Orthodontia Basics Every Parent Should Know

When it comes to oral health, we all know to take our kids to the dentist for regular teeth cleanings and check-ups, but there’s another aspect of dental health that you might be overlooking: orthodontics. So, in honor of February as National Children’s Dental Health Month, local orthodontists weigh in on important topics such as when to see an orthodontist, which apparatuses are used for treatment, and why orthodontia is an important aspect of children’s dental health. Here’s what you need to know.

What is Orthodontics?

Though it may seem like orthodontics is solely about the cosmetic appeal of a smile, the practice has greater benefits than just aesthetics. “Orthodontics is a specialty that involves aligning the teeth and improving the bite,” says Alexis Fermanis, D.D.S., of Brooklyn Family Orthodontist. In short, orthodontia corrects a number of issues, from under bites, overbites, and cross bites, to misaligned jaws, teeth that grew in improperly, and overcrowded teeth (those that overlap in order to fit together).

However, that doesn’t mean orthodontic work will cramp your child’s style. “What orthodontics basically does is not just aligns the teeth within the jaws, but also aligns them such that it maintains the balance with the soft tissue of the face,” says Ameeta Sachdev, D.M.D., of Sachdev Family Orthodontics in Garnerville. “Earlier orthodontics was just concerned with aligning the teeth irrespective of what the face looked like, but now orthodontics has evolved to where…we also do it in such a way where it is harmonious to the face.” In other words, your treatment can be customized for your looks.

When to See an Orthodontist

There are a number of reasons that would indicate it’s a good time for your child to see an orthodontist. Maybe you noticed something a bit off about her smile or your dentist made a referral. Regardless, at a certain age, it’s a good idea to bring kids in for a quick check-up. “Every seven-year-old should be brought to see an orthodontist,” says Chaninah Zweihorn, D.D.S., owner of Zweihorn Orthodontics in Brooklyn and Queens. “It’s very rare for the orthodontist to have to do any treatment or intervention at that point. It’s just a check in to see that everything is proceeding as expected.”

There are a few things you can check for at home that would indicate a visit necessary. You’ll want to check your child’s teeth and look for these red flags. “The one that most people notice is crooked teeth or spaced teeth,” Dr. Zweihorn says. “In terms of bite and health of the jaws, [check] if a tooth is biting in the wrong place. If a bottom tooth is in front of a top tooth [under bite], that is a very significant issue.” Besides an under bite, Dr. Fermanis recommends checking your kid for asymmetry in his jaw or bite, having to shift the jaw in order to close his mouth, or severely crowded teeth.

If your child has an overbite, where her front teeth stick out significantly, then the severity of the overbite and her age are factors to consider before immediately seeing the orthodontist. For a young child, a large overbite that he gets teased about is worth treating to avoid bullying. If there aren’t any emotional downsides, it might be best to wait until he’s older because it can be difficult to entirely fix an overbite at a young age, according to Dr. Fermanis. For an older child, consider the severity of the condition. A significant overbite can lead to “increased risk of trauma to the teeth during a fall,” Dr. Zweihorn says. As a general rule, if your child can fit her lower lip between her top and bottom teeth, she should see an orthodontist.

Methods of Treatment

Orthodontia relies on using various appliances to correct oral health issues and as technology advances, so do the materials used in treatment. The braces available today have made advances since the braces of your childhood, and the types available are numerous in their pros and cons. But braces aren’t the only option. There are myriad appliances that work to treat different conditions for various age groups.

Palate Expanders. Braces are not recommended for children younger than 7, but that doesn’t mean there aren’t pre-braces appliances that can be used to help set your child up for a lifetime of good oral health. “One of the more famous ones is an expander,” Dr. Zweihorn says, “which helps the upper jaw to grow properly, helps to have enough room for teeth to grow in if that’s needed, and helps the jaws to relate to each other with a proper bite if necessary.” This can help alleviate issues of overcrowding without having to wait until the child is old enough for braces.

Traditional Braces. This is the most common and well-known method of correcting orthodontic issues. Braces involve gluing brackets to the teeth and using connecting wires to reposition the teeth and/or jaws. One of the biggest benefits to choosing braces is it gives the orthodontist more control in your child’s treatment, according to Dr. Fermanis. Additionally, the impact braces will have on his teeth is very predictable, and they are easy to adjust in office.

Unfortunately, braces have some downsides worth thinking about before committing. “The disadvantage is you have to watch what you eat,” Dr. Sachdev says. “You have to take care of your braces because if you keep breaking them, your treatment can be prolonged. It’s a little challenging to floss and brush.” And, of course, there are some who just don’t like the look of braces.

Lingual Braces. Luckily, braces can be metal or clear depending on the patient’s aesthetic, with the clear braces being significantly more discreet. For the cosmetically conscious patient, there are also lingual braces, which attach to the back of the teeth instead of the front. Lingual braces “are the most aesthetic option because they’re the least noticeable,” Dr. Fermanis says. “You’re not taking something in and out of your mouth all the time, but those are the most difficult to get used to because they’re next to your tongue.” It can take up to two weeks to adjust to them, whereas traditional braces take three to five days, according to Dr. Fermanis.

Clear Aligners. If your child can’t handle the upkeep of braces, clear aligners are also an option. Clear aligners, made popular by the brand Invisalign, are pieces of plastic specifically molded to the individual’s mouth that can be taken out when necessary. Your child can take her clear aligner out for eating, drinking, brushing and flossing, and important photo shoots. However, this convenience can also reduce effectiveness. “With Invisalign, because they’re removable, they’re much more dependent upon the cooperation of the patient and wearing them as they’re supposed to,” Dr. Zweihorn says. Clear aligners also make it more difficult to have a flexible treatment plan, as is available with traditional braces. “With Invisalign, because the appliances are made by a laboratory, changes need to be made working with the laboratory and are harder to make in the office as needed,” Dr. Zweihorn says.

Head Gear. Though less popular in recent times, another means of orthodontic treatment is headgear, or night braces. Headgear is an appliance that attaches via straps around the head and/or neck. “Headgear is typically used to correct a skeletal problem in younger children (eight to ten years old) such as a severe overbite or an underbite,” Dr. Fermanis says. “Most of the time we recommend using them eight to twelve hours a day.” Though it may seem like an appliance doomed to cramp your kid’s style, headgear is “prescribed for home-only wear to address growth problems in the upper jaw,” according to Dr. Zweihorn, so there’s no need to worry about sporting headgear on picture day.

Retainers. After orthodontic treatment is completed and the braces have come off, it’s common to have a retainer prescribed. There are a number of different types of retainers, both removable and semi-permanent, but the function is more or less the same. “A retainer won’t necessarily move the teeth,” Dr. Fermanis says. “Instead, a retainer is supposed to hold the teeth in their current position.” The goal is “to maintain the results achieved with braces or aligners,” Dr. Zweihorn says.

Ultimately, dental health is an important investment for the future, both in terms of physical wellness and your child’s self-esteem. “Believe it or not there are a lot of people don’t like to smile… because they’re very conscious about their teeth,” Dr. Sachdev says. “It does affect them a lot psychologically and it affects their personality, whether they realize it or not.” Maintaining a good bite and healthy teeth are valuable, but orthodontic care can do more than that; it can boost your child’s confidence.

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