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  • Why is my orthodontist telling me my child needs braces so early!?
  • simply-orthodontics-when-to-start-brace I get this question a lot! Even with all the information online I think coming from my mouth (ie a specialist) they feel more comfortable hearing it from me.  A lot of parents think it’s a scam in that it’s a way for orthdodontists to get more money. There are truly so many philosophies on when a child should get braces.  The goal of orthodontists is to be able to fix jaw issues before they can’t be fixed.  Most of the time the treatment methods we use works but in some cases unfortunately they don’t.  Growth in humans is so difficult to predict, and as orthodontists we try our very best to modify growth. Sometimes the genes are so strong that certain features cannot be fixed but it is definitely better to attempt treatment than not.   That being said…I base my reasons on research. So here is my research based professional opinion.   If you could fix something for your child and avoid a surgical procedure in the future why would you NOT do it? Herein lies the basis for interceptive orthodontic treatment or more commonly Phase I.  Research shows five main reasons to treat children orthodontically with phase I   1) Finger/thumb sucking habits: These can cause open bites which are extremely difficult to correct later in life if they persist.  These should be addressed once the permanent teeth begin erupting.  Prior to the permanent teeth erupting there is not any permanent damage yet.   2) Posterior crossbites: This means that the upper jaw is too narrow and the back teeth are biting flip flopped.  The palate in humans fuses prior to adolescence which is why kids need the so called “expander.” In adults this can only be corrected with surgery.   3) Anterior crossbite: Front teeth flip floped or an underbite.  Single teeth in crossbite are bad because they can cause recession of the gums in the bottom teeth.  They act like a wedge and wedge the lower tooth forward.  Lost gums are extremely difficult to regenerate.  An underbite needs to be corrected ASAP because bones that can be manipulated at an early age fuse later in life.  Yes this may require the dreaded headgear/face mask but surgery later in life…or headgear as a child…pick your poison.  The bad news is underbites sometimes cannot be corrected the genes are too strong and sometimes surgery is still warranted. My instructor once told me “play the game until you lose, then change the rules so you win.” That is the deal for the underbite.   4) Psychosocial: Who wants their kid to be bullied!? Not me. Kids now are getting bullied and made fun of at a younger age.  I really don’t promote braces at a young age…it’s tough for the orthodontist, it’s tough for the parent, but if it prevents a child from getting made of, or makes them feel a ton better about themselves you bet I’ll recommend braces. It is a short term investment for a long term benefit.   5) Risk of palatally impacted canines: These are miserable to fix when all the adult teeth are in. A new study says that 85% of these bad boys can be prevented with some expansion and interceptive treatment to create space.  Otherwise you are looking at a lengthy full phase of orthodontic treatment with surgical exposure of the canines. Doesn’t sound good to you? Doesn’t sound good to me either.  It's still correctable at an older age but if we can try to prevent them we should definitely try.   So early treatment, in my eyes if necessary, is definitely warranted.  It can be a challege for child, parent and orthodontist, but the benfits outweigh the negatives.  Don't be afraid of it, bring your child to see me and we can make the best decision at Simply Orthodontics! -Simon Shung, DMD