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Brace Yourself
When is the Right Time for Orthodontics?
© Copyright 2000
by Parents' Press
Photo by Skjold
Photographs, all
rights reserved
By Jennifer Nelson
Amy Schoenberger, 12, of St. Petersburg, Florida, had two upper eyeteeth missing since birth, which required extensive orthodontics and possible implants (false teeth which are implanted into the bone) to fill in the gaps. Her parents, Penny and Jim, had to choose among several complicated and costly - $8,000 or more - treatment plans for Amy's smile.
Like many parents, they wanted to provide the best for their child, and a nice smile along with straight teeth can offer huge social advantages.
"The two reasons for orthodontic treatment are aesthetics and function," says Dr. E.G. Righellis, an orthodontist and an associate professor at the University of California, San Francisco.
The effects of appearance shouldn't be dismissed lightly. Crooked teeth can have profound effects on children's self-esteem and social skills. Braces can nearly always improve appearance.
Function is equally important. "Even one crooked tooth can throw the bite off or cause other problems later on," says Kenneth Brehnan, D.M.D., an Albany, CA orthodontist.
Tooth function deals with how the jaws open and close; how teeth fit together; and whether or not children can clean and floss their teeth properly. The goal is to treat misarranged, crowded or ill-fitting teeth in the hopes of preventing other problems, including gum disease, trauma, cavities and speech disorders.
But the investment in time and money can be steep:
Two
to three years of monthly appointments.
A
modified diet, avoiding hard and sticky foods.
Parents
must monitor their youngsters who are wearing retainers or appliances,
and promptly return to the office if wires become damaged or
broken.
Treatment
costs can total up to $4,000 per patient, and are not covered
by most dental insurance. This makes it one of the greatest out-of-pocket
expenses familes face. Most orthodontists offer payment plans.
Babes in Braces
According to the American Association of Orthodontics, 80 percent
of those who wear braces (an estimated 4.5 million Americans)
range in age from 6 to 18 years old. However, the practice of
treating children at the younger end of this age range is not
without controversy.
Is putting braces on kindergartners best, or is it wiser to wait until adolescence? Some orthodontists want to treat children early, while others advocate waiting until all the permanent teeth are in. Some believe it's necessary to remove teeth, while others go to lengths to prevent the extraction of permanent teeth.
Proponents of early treatment argue that it can accomplish what nature has not expand and remold jaws and coax teeth into going straight.
Joanna Bedsaul, 12, of Gautier, Mississippi underwent early treatment in hopes of lessening a severe overbite. She wore an orthodontic appliance for a year at age 8 to correct her bite.
Her mother says the early treatment was a good thing. "I like that they wanted to get started right away instead of waiting for kids to pick on her about her overbite," says Penny Bedsaul.
Other cases aren't as simple. Gary Nelson of Jacksonville, Florida is not so sure about the benefits of early treatment. His daughter underwent two years of early orthodontics for the correction of a cross bite (when the bottom jaw protrudes farther than the top) and crowded teeth.
Ashley is now 11, and her orthodontist recommends full braces for 18-24 months along with the extraction of two to four permanent teeth.
"I feel somewhat disillusioned," says Nelson. "Seems like I'll pay twice as much for the treatment and Ashley still needs permanent teeth removed. She'll be in braces nearly four years by the time we're finished. It doesn't look like early treatment accomplished a thing."
Straight Facts
In 75 percent of patients, early treatment isn't necessary. "Most
children can wait until their permanent teeth are in to start,"
says Brehnan.
Early orthodontics can try to turn a situation into a non-extraction case. But it's important to note that there are no guarantees.
"There are certain criteria for early treatment," says Righellis. Primarily, it is for those with "jaw fit problems," he says - children with overbites, under bites, and cross bites, along with those who have severely crowded teeth.
Righellis asks two questions when he evaluates these young patients:
Is
this the only time we can successfully treat the problem?
How
long will the results last?
These are excellent questions parents can also ask when deciding for or against an early treatment plan.
Each school of orthodontics can have a slightly different philosophy: early vs. later treatment and the advisability of tooth extraction. The age of the orthodontist and the end result envisioned can also subtly influence the treatment plan.
"Whatever the reasons, you should get two, even three, opinions, especially for complex cases," says Penny Schoenberger not only for costs but also for the plan itself. Her daughter Amy has been in braces for 18 months now and is doing well.
The New Braces
Space age technology has streamlined braces, so they are more
comfortable and less noticeable than ever before. And most kids
pick brightly colored elastic tooth bands to coordinate with
holidays, school colors or their favorite sports teams.
Whether you opt for early or late treatment or out of orthodontics altogether arm yourself with as much information as possible. Get the facts. Ask for recommendations from friends and the family dentist and speak with several orthodontists. Educate yourself about your child's specific circumstances and talk with other parents who have undergone similar treatment for their child.
With a little research and patience, a willing participant, and a good payment plan, your child can end up with a great grin for life.
Before & After
The "Smile Bank" lets children & teens see the results of orthodontics before they get braces.
Just send in a close-up photo with a big, toothy grin and an orthodontist will prepare a computer generated "after braces" picture of your new smile. Mail the photo with return address to the American Association of Orthodontists, c/o SMILES, 401 N. Lindbergh Blvd. St. Louis, MO 63141-7816.
Information
Call the AAO at 1-800-STRAIGHT for information and a free video about orthodontics.
Light-hearted but useful information is available online at The Orthodontