady pressure on the teeth, which eventually moves them into a straighter position. Most kids just need braces with brackets, wires, and rubber bands. The brackets attach to the teeth and are connected by a wire and rubber bands. The wire is tightened bit by bit over time to slowly help line the teeth up properly. The rubber bands come in fun colors that kids can pick. Though metal braces are still used, so are clear or white ceramic braces, which are much less noticeable. Some even go behind the teeth (lingual braces).
Clear removable braces that move teeth with plastic trays called aligners (rather than wires and rubber bands) are also available, but these are only right for some people. Some kids may need other devices, too, such as headgear (don't worry — this is usually worn only at night!). Headgear uses a horseshoe-shaped wire that attaches to the back teeth, providing stronger force to move the teeth. The orthodontist also might recommend that your child have one or more teeth removed to create more space in his or her mouth. Once the braces are on, your child will have to visit the orthodontist every few weeks for monitoring and adjustments.
How long your child will need to wear braces?
It depends on the problems the orthodontist is trying to fix, but the average is about 2 years. After that, your child might wear a specially molded retainer — a small, hard piece of plastic with metal wires or a thin piece of plastic shaped like a mouthguard. Retainers keep the teeth from wandering back to their original places.
Caring for Braces
Because it's so easy for food to get stuck in wired braces, kids who wear them need to work extra hard to keep their teeth clean. Brushing after meals is essential, as is daily flossing (the orthodontist can give your child a special flosser to use in and around braces). Regular dental cleanings and checkups to look for cavities are also a must.
Your child should avoid certain foods (such as popcorn, hard and sticky candy, and gum) because they can damage braces. Sugary sodas and juices can be a problem, too, because they can contribute to tooth decay. Kids with clear plastic aligners should always remove them when it's time to eat.
Because braces put pressure on the teeth, they can feel uncomfortable once in a while, especially after the orthodontist makes adjustments. Taking over-the-counter pain relievers and eating soft foods can help if this happens.
See the orthodontist right away if your child has a loose wire or bracket, or a wire that is poking his or her mouth. If the orthodontist can't find a problem, your child might use some soft orthodontic wax to cover any sharp spots on the braces that are bothersome or rubbing against the inside of the mouth or gums.
- Orthodontics for Beginners by Garri Tsibel, DDS
About The Writer
DR. JOYCELYN FRANCES ESGUERRA, Dentist
Dr. is the dental and oral healthcare expert of Wyeth Nutrition parenTeam. Having run a private clinic for more than 20 years now, Dr. Joycelyn Esguerra has developed an expertise in orthodontics, TMJ orthopedics, cosmetic dentistry, and biological dentistry. As a dentist, her work has included educating patients on oral care, assessing teeth and diagnosing patients' dental conditions, evaluating treatment options and providing treatment plans to patients, and carrying out clinical treatments such as restoring teeth affected by decay and treating gum disease.
Dr. Esguerra received her degree of Doctor of Dental of Medicine from the College of Dentistry at the University of the East in Manila. She also completed a 6-month long comprehensive preceptorship program on Functional Jaw Orthopedics and TMJ Dentistry at the TMJ Integrative Dentistry Academy of the Philippines.
An active member of the medical community, she has served the Mandaluyong City Dental Chapter in various roles, including President, Executive Vice President, and Board of Director. Dr. Esguerra is also part of the Philippine Dental Association (PDA) and the TMJ Integrative Academy of the Philippines.
The views and opinions expressed by the writer are his/her own, and does not state or reflect those of Wyeth Nutrition and its principals.