How to "Brace" yourself for your child’s first orthodontic visit: A parent's guide
I grew up around teeth, my dad was a dentist, and his father was a dentist. Having a career in teeth was baked into my DNA. After finishing dental school at the Medical College of Georgia in 2008, I spent 3 years in Nashville TN at the Vanderbilt Medical Center to complete my Orthodontic residency. After 7 years of schooling, I was ready to create beautiful smiles on my own. For those who go through it, professional school and residency seems like it will be the most challenging series of events in your lifetime; at least it did for me. That was until 2014 when my wife, Amy, and I had twins; you go through your whole life thinking you're learning everything along they way to make your prepared for anything life throws at you and then all of a sudden you realize you have no idea what you're doing. After spending a few nights at the hospital, in our case Northside, you go home and you're on your own; trial and error at its finest. At this point you really learn how nice it is that there have been plenty of people who have done this before you; Seeking others advise, and incorporating the parts that you want to into your plan can make hard things seem simple, or at least simpler.
Over the last 8 years I have had the pleasure of treating over 6500 orthodontic patients across Georgia and I’ve probably seen just about everything. There are some common questions and principles that I can share that I think would make you more knowledgeable to make a more informed decision of when and why to bring your children to the Orthodontist:
Q: At what age should I make the initial consultation for my child at the Orthodontist and why.
A: The American Association of Orthodontist recommends scheduling the first consultation with an orthodontist no later than 7 years old. It seems a little young (having two 7 year-olds myself, I would have probably laughed at this) but there are some key problems that we can catch early and correct. At this visit we will take some photos and get an X-ray from the dentist (when possible) and review the growth of the jaw and the erupting of the teeth.
Q: When is phase I or early orthodontic treatment needed:
A: There are only a few good reasons to do early orthodontic treatment (aka phase I or 2-phase treatment) for these younger patients. Crossbites are something that we try to correct early when we see them because if left untreated they can change the pattern of facial growth and lead to issues including premature wear of the teeth.
A crossbite has 2 forms; one is a posterior crossbite, which occurs when the back top teeth fit inside the bottom teeth and the other is an anterior crossbite. This occurs when the top front teeth fit behind the bottom teeth (like a bulldogs teeth). Crossbites can be a skeletal issue such as the jaws not being proportional, or a tooth issue, or a combination of the two. It's important for the Orthodontist to determine what is going on and to attempt to correct it to prevent the problem from worsening or creating additional issues.
Another problem we look for are habits; these include thumb, finger and lip habits. By age 7 when the adult incisors are erupted the habits should be stopped as they will create additional issues such as increased overjet (buck teeth), decreased overbite (open bite) and will create/ worsen a posterior crossbite. When an appliance is made to stop the habit it usually works within a week or two. We get an exceeding good response from these habit appliances and can typically remove them within a month.
Often when we consider early orthodontic treatment we are not concerned about spacing or crowding issues within reason because this can be corrected once all the adult teeth have erupted or are close to erupting. If everything else looks normal, this means that only one orthodontic treatment may be necessary. One exception to this is that sometimes when the teeth are not ideal our children may not like their smile or unfortunately people at school may say things about their teeth - when poor alignment of the teeth lead to psychosocial issues, aligning the teeth with braces is a quick and typically easy way to boost your child’s self confidence.
Q: How long does a Phase I treatment last?
A: It depends on what we are trying to correct and how the teeth / jaws initially began. However as a rule of thumb the Phase I treatment should last about 9-12 months if we need to widen the top jaw with an expander and could be less time if we are just straightening the teeth
Q: Do I need a referral to see an orthodontist?
A: No, you don’t need a referral to see an orthodontist. If you are going to a pediatric dentist and they notice something outside the scope of normal eruption they may refer you to an orthodontist. Some of they larger corporation run dental offices may have an orthodontic office within the office or “next door” that they will try to refer you. This keeps everything within their company, but you are welcome to go anywhere you want.
Q: Will my insurance cover phase I treatment?
A: If your insurance includes orthodontic treatment then it will cover phase I orthodontic treatment as per the policy. At Village Orthodontics, we will file the insurance for you. This definitely makes it easier for you and helps you use your insurance with less hassle.
Q: How much is a phase I treatment consultation?
A: At Village Orthodontics we never charge for consultations. Knowledge is power and we want to empower our potential patients so that your can make the best decision for yourself and your children.
Q: What are the advantages of a phase I treatment?
A: There are 6 main advantages of phase I treatment when indicated
1. May reduce the need to pull permanent teeth in the future.
2. Some problems that can be treated quite well in a growing child but may require corrective surgery if treatment occurs after growth ends.
3. Normalize the relationship of the upper jaw tllo the lower jaw, especially in the case of an underbite.
4. Intervene in a child’s prolonged sucking or abnormal swallowing.
5. Damaging pressure can move teeth in the wrong directions and/or change the shape of the bone that supports teeth.
6. Tuck in upper front teeth that stick out to reduce the risk of those teeth being broken or knocked out.
Q: How long of a break is there between phase I and II Orthodontic Treatment
A: The break between the 2 phase really depends on a few factors and varies because everyones eruption pattern is different. These factors include when did the phase 1 treatment start, how quickly / at what age do we estimate all the adult teeth will be erupted, and how long will the phase I take. We like to make sure there will be a nice 1-2 year break between phases.
Q: Can all children benefit from 2 phases of Orthodontic treatment:
A: No, there is not an advantage for all children to have 2 phases of orthodontic treatment. Having 3 kids myself, I think there is an advantage of waiting for all the adult teeth to be almost erupted before starting treatment. One we will not wear out our kids of having braces, they are better brushers when they are older (most of the time), and they tend to be more responsible and take care of their braces better when they are older. That said when there is a true need for a phase I treatment as we discussed earlier, the advantages of treatment outweigh having to have braces twice.
