The Benefits Of Orthodontic Treatment For Kids And Teens

Orthodontics are the application of treatments designed to correct or prevent irregularities of the teeth. Orthodontics can be sought out to help correct chewing and bite problems, speech problems, eliminate pain, or to correct unsightly misaligned teeth. The restoration of a beautifully aligned, straight smile is often the main reason parents seek out an orthodontic consultation.

Children and teens are benefited by orthodontics by:

1. Correcting underbites or overbites, assisting in better chewing, swallowing, and speech function by widening the palate, and fixing teeth overcrowding issues.

2. Orthodontics can treat painful conditions, like TMJ (Temporomandibular Joint Disorder).

3. Enhancements to a child’s self esteem can be achieved by fixing issues like missing or crooked teeth, closing gaps, and more.

4. When teeth are properly aligned through orthodontics, care for them can be achieved much easier.

5. Children who have needed braces learn what it means to take responsibility in their oral care. They learn it is essential to maintain the results achieved through their orthodontic treatments.

Orthodontics for kids and teens have many benefits. If you are considering getting orthodontics for your child, consider scheduling a consultation with an orthodontist to discuss the details of how orthodontics work and the requirements of both parents and children during the treatment.

You and your child will be pleasantly surprised at the advances which have been made in braces. They aren’t the huge metal contraptions they were just 15 years ago. Now you have ample choices: ceramic or smaller brackets, Invisalign clear trays, and more.

So how long do orthodontics treatments last? Generally, and depending on the severity of the problem, they can last from 1 to 3 years. Kids adapt rather well to them to, and are usually good at keeping up with the orthodontist’s instructions. Parents love it too – especially the appreciative smiles at the end of the treatment!

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Kids and Teens Can Benefit From Orthodontic Treatments

Ins and Outs of Instant Orthodontics

Instant orthodontics are a type of cosmetic dentistry that can be used to repair, restore, replace, or transform teeth. They can be used to repair broken teeth, replace a missing tooth, or transform the appearance of an otherwise unsightly tooth.

Porcelain veneers, bridges, crowns, and bonding are all forms of instant orthodontics that are used today. Any single type of instant orthodontics can be selected to restore your smile, or your dentist may opt for a combination of several techniques in order to obtain the ideal results in an individual case.

What Are the Benefits of Instant Orthodontics?

When you were a child did you ever lose your tooth by playing? Or perhaps you had carries? Maybe you were into sports and you lost a tooth in that manner? You were probably worried if it was a permanent tooth that there was no other to replace it. This is an area where instant orthodontics may shine.

Braces can cause a lot of discomfort – there’s dietary and sports restrictions, it can be quite costly, and many times you endure extended appointments. Instant orthodontics on the other hand, can correct problems in a short period of time. Many times in one to three dental visits your smile is as good as new.

Some instant orthodontics can be used simply to cover up discolored teeth or straighten a crooked tooth. Veneers can restore a chipped tooth and bridges can fill in gaps left by missing teeth. These procedures are relatively painless and do not carry the risk of many of the complications that are associated with other dental procedures like pain and tooth sensitivity.

Especially for children and pre-teens, the thought of wearing braces and then retainers for months is simply not conceivable. Instant orthodontics provide the results in a fraction of the time. These procedures can have your little angel smiling again in no time without months of budgeting for the cost of traditional orthodontics.

Many dentists offer special pricing plans and financing for families opting for instant orthodontics, so be sure to ask what is available during your consultation with a pediatric dentist.

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What You Need to Know About Instant Orthodontics

While braces come with major benefits, they are quite costly. In fact, the entire spectrum of treatment can cost $3000 or more. In addition, there is a time commitment where parents must bring their kids to numerous adjustment appointments throughout the process of treatment. So, parents aren’t likely to take the idea of braces very lightly. In fact, they are more likely to attempt to help their child take great care of their braces. Parents can use these tips to help teach their kids how to keep their braces properly cared for.

