Orthodontics for Children and Adolescents

An orthodontic evaluation is done during the patient’s dental visit. Some early orthodontic treatment may be beneficial to young children. Otherwise waiting until all permanent teeth have erupted is appropriate. Adults can also benefit from orthodontic treatment. Treatment time will vary with each patient depending on the problems needing correction.

Why is orthodontic treatment important?

Crooked and crowded teeth are hard to clean and maintain. This may contribute to conditions that can cause not only tooth decay but also gum disease and tooth loss. Abnormal wear of tooth surfaces, excess stress on supporting bone and gum tissue, or misalignment of the jaw joints resulting in chronic headaches or pain in the face or neck may also occur.

When should treatment begin?

There is no answer to this problem because each orthodontic problem determines it own best starting time. Your dentist and/ or orthodontist should determine when treatment should begin.

Early orthodontic treatment may be effective in younger children if they exhibit the following conditions:

  • Crossbite of the back and/or front permanent teeth
  • Narrow dental arches
  • Inadequate growth and development of the midface
  • Severe crowding of the permanent teeth
  • Tipping of the permanent teeth that prevents normal eruption
  • Permanent teeth that are extremely protruded (deep overbite/overjet)
  • Permanent teeth that are eruption in the wrong direction

How are orthodontic problems corrected?

First, pretreatment records are made. These records are important tools for the dentist to use in making an accurate diagnosis. They include medical/dental history, clinical examination, study models of teeth, photos of your face and teeth and x-rays of your mouth and head. This information will be used to decide on the best treatment.

A customized treatment plan is designed by the dentist to correct orthodontic problems that have been identified. Braces and/or a variety of orthodontic appliances may be necessary for treatment. Some severe orthodontic problems may also require orthognathic surgery.

When the orthodontic appliances/braces are in place, this is considered the “active treatment” phase. Adjustments will be made periodically so that the teeth will move correctly and efficiently. The time required for orthodontic treatment varies from person to person. An important factor in how long a patient wears braces is how well the patient cooperates during treatment — for example, by following instructions to wear rubber bands, good oral hygiene and not having broken appliances or brackets.

Today’s braces are generally less noticeable than those of the past. Brackets, the part of the braces that hold the wires, are bonded to the front of the teeth. These brackets can be metal, clear, or tooth-colored. Modern wires are also less noticeable than their predecessors. Today’s wires are made of “space age” materials that exert a steady, gentle pressure on the teeth, making the tooth-moving process faster and more comfortable for patients.

How long will treatment take?

Although the average treatment time is about 24 months, this varies with individual patients. Adult treatment may take longer than a child’s treatment. Other things to keep in mind are the severity of the problem, the health of the teeth, gums and supporting bone and how closely the patient follows instructions. While orthodontic treatment requires a time commitment, most people feel the benefits are well worth the time invested.

After active treatment is completed, the “retention” phase begins. A patient will need to wear a retainer so that the teeth stay in their new positions. Retainers should be worn full time the first year after orthodontic treatment is completed. Less wear time like nighttime wear will be recommended thereafter.

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