When to Start Braces
Many parents comment on the number of kids in second or third grade who have some braces.
Treating with two phases of orthodontic care can usually be avoided. Good evidence exists that most orthodontic treatment is best provided at one time as a pre-teen.
However, there ARE times when early orthodontic treatment is useful.
Orthodontic problems that are best treated early:
- lower front teeth that bite outside of upper teeth (a cross bite)
Saving Space
Baby teeth are useful for many things:
- chewing on things (not always a good thing)
- eating
- talking
- smiling
- guiding permanent teeth into proper position
- saving space for permanent teeth
It is a rare day in my pediatric dentistry practice when I do not have to think about the space available for permanent teeth to grow in properly. Sometimes I have to extract teeth to make room then hold the space open with a metal space maintainer.
Tartar or Calculus
You know that hard stuff that seems to grow on your teeth and that sounds screechy but makes your teeth feel nice and smooth when the dental hygienist scrapes it off?
That is calculus (Greek for ‘small stone’) and also called tartar (but has nothing to do with the sauce).
Tartar forms by many days of mineral-containing saliva or spit washing over your teeth and calcifying any plaque on your teeth. Because plaque forms continuously, people who have lots of minerals in their saliva make more tartar.
Retainers
Retainers are what we use to retain, or hold in place, teeth after they have been straightened with braces. In years past, orthodontists believed that wearing retainers for two or three years was enough to keep them straight for life.
This is only correct on about one third of patients. Another third will have minor movement of their teeth without retainer wear, and the last third will have significantly crooked teeth that require more braces to straighten them.
Filling Materials
When a tooth gets a cavity it must be filled or it will continue to decay and get worse – even to the point of death.
What kind of materials are available to fix holes in teeth?
The most common material for about a century has been silver and copper mixed with mercury with a little tin. This mixture is called amalgam or simply silver filling.
Molar Sealants
Permanent molars usually have very deep pits, grooves, and fissures on the biting surface. These holes can be very difficult to keep clean so they are the most common place to get cavities.
In the 1970′s dentists started cleaning out these pits and fissures then squirting runny plastic into the cleaned out grooves to keep bacteria from growing there. This procedure is called a dental pit and fissure sealant.
First Dental Visit
Many parents are rightfully confused about when is the right time to start their children’s dental visits. Some Pediatricians say the first dentist visit should be about age two or three.
Many general dentists have difficulty managing young children so they ask parents to bring them in after age three.
The American Academy of Pediatric Dentists recommends that the first dental visit be soon after the first tooth erupts or by age one.
Tooth Pain
A toothache is one of the most painful experiences in life. It has been compared with severe back pain and even childbirth.
Although there are many potential causes of toothache, the most common cause is a cavity that infects the pulp inside a tooth and that infection spreads throughout the tooth and into the surrounding bone.
As the infection enters the bone, our bodies try to stop the infection by making chemicals that attract our attention – pain.
Cavity Infections
Some people tell me that “weak teeth” run in the family. I respond that everyone in the family most likely have an aggressive type of plaque on their teeth. Because cavities are caused by bacteria, they are the result of infection.
Infection with a specific type of bacteria is more likely to lead to a cavity than other types of bacteria. One of the most aggressive bacteria is called Streptococcus mutans. It is related to Strep throat bacteria but grows especially well on teeth.
First Dental Visit
The American Academy of Pediatric Dentists recommends the first dental visit to be whenever the first tooth erupts or by the child’s first birthday.
I agree that this works for first children but I think than once parents have been through the practice of taking their infant off the bottle by age one, brushing and flossing daily, watching sweets, and using fluoride suplements appropriately, the following kids can wait until two or even three for their first dental appointment.
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