As an orthodontist, one of the most frequent questions I’m asked is “When should I bring my child to come see you?” When I answer “At age 7,” I usually get that what-planet-did-you-get-your-degree-on look back. I’ve come to expect it now, and I understand why moms think that sounds crazy. Most parents are thinking that their kids just now started first grade and have tons of baby teeth left, so braces should be light years away. And there’s some truth to that. I hope that here I can clear up a few questions and misconceptions about what parents should do, when, and why when it comes to their little ones’ teeth.
Taking your child to the orthodontist at age 7 isn’t me talking—it’s the American Association of Orthodontists’ official recommendation. While many parents are afraid that going to the orthodontist that young means he’s going to tell you that your child needs braces right now, that really isn’t as likely as you might think. The reason that we like to see kids so young is to look for normal development of the teeth and jaws so that we know that everything is as it should be. Most of the time, we see normal, healthy kids that just need to be observed once or twice a year until they really are ready for orthodontic treatment down the road. But, if we do see something that isn’t quite right, then at least we’ve caught it early and can fix it.
Research shows that there are actually only a few conditions that really NEED to be treated at 7, 8, or 9 years old. Unfortunately, there is a lot of over-treatment being done by some orthodontists out there, and that casts doubt on the good intentions of the rest of us. While there are legitimate reasons that some kids need to be treated early—like severe crowding of the teeth, premature loss of certain baby teeth, certain types of dental crossbites, and even psychosocial reasons like being teased for crooked teeth—in most cases kids are better treated once when they are older in a single phase of orthodontic treatment. The photos above are a good example of child who was not happy with her smile and was getting teased at school. Through early treatment, we were able to fix her smile in 5 months.
When you do see a young child with braces or another orthodontic appliance, that child is likely going through what we call a “Phase I” or “Interceptive Phase” of treatment. These treatments are typically short—usually a year or less—and they can give us orthodontists the opportunity to guide jaw growth and proper tooth eruption, correct potentially harmful oral habits, lower the risk of injuring protruding or “buck” teeth, or sometimes just improve appearance. Having an early treatment doesn’t mean your child won’t need braces again when they’re older—it usually just means that you have addressed a specific problem early to avoid complications that would occur if left unchecked. Sometimes, though, having an early treatment can help avoid the need for future orthodontics altogether.
So, what should you hope to see with your little one’s teeth at age 2 to 6? Spaces. Lots of spaces. That’s because the adult teeth in the front are a good bit bigger than the baby teeth, so you need extra space in there for the adult teeth to have room to come in. If you’ve been thinking you’re lucky because your kid has a Hollywood smile with no spaces anywhere, you can bet the farm on some crowded adult teeth down the road. Spacing of the baby teeth is your best shot at having little or no crowding of the adult teeth later on.
It’s also pretty normal to have thumb or pacifier habits until age 5 or 6, but after that the adult teeth start coming in. That’s when it’s best to see these habits stop so that we don’t see unwanted effects on the adult teeth. Some kids can stop on their own or with a little help from mom and dad, while others need a little help from the orthodontist to kick the habit.
So what’s the take home message? Don’t be afraid to take your 7-year old to the orthodontist, and don’t think you’ll have to check your wallet at the door when you do! Chances are that everything will check out normally and that you’ll have peace of mind in knowing just that. But if the orthodontist does find something that needs fixing now, you should feel good that you caught it early. That’s called being a proactive parent, and your little one is all the better for it.
*You can find Dr. Grant Coleman at www.bracesincharlotte.com.