Brushing Is Important With Braces
The first thing to teach your child who is wearing braces is how to brush properly while they’re in them. Even if their brushing skills weren’t great before they were fitted with braces, they have to change it immediately. Instead of only requiring them to brush in the morning and at bedtime, they need to be brushing after they eat anything at all throughout the day.

Because of the have to brush after every meal, it’s likely your child will need to take a toothbrush and paste to school with them to use after lunch. Teachers rarely have a problem with this necessity.

It’s Vital To Floss With Braces
Just because your child has braces doesn’t mean they can skip out on flossing. In fact, flossing is just as important as brushing even when they are wearing braces on their teeth. A good orthodontist will show the child how to floss between the metal to get great results. You’ll want to be there for the lesson so you are able to help them remember what was said when they get home and try to do it for themselves.

What Foods To Avoid With Braces
When your child first gets braces the orthodontist will likely go over a list of foods the child can’t eat which in treatment. As a parent, it’s your job to ensure the child does steer clear of hard candy, sticky foods, gum, sharp foods, ice and other potentially damaging food items.

How To Handle Braces Mouth Abrasions
One of the worst parts of having braces is dealing with mouth abrasions. Mouth sores, ulcers, bites, scrapes and discomfort is part of the braces deal. They are quite common due to the contact the wires have with the sensitive areas of the mouth. To help your child, be sure you always have dental wax on hand to apply to the hardware where the rubbing is occurring.

Get Your Child To The Orthodontist Regularly
Braces change the position of teeth very quickly. Thus, it’s important for the child to be seen at the orthodontist’s office about every six weeks during treatment. Each and every visit they will likely get new wires and bands because without new ones there’s likely very little changing heading on. At these appointments parents and kids can also bring up any problems they’re having with the braces. It’s important for parents to get their children to these appointments!

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Tips For Parents Who Have Kids In Braces

Teens and adults adore Invisalign simply because they are hardly noticed by others. Traditional metal braces are quite noticeable and can be embarrassing.

However, Invisalign invisible braces can only be noticed under close inspection. In addition, they offer a comfort regular braces often cannot. Traditional braces often bring on mouth abrasions but patients who use Invisalign rarely experience these same problems.
Those who are suffering with crooked teeth, crowded teeth or spacious teeth areas can often be great candidates for Invisalign.

Talking With Your Dentist About Invisalign For Teens:

Certified Orthodontic Consultation
Before you get Invisalign it’s important to meet with a certified orthodontist who can tell you if you’ll benefit from Invisalign treatment. Usually most patients to fit the bill for this treatment but if you have severe malocclusion, you may not.

The Creation Of Invisalign Invisible Braces
After you’ve gotten the “ok” from your certified orthodontist, the next step is the actual Invisalign braces creation process. To aid in this process, your orthodontist will take x-rays, photos and impressions of your teeth. From these a prepare will be created to take you from your current teeth to the straight teeth you crave.

The lab then creates various clear aligners for you to use throughout your Invisalign treatment. They do this using an innovative 3-D computer imaging program. You can expect to need between 15 and 30 aligners for the entire process, but it all depends on your current state of dental placement and where you want to end up.

What To Expect Throughout Treatment With Invisalign Invisible Braces
After the lab has created your Invisalign aligners, you’ll go home with them and wear them on a non-stop basis. The only time they’ll be removed is when brushing or eating. You will need to revisit your orthodontist every few weeks to get a new aligner, as your teeth are shifting. The new aligner will help your straightening process continue seamlessly.

Commonly your doctor will send you home with several sets of aligners and only want to see you back every six weeks or so. They’ll expect you to be responsible enough to change your aligners as directed and will only have to see you to be certain the process is working well for you. With Invisalign you can expect it to take between 6 and 18 months to get results.

What Happens After Invisalign Treatment?
When your Invisalign invisible braces treatment is over, you’ll have a great smile you can be proud of. You’ll no longer need the clear aligners and will only need to see your regular dentist for basic dental care.

