About Families Online

Feature Articles for April 2003

When should a child get braces? Although individual problems determine the best time to start orthodontic treatment, the American Association of Orthodontists (AAO) recommends that every child have an orthodontic screening at an early age. This could be as young as two or three, but should be no later than age seven.

Many orthodontic problems are easier to correct if detected early rather than when jaw growth has slowed. Unfortunately, many parents assume they must wait until a child has all of his or her permanent teeth, only to find out that treatment would have been much easier if started earlier.

Dr. David Hamilton, a past president of the AAO, cites a four-year-old boy whose teeth didn’t meet properly and whose lower jaw was off-center. Early correction meant he didn’t have to spend any time in braces as an adolescent.

Early orthodontic treatment can have a tremendous impact on a young person’s oral health and emotional wellbeing, says Hamilton, who practices near Pittsburgh. “We perform minor miracles every day,” he says. “Parents tell me daily how much better their seven-, eight- or nine-year-old children feel about themselves because now they can smile, and classmates don’t make fun of them. No child should wait until reaching the teens to feel good about his or her smile.”

Among the patients of Dr. Chris Carpenter, an AAO member in Denver, is a six-year-old boy with a prominent lower jaw. Less than a year of early treatment means his case will be much easier to complete later on.

Then there’s Josh Miller, a nine-year-old who had a severe overbite. As an adult, Josh’s father Kyle had to undergo jaw surgery to correct his bite. Josh didn’t need to. His teeth are now straight and his jaws aligned, a result accomplished through orthodontics alone. Also, none of his teeth needed to be extracted, as had been the case for his dad.

Kyle Miller is grateful his son didn’t have to go through a similar ordeal. “There was no risk, but great rewards,” he says of his ebullient 15-year-old, now out of braces and dutifully wearing his retainer per Carpenter’s instructions. “We were optimistic throughout treatment, and of course are very pleased with the results.”

Early treatment can prevent problems
As the Miller case illustrates, early treatment can eliminate the need for more drastic measures. “Most bite problems are inherited, and therefore can’t be prevented, but early diagnosis can help,” Carpenter says. “Our primary goal is to correct severe problems that, if let go, will be much more difficult to correct later on in life.”

Orthodontists may use one of several orthodontic appliances designed to guide bone growth. In some patients, early treatment achieves results that may not be possible once the face and jaws have finished growing. “Teeth move more easily in younger kids,” Hamilton says.

Although many people associate orthodontic treatment with adolescence, orthodontists can spot subtle problems with jaw growth or with the teeth much earlier, while the primary or “baby” teeth are present. Some of the more readily apparent conditions that indicate the need for early examination include:

• Early or late loss of teeth
• Difficulty in chewing or biting
• Mouth breathing
• Thumb sucking
• Crowding, misplaced or blocked-out teeth
• Jaws that shift or make sounds
• Speech difficulties
• Biting the cheek or the roof of the mouth
• Teeth that meet abnormally, or don't meet at all
• Facial imbalance
• Jaws that are too far forward or back
• Grinding or clenching of the teeth

Early diagnosis provides peace of mind
Frequently, taking a child to the orthodontist results in a recommendation of “let’s wait and see,” notes Hamilton. “We may simply want to check your child periodically while the permanent teeth are coming in, and as the jaws and face continue to grow.”

Detecting an orthodontic problem early enables the orthodontist to determine the best time to begin treatment. And early intervention can make the completion of treatment at a later age easier. Whatever the orthodontic diagnosis, the AAO emphasizes the importance of keeping in regular contact with the family dentist.

Free brochure
For a free brochure, “Your Child’s First Orthodontic Check-Up,” or for information on adult orthodontics and many other topics, call 1-800-STRAIGHT (787-2444). Or write the American Association of Orthodontists at 401 N. Lindbergh Blvd., St. Louis, MO 63141-7816, or e-mail info@aaortho.org.

Anyone considering orthodontics can take advantage of the “Smile Bank,” the AAO’s free computer-imaging program. Just send in a close-up photo with a big, toothy smile and an orthodontic specialist will prepare a computer-generated “after braces” picture. Mail your photo (and return address) to the AAO, c/o “SMILES,” and you’ll receive a free photo showing how your smile might benefit from orthodontic treatment.

Courtesy of the American Association of Orthodontists