accessibility ACCESSIBILITY
Grace W. Simco, DMD, MSD
Raphael T. Schach, DDS, MS
Diplomates, American Board of Orthodontics

Braces for Children and Adolescents

Many children today can hardly wait to get braces.  They are excited about the different colored ties that orthodontists place on them, and that the colors can be changed at each appointment.  Braces, for many, are considered "cool". Some children, however, are ambivalent about getting braces.  On one hand, they like the idea of perfect teeth, but on the other hand, they are nervous about getting them. We understand that! Parents can relax because we have an average of over 20 years of experience with children and take pride in our patience and in creating a friendly and comforting environment for them.  More good news is that the placement of orthodontic braces is rarely painful, most patients have minimal problems, and the end result should be a beautiful, straight smile.

The American Association of Orthodontists (AAO) recommends that children first see an orthodontist around the age of seven to screen for possible problems that would benefit from early (interceptive) treatment.  Dr Schach does not charge for screenings and rarely needs to provide any treatment at that time.  If treatment is needed, however, providing it can simplify future care, reduce expenses, and sometimes improve the final results.  In rare cases, facial or oral irregularities are noted before the age of seven and are an indication for an orthodontic examination before that age.

What Causes misalignment of teeth?

Poorly aligned teeth can cause problems with speaking, biting and chewing.  Most irregularities are genetic or occur as a result of developmental issues.  Conversely, some irregularities are acquired or greatly exacerbated by certain habits and behaviors such as:

  • Mouth breathing
  • Thumb or finger sucking
  • Prolonged pacifier use
  • Poor oral hygiene
  • Poor nutrition

What’s involved when a child gets braces?

The orthodontist initially conducts a visual examination of the child’s teeth.  This will be accompanied by a panoramic X-ray, an X-ray image of the side of the head, photographs, study models (impressions), and a bite registration. This preliminary assessment is crucial because it aids the orthodontist in developing a diagnosis and planning the most effective treatment.

In most comprehensive cases, the orthodontist will recommend “fixed” orthodontic braces for a child.  Fixed braces cannot be lost, forgotten or removed at will, which means that treatment is controlled by the orthodontist and, therefore, will probably be completed more quickly. Sometimes removable appliances are all that is needed. Removable appliances can be removed by the patient for easier cleaning.  They are generally used to treat less severe problems.

Here is a brief overview of some of the main types of orthodontic appliances used on children:

  • Fixed braces – Braces are comprised of brackets that are affixed to each individual tooth and an archwire that connects to the brackets and moves the teeth.  The brackets are usually made of metal, ceramic, or a clear synthetic material which is less noticeable to the naked eye.  After braces have been applied, the child will have regular appointments to have the braces adjusted by the orthodontist.  Orthodontic elastic bands and various auxiliaries are often added to the braces to aid in the movement of specific teeth.
  • Invisalign® - Invisalign®, while not suitable for young children, can sometimes be used in adolescents to straighten the teeth as Invisalign Teen®.  This type of orthodontics consists of a series of custom-made, clear, removable aligning trays that are worn 22 hours each day.  Each aligner is worn for approximately two weeks. After that period of time, a new aligner is dispensed by the orthodontist which continues the prescribed tooth movement.  In addition to the reduced visual impact of no braces and no wires, the fact that they are removable makes dental hygiene much easier and predictable.  The number of aligners is dependent upon the severity of the problem.
  • Removable appliances -  Removable appliances can be used to correct cross bites, protect the palate from impingement by the lower teeth, open the bite, and produce minor and moderate tooth movements.  Their biggest advantage, perhaps, is that because they are removable, the teeth are easier to keep clean. 
  • Headgear – This type of appliance, while not used as much with the current generation because of concerns with compliance, is still a treatment modality that can be very useful in treating developmental irregularities.  A headgear is a removable appliance that attaches to the back teeth.  When worn, it places pressure on those teeth which, in turn, places pressure on the bone supporting those teeth. Such pressure provides growth modification of the upper jaw and some tooth movement.  A headgear is intended to be worn a minimum of 12 hours each day and must be worn as recommended to achieve the intended result.
  • Retainers – Retainers are typically utilized in the final phase (retention phase) when movement of the teeth has been completed.  Retainers prevent relapse of the teeth toward the original position. Wearing a retainer ensures that teeth maintain their proper alignment and gives the jawbone around the teeth a chance to stabilize. 

If you have questions about braces for children and adolescents, please contact our office.

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