Child and Teen Orthodontics

Orthodontic braces are a big part of life for many people. While braces may have had a bad reputation in the past, today's braces make it easy to look good and feel good! Please contact our practice to schedule your next orthodontic checkup.

INITIAL EXAM & SUBSEQUENT GROWTH OBSERVATIONS 

When should my child get their first orthodontic exam?

It is recommended a child’s first orthodontic appointment be at age 7-8 unless advised earlier by your family dentist or pediatric dentist. 

What age should my child see an Orthodontist?

Around 7-8 years of age is when the adult incisors and first molars are erupting or are fully erupted. This is a good time to seek a consult to catch early on any bite problems or growth issues with the adult teeth.

What happens at my child’s first orthodontic appointment?

At your child’s first visit the Orthodontist will listen to any concerns you or the child’s family dentist has. The Orthodontist will perform a comprehensive examination which will include-

• Health/Medical history
• Dental history
• History of trauma to teeth, face, jaws
• Existing or past oral habits
• Examination of the teeth and checking the bite and jaw functions
• Panoramic X-ray of the child. *Additional X-rays may be advised*

This will allow the Orthodontist to look for any deviations from the usual and make recommendations accordingly.

What happens after my child’s first orthodontic visit?

If there are any potential issues that present at this 1st visit, the Orthodontist will make recommendations on further course of action. 

If everything is within normal realms of development the Orthodontist will advise the child to be seen semi-annually, annually or bi-annually.

My child has no issues. Why should I still see the orthodontist?

At your first orthodontic evaluation all may be within normal limits. However, with yearly exams and growth observations your Orthodontist is able to closely monitor any potential issues that may arise such as crossbites, deep bites, impacted teeth, missing adult teeth, over-retained baby teeth, pre-mature/early loss of baby teeth causing space loss, ectopic eruptions, skeletal growth and much more.

EARLY INTERCEPTIVE ORTHODONTICS or PHASE 1 ORTHODONTICS FOR CHILDREN

How do I know my child needs early orthodontic treatment or what are the signs that my child could benefit from orthodontics?

At your first consultation or follow up recall exams, your Orthodontist may notice    certain problems that may require immediate correction or regular monitoring. They will discuss with you what course of action if any may you take at that appointment. If your child has; large spaces between their teeth, early or late loss of baby teeth or has crowded teeth, they may need treatment

What are some problems that may need early orthodontic treatment?

The problems that may cause complex immediate or future issues such as - crossbites, impacted teeth, missing adult teeth, over-retained baby teeth, pre-mature/early loss of baby teeth causing space loss etc. may need Phase 1 orthodontic treatment.

It is important to understand, Phase 1 treatment is to address limited specific goals and is not similar to Comprehensive/Phase 2/Full orthodontic treatment

What is the right age or time to start orthodontic treatment?

Early or Phase 1 treatment is performed in mixed dentition (mix of baby & adult teeth) to address effects of scenarios that can lead to complex problems later on. This stage can vary in children anywhere from 6-10 years of age.

What are the types of Phase 1 early orthodontic treatment?

Phase 1 treatment types can range from – Referral to your family dentist for baby teeth extraction, space maintainers, Passive appliance therapy, limited braces, expanders and more.

How long does Phase 1/limited/interceptive/early orthodontic treatment last?

This depends on what kind of treatment your child needs. On an average it can last anywhere from 6-20 months. Rarely, a child may be ready for Phase 2 comprehensive treatment right after Phase 1 treatment ends.

Why should I get Phase 1 early orthodontic treatment for my child if they will need a second round of treatment?

Sometimes, Phase 1 treatment may lead to requiring minimal to no treatment in the future. Some complex orthodontic problems will demand a second round or Phase 2 treatment for children and adolescent patients. However, a Phase 1 may have everted complex issues like surgeries, multiple extractions, extended treatment times, non ideal bite, extensive wear of teeth etc.

COMPREHENSIVE ORTHODONTIC TREATMENT FOR KIDS & TEENS

Why does my child need a second round of orthodontic treatment?

With yearly exams, growth observations and early Phase 1 orthodontics many complex scenarios can be avoided or simplified. This may in turn lead to requiring minimal to no treatment in the future. However, some complex orthodontic problems will demand a second round or Phase 2 comprehensive treatment for children and adolescent patients after all or most adult teeth have erupted.

What to expect with full/comprehensive orthodontic treatment?

