The American and Canadian Associations of Orthodontists recommend that children be evaluated by a certified Orthodontist by the age of 7. Having your child examined at an early age may help Dr. Richardson detect developing problems, and may prevent more serious dentofacial problems in adolescence. It also gives Dr. Richardson baseline information regarding your child’s dentition, as well as the bones of their jaws and face. This makes it easier for her to monitor changes and predict when treatment should begin, allowing her to achieve results that may not be possible once the jaws have finished growing.
In most cases it is best to defer Orthodontic treatment until all of the adult teeth are present, and this often correlates to the time puberty begins. However, there are specific teeth and jaw related problems that necessitate early intervention, even before all the permanent teeth are present. Here are instances that necessitate early Orthodontic intervention:
When a thumb or finger sucking habit continues beyond the eruption of the first permanent molars (usually around age 6), there can be adverse effects on the teeth and jaws. A chronic habit of this nature can cause the upper front teeth to be proclined (angulated) beyond normal and tilt the lower teeth back. It can also cause the upper jaw to become narrow and alter its growth, and will often prevent the top front teeth from growing down normally over the lower teeth, creating what Orthodontists refer to as “anterior open-bites”. If left untreated, the jaw bones can be permanently effected, and braces combined with surgery may be required to correct the problem. In addition to difficulty chewing food, children with this condition often have speech problems such as lisping. A large or forward thrusting tongue can have a similar effect to a digit habit and should also be treated early.
When the upper jaw (palate) does not grow as wide as the lower jaw, the back teeth can form a crossbite. Crossbites are not always obvious to parents, but can cause long term effects on the symmetry of the face and the direction of lower jaw growth. Simple appliances can successfully widen the upper jaw and move the teeth back into a more favorable position.
Occasionally a lower front tooth will become trapped behind the upper tooth (and vice versa). If left untreated, the gum tissue of the tooth in crossbite can become stretched and thin, and this can jeopardize it’s health. Once the gum is compromised, periodontal treatment will be necessary to graft (or `patch“) the affected area. Simple early
treatment can prevent adverse loss of gum tissue and move the tooth back into the correct position with the opposing tooth.
Severely Protruding Front Teeth (“Bucked teeth”)
When upper front teeth are severely angulated beyond normal, they are at a greater risk for trauma should the child fall or sustain a facial injury. Additionally, children with protruded teeth often suffer from self esteem issues problems and this can have long term effects on their self-esteem. Dr. Richardson may recommend early braces for these patients to bring the four front teeth back into a safer, more pleasing position.
Skeletal Crossbites (Underbites)
Dr. Richardson may be able to detect jaws which are growing disproportionately at an early age. Depending on the extent of the discrepancy, she may recommend early treatment to help guide jaw growth.
When new permanent front teeth grow in crooked, it may be due to a lack of space for the bigger adult teeth. Dr. Richardson may recommend removing baby teeth to allow the adult teeth space to grow, or to prevent more complicated Orthodontic treatment in the future. Abnormally growing permanent teeth or extra permanent teeth (called “supernumeraries”) can have a similar effect and may need to be removed.
It is normal and desirable to have some spacing in the baby teeth. However, the Orthodontist can determine if the space is excessive, and whether there may be an underlying cause for the extra space.