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Wednesday, March 7, 2012

When is the Best Time to Start Braces?

When we move teeth orthodontically, what happens is that a small pressure exerted over a long period of time stimulates the cells in the bone to resorb in the direction of tooth movement. Once a space is made, the tooth is pushed into the space. Bone fills in behind where the tooth once was located. The process repeats itself again till the tooth is in the final desired position. This process can take place at any age. Yes, you can get braces at 40 years of age! The only caveat is that it usually is easier when the patient is younger. Isn’t most everything? There are however, certain things that can only be done in a growing patient (a preteen or teenager). Once growth ceases, the boney growth of the face halts as well. When a child is growing, certain forces can be applied to guide the growth. That’s usually one of the things a headgear does.

So, when is the best time for my child? Well, it depends on the discrepancy or problem you are trying to correct. If a child has a crossbite, I tend to want to correct it as soon as I see it. I have even corrected a posterior crossbite in a 3 year old! Most of the time braces are not indicated until the patient is between 9.5 and 12 years of age. That’s when a lot of growth takes place. Some children are really ahead of the game in terms of growth. They will get braces sooner. Some patients without severe discrepancies can wait till all their baby teeth fall out around age 12 or so. Different Orthodontists and Pediatric Dentists have different philosophies regarding when to start a particular case. Don’t be surprised if you get a second opinion with a slightly different answer.

I like to see the patient early on so I can guide the eruption of the teeth with early intervention. Placing a lingual arch space maintainer and/or selective removal of certain baby teeth can improve the pattern of tooth eruption. Also, early expansion of a constricted maxillary arch can really help the overall treatment result. One particular case with severe crowding that I remember used timed extractions of baby and then later, permanent teeth. The child ended up not needing any braces at all! So, every child is different. Hey, you know that already.

So, early on, get a Pediatric Dentist or Orthodontist to look examine your child. Most initial crowding problems manifest themselves around 7 years of age when the first permanent teeth are erupting. Good luck, just remember that orthodontics is a long-term proposition. Treatment often takes place over several years. After initial early treatment, you may only be wearing “braces” for 12 to 24 months, but you will wear a retainer once your braces are removed. Oh yes, many of us remember our “retainers”.

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