Does your child need Orthodontic work?

I’m often asked does my child need ortho and when should we start. A lot of times, we can already see the crowding and misalignment issues when the child has their baby teeth still. When the patient starts to get some permanent teeth, the picture is usually even clearer.

If the jaws are aligned and the correct size and the only real issue is crooked teeth, then likely we would wait until all the adult teeth are in.

If the upper jaw is too narrow, then this is something we like to correct at around age 8. If we widen the jaw at this age, it will create space for the permanent teeth and help prevent future problems (ie impacted eye teeth). Also, by expanding the palate, this will tend to open the airway and help with breathing.

If the jaws are misaligned, then it’s a good idea to correct this while the jaws are still growing. Use growth to help with treatment.

Thumb sucking can have a big impact on jaw development. Therefore, the sooner a patient stops this habit the better (Ideally by age 6). There are appliances that can help the patient with stopping this habit. Prolonged thumb sucking can create an open bite at the front, this in turn can result in a tongue thrust, where the tongue jets out to fill the space created by the thumb sucking. Again early intervention is ideal.

The one area that we can be fooled is when the teeth look descent but the bite is not right. If left untreated this can result in extreme wear, tmj issues, sleep issues, pain, headaches. Therefore, we want to ensure that the alignment of the jaws is ideal for long term health. A couple of conditions that need to be identified is deep over bite, under developed upper or lower jaws.

Finally, braces usually require all the permanent teeth to be present. The latest time to do braces for teenagers would be around grade 10, since braces usually take approximately 2 years. You want to finish the treatment before the patient goes away to college or university as this would be difficult to facilitate ongoing treatment.

Sincerely,
Dr. Ian Gray