Does My Child Really Need Braces?

As a parent, we are always trying to make the best decisions for our children.  As a new parent, I understand that these decisions are often difficult and not always clear-cut.  When most people think of orthodontic treatment or braces, they think of the preteen and teen years.  I talk to other parents all the time who ask me why their dentist or physician recommended an orthodontic consult or braces when their child does not even have all their permanent teeth yet.

I did touch a little bit on this topic with my previous blog- Orthodontic Problems in Growing Children. Today, I am going to focus on one type of orthodontic problems that we always screen for in children- the crossbite.  In our office, this is probably one of the most common problems that we treat in children.  My niece, Caroline, is a great example of this problem.  Caroline was 7 years old when she started treatment in our office.  Her pediatric dentist recommended that she see an orthodontist.  Here’s Caroline at her initial consult (you can see my nephews here as well- we had the whole crew).

Caroline had a posterior crossbite.  This means that the top teeth fit inside the bottom teeth, not outside like they should.  So, what’s the concern? At age 7, Caroline (like most 7 year olds) had LOTS of growth left.  If left untreated, this crossbite can cause asymmetric growth of the lower jaw and cause a shift of the bite (just look at the center lines on her “before” picture).

So why treat now? First of all, the sooner we can correct this problem, the sooner we can prevent any growth problems.  Also, when we are younger, our jaw bones are much more pliable than when we are older.  As adults our bone are very rigid and harder to change.  This treatment aims to prevent bigger problems in the future. In Caroline’s case, we used a simple expansion appliance to correct the crossbite.  She did great! After just a couple months, the crossbite was corrected with a very light nickel-titanium spring.  In her case, she then needed just a few braces to help guide in her 2 lateral incisors (side teeth).

Expansion appliances can be helpful to correct these crossbites, but can also be useful for other problems as well in growing children.  Sometimes expansion of the upper jaw can aid with breathing/ snoring problems or can even help prevent impaction of canine teeth as they erupt.  Most of the time, these treatments are LIMITED.  Your child will not have braces on all the teeth and will not be in treatment for too long (usually less than a year).  As orthodontists, we try to keep these treatments simple, straightforward, and brief for both the patient and the parents.  So while early treatment is not necessary in all children, in some kids, it can be critical to prevent bigger problems in the future! The American Association of Orthodontists also has great resources on all of these topics.