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Things to Know about Invisalign Braces

A girl from Gladstone, Oregon asked me why her front teeth stuck out so far.  She was a first grader who found it very hard to stop being a thumb sucker.

Teeth are connected to jaw bones by thousands of tiny fibers that surround the roots and permit slight movements of the teeth during chewing and prevent the teeth from being dissolved away by the bone cells called osteoclasts.

These tiny fibers are called the periodontal ligament and although they are only a fraction of a millimeter long, they are critical for the health of your teeth.

Periodontitis (gum disease) results if the periodontal ligament is damaged by infection, and can lead to tooth loss.

Ankylosis (fusing of tooth to bone) occurs when the periodontal ligament is damaged by trauma and prevents tooth movement and tooth eruption.  See my article on ankylosis for more information.

What does all this have to do with braces?

Now most people would laugh at you if you told them that you could move your teeth with your fingers, but they do not think of it in terms of a thumb sucker.

My grandmother used to tell me that I could straighten my crooked front teeth if I frequently rubbed and squeezed them straight, fingers on the outside, thumb inside.  After becoming an orthodontist, now I know that she was right!  It could have worked (if I did it for more than 6 hours each day).

Well, my thumb sucking first grader from Gladstone had been using her thumb to press on her teeth which in turn stretched the periodontal ligament on one side of her front teeth and squeezed the ligament on the other side.

It happens that when bone is pulled against, it tends to grow and where there is a lack of tension, the bone recedes.  You can imagine that her thumb pushed up on the inside of her tooth and so the tooth moved up and out.

We do not know why this happens on a molecular level but we do know that the stresses and strains of life affect our bones and that the parts of bones that get worked hard grow stronger and bone that is not used dissolves away.

Apparently distortions in the structure of the bone send signals to the cells living inside and on the bone, the osteocytes, to activate either osteoblasts that make more bone or osteoclasts that dissolve bone away.

Orthodontists use the method of steady pressure on a tooth from wires or plastic to activate the osteocytes on each side of the tooth and literally grow the tooth from one place to another.

Now you know.  You should always listen to your Grandmother!

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How Braces Move Teeth

Some people have a narrow palate for a variety of reasons:

• thumbsucking
• pacificer use
• low tongue posture
• birth defects like a cleft
• mouth breathing
• unknown reasons

Depending on how the narrow palate formed, the treatment will include some intervention such as surgery for a cleft or a habit treatment.  But almost every treatment will include an appliance to widen the narrow palate if there is  a cross bite.

Crossbites are the upper teeth biting inside the lower teeth.  See this discussion of crossbites for more details of the various kinds of crossbites.

Although both sides can be in crossbite, most crossbites occur only on one side, a unilateral crossbite.  These cause the lower jaw to swing toward one side so the lower midline is moved toward the crossbite side. 

Because the lower jaw is made out of one bone, it is harder to change shape.  The upper jaw is made of two bones that can be moved more easily and effectively.  An appliance to widen the upper jaw usually works in 6 weeks and then stays as a retainer for another 4 months.

I like to use an expander that covers the posterior teeth because it helps prevent the downward movement that is usually found with expansion of the upper jaw due to biting force.

This expander is bonded to the teeth to seal out plaque and to get a very firm hold on the teeth so that they do not tip and they move the bones apart more effectively.

This bonded palatal expander moves the jaw bones relatively rapidly compared with a removable one that takes many months to widen the upper teeth (and that mostly moves the teeth rather than the bones) so it is called a Rapid Palatal Expander or RPE for short.

A RPE will almost always spread the maxilla or upper jaw bones enough to make a temporary space between the upper front incisors.  The gingiva or gums are full of stretchy collegen fibers that connect the teeth and act like rubber bands to close the space between the front teeth rather quickly.

 After correction of the crossbite, the lower jaw will move back to center the midline and the non-crossbite side moving backwards to match the joint on the now corrected crossbite side.  This is according to: Changes in condylar position and occlusion associated with maxillary expansion for correction of functional unilateral posterior crossbite in American Journal of Orthodontics and Dentofacial Orthopedics, Volume 111, Issue 4, Pages 410-418 by K. Hesse, J. Årtun, D. Joondeph, D. Kennedy.