Depending on problems you may have, this treatment is planned to fix minor or complex teeth alignment issues with or without bite correction in a comprehensive manner. 

Your orthodontist will discuss the details pertaining to your or your child’s treatment at the consult appointment. In complex treatment scenarios more than 1 appointment may be required to plan out the best treatment options and reach a decision. 

I am ready to start my child’s/my orthodontic treatment. What is my first step?

• At the consultation appointment you will discuss with your orthodontist some treatment options and what course of treatment might be best for your child/you. The treatment co-ordinator will address financial questions and what to expect through the course of your time at the office during treatment.
• At this time your orthodontist may acquire initial diagnostic records – Photos, Digital scan of your mouth and X-rays as needed. This is required for the completion of a thorough and complete evaluation to assure the best available treatment option is chosen and decided.
• If your child’s/your oral health is up to date most times treatment can be initiated the same day or at the first available appointment.

*All the steps mentioned above may be done at the same visit or at separate visits. It depends on several factors – Good oral health, appointment time availability, patient’s schedule for the day, pre-orthodontic preparation for appliance, specialty consultations, extractions etc. 

Will I need teeth pulled/extracted for my orthodontic treatment?

Extractions of some adult teeth and or wisdom teeth may or may not be required. The requirement depends on – how much crowding do you have, are any teeth impacted, is your bite not aligned etc. If required they will be performed by your your family dentist or another dental specialist.

Will my orthodontist extract my teeth?

Most orthodontists focus on their specialty and will refer you back to your family dentist or another dental specialist for extractions.

What kind of braces should I get?

You can choose metal braces or clear ceramic braces. However, for certain bites clear ceramic braces may not be advised as they can cause aggressive wear on your teeth.

Do you offer clear aligners?

Yes, clear aligners may be a good esthetic option in some treatments. We will make recommendations with aligners based on your treatment needs.

What are differences between braces & clear aligners?

Some of the differences between the braces & clear aligners are-

• Braces are fixed.

Aligners are removable.

• You can eat with braces and don’t have to keep track of hours. Braces are working round the clock.

You must remove aligners to eat or drink. You can only drink water with aligners in your mouth. Aligners must be worn 22 hours a day for them to work. You must keep track of ‘hours aligners are worn’ each day for successful on time treatment outcome.

• You have limitations of what you can eat with braces so you do not break them. 

You can eat anything with aligners since you remove them before eating.

• Metal Braces are most visible.

Clear Braces are less visible

Aligners and their attachments are least visible making them an esthetic choice.

How many visits before I can get my braces?

Depending on patient’s oral health status, schedule availability and treatment plan the answer to this question can vary. You can get your braces put on anywhere from the first visit to the office to the subsequent.

How much time will my orthodontic treatment last?

In majority of patents depending on the problems your teeth and bite present, full orthodontic treatment can last anywhere from 6 months to 30 months (2.5years).

Why did my friend have braces for more than 2 years or What are some of the reasons my treatment may go beyond the estimated treatment time?

Every patient is unique and presents with unique challenges. Some of the common reasons you may have braces for longer than the 2-2.5 years can include but not limited to – 

• Complex problems requiring longer treatment times.
• Unexpectedly slowly moving teeth.
• Not seeing the Orthodontist for adjustment visits as advised.
• Repeated/Multiple breakage of orthodontic appliances (brackets, wires, bands, aligners etc.)
• Not complying with elastic/rubberband wear
• Not maintaining good oral hygiene that can delay treatment and cause infection and cavities.
• Patient stops seeing the Orthodontist and halt treatment for unknown reasons.

Will my braces hurt?

Braces today have evolved and are made with advance technology keeping them as small as possible and use light forces on your teeth. You will be aware of their presence when you first get them on your teeth just like you notice a new shoe on your foot. However, in a couple of weeks you will get use to them. There might be some discomfort after your adjustment visits which easily controlled by OTC pain medications.

How often do I visit my Orthodontist after starting treatment?

This varies from patient to patient and what stage of treatment you are at. Typically, you will be advised to have an adjustment anywhere from 2-8 weeks. You must follow the Orthodontist’s recommendation on the interval of visits as it is a very critical for a successful treatment outcome.

Do I have to wear rubberbands/elastics?

Some orthodontic treatment require wearing elastics to correct and/ or stabilize your bite. When required, the orthodontist will discuss with you if they need to be worn all day and night or at night only. You will be told how many hours to wear them for, how to put them on, how often to change them etc. If you are compliant with your elastic wear you can assure a successful outcome.