What this tells me is that because the non-crossbite side cannot easily move backward (due to the structure of the joint), the other side has to move out of position downward and forward.  Once the upper jaw is expanded to the correct width, the lower jaw can resume the correct position and the corrected side joint will move up and back to match the crossbite side.

Overall, the RPE is a relatively quick and effective way to expand your palate for both unilateral and bilateral posterior crossbites.

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Expanding Your Palate

• crossbite
• cross-bite
• cross bite

An anterior crossbite involves the front teeth and a posterior crossbite involves the back teeth.

Rarely, the upper posterior teeth bite completely outside the lower teeth in a condition called a scissor bite. 

A posterior crossbite can involve either one side, called a unilateral crossbite, or both sides, called a bilateral crossbite.

Now that all the definitions are out of the way, lets look into why they are a problem.

All crossbites cause a shifting of normal chewing patterns.  The lower jaw works best to chew food if it is free to move not just up and down but side to side and front to back.  Think of a cow chewing its cud with the exaggerated jaw movements and you will get the idea.

When the upper jaw has one or more teeth that hang down inside the lower teeth, the full movement is not possible and a more up and down chewing movement results. 

Upper front teeth can also look bad if they are in crossbite and the lower teeth rub the front of the upper teeth.

Most seriously, the lower front teeth are much more likely to have gingival recession or other gum and periodontal problems if they are pushed forward by upper teeth in crossbite.

How can crossbites be corrected?

Anterior crossbites are corrected with an appliance that attaches to the permanent molars and pushes or pulls the upper front teeth forward.  Usually this is a rather quick procedure that might take a few months. 

Once an anterior crossbite is corrected, it will usually stay corrected if the upper teeth cross over the lower teeth enough vertically.

Posterior crossbites are usually corrected by expanding the palate, but sometimes by just moving one or two teeth. See the article on Expanding Your Palate for more on this.

Correcting scissor bites are a bit more difficult and usually requires some braces, at a minimum on the involved teeth and the opposing teeth with  a rubber band stretched vertically.  More often, braces on all the top and bottom teeth  in the area are more effective.

As you can see, crossbites can be a problem but can also be fixed  with relatively little work.

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Crossbites

The primary baby teeth are important for chewing and biting and speaking and especially for maintaining the space needed for the future permanent adult teeth.

Luckily, missing front teeth do not seem to have as much trouble with space loss as missing back teeth.  A gap-toothed grin in a kid is much cuter than in an adult!

But when a primary molar is lost by infection or trauma, the gingival gum fibers and the angle of the jaws closing together make for a strong tendency for the adjacent teeth to move into the newly open space.

In other words, the space will be lost.

While initially the loss of a primary tooth does not seem like such a terrible thing, the future consequences could be the loss of a permanent tooth, extensive and expensive orthodontic appliances, and even an uncomfortable bite that causes abnormal wear on the poorly positioned teeth.

We routinely make a small appliance that spans the gap to keep the the space open.  This is called a band – loop space maintainer.  It is made with a metal orthodontic band with a wire stretching across the missing tooth’s space.

Adults need to have an artificial tooth made to replace missing permanent teeth because the teeth on the other jaw can over erupt.  Children are growing so much and their adult teeth will come in soon enough that this is usually not a problem for them.  An artifical tooth is not needed.

If more than one tooth is missing, a better way to save the space is to use an appliance that goes from a permanent tooth on one side to one on the other side of the mouth.  These are called a lower lingual arch to replace bottom teeth or a transpalatal arch to replace upper teeth.

If teeth are crowded, sometimes teeth must be extracted to make room for the others to line up.  Often a lower lingual arch or transpalatal arch can keep the room that remains, and even stretch the space.

Taking care of them is easy with only minor restrictions of not playing with them and keeping them clean.  These appliances will stay in place until the permanent teeth erupt.  Usually braces are needed after all the permanent teeth erupt but the treatment will be easier.

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Saving Space

Some orthodontists recommend treating crooked teeth or teeth that do not occlude (bite together properly) in two phases or treatment steps.  The first phase usually starts around second or third grade and a second phase around sixth grade.

Treating jaw problems early has not been well supported with excellent randomized controlled clinical trials.  These studies show that equivalent results are achieved with either one or two phases of treatment but that two treatment phases usually costs more and takes longer.

I believe that there ARE tooth alignment or spacing problems that are best treated early; before the back primary teeth come out. 

Reasons to treat early:

• Congenital problems such as cleft lips are best treated very early, then off and on for many years.
•  
• Thumb or finger sucking, pacificer use or tongue thrusting all can move teeth and even bend the jaw bones. 
•  
• Appliances to treat these problems early are very appropriate if other methods fail.
•  
• Upper teeth that stick out very far risk being broken in an accident so braces can help pull these back to safety.
•  
• Upper teeth that bite inside lower teeth are called crossbite teeth and should be treated early.
•  
• Narrow upper jaws are best treated early when the bones are most flexible.
•  
• Very crowded teeth may need to be extracted to make room for the others to straighten up.
•  
• Holding space is always a good idea with primary tooth loss.
•  
• Because the lower primary molars are usually much larger than the permanent premolars that replace them, holding this space with a metal wire appliance can usually save space for alignment without extractions.

Reasons to wait until later for orthodontic appliances:

• Two sets of braces costs more than one set.
•  
• The novelty of braces  wears off quickly so they are not so fun to wear any longer than necessary.
•  
• Putting braces on, getting straight, taking off, wearing retainers, putting braces on, getting straight, taking off, wearing retainers: just takes longer.
•  
• The longer braces are on, the more difficult it is to keep them clean and avoid cavities.
•  
• Braces come off when the second molars are straight, usually after age 12. 
•  
• Retainers for life follow orthodontic appliances so the sooner you start, the longer you will need to have retainers.

As you can see, there are some reasons to start early but if your child has crowded teeth and can wait until middle school, you and your child will be better off for waiting.

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When to Start Kids Braces?

We move teeth with brackets glued to teeth and wires between them.  The trick to moving teeth orthodontically is to have the gentle forces continue for a long enough time.

Wires are where the forces come from.  Orthodontic wires get bent into the crooked teeth and as they straighten, they pull the teeth straight also.

Relatively new super wires are able move teeth faster and more comfortably. They can be soft with cooler temperatures and stiffer with warmer temperatures.

The advantage of changing stiffness with temperature is that they can be cooled to bend them into the braces easily then they move the teeth more quickly as they warm up to body temperature.

These thermally sensitive orthodontic wires come in many different shapes:

• simple round wires
• braided round wires
• square wires
• combination wires with rectangular and round in others
• rectangular wires
• wires with different strengths in different areas

Orthodontic wires also come in several different materials and a huge variety of thicknesses.

Which super wire  to use is dependent on how crooked the teeth are and if teeth roots need to be moved or not.  Extremely crooked teeth will usually need small diameter braided round wires.  Less crooked teeth will use solid round wires.

If only the front teeth are twisted but the back teeth are not, then we consider using a wire with different stiffnesses in the front and the back.

Rectangular wires are used to move tooth roots.  The slot in the orthodontic bracket is rectangular so a rectangular wire will be able to twist and torque the tooth roots in the proper directions.

These super orthodontic wires are made of an alloy of  nickel, titanium, and copper.  Other wires are made of nickel and titanium but heat treated differently to make different metal crystals with different flexibility properties.

When we get close to the end of treatment, we need to bend the wires.  These wires are made of stainless steel or titanium alloys.  The bends compensate for the brackets being slightly out of position since it is impossible to get them perfectly placed when first glued on.

Orthodontic wires are hard to clean and sometimes pokey but they are the work horses that get your teeth straight.

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Super Orthodontic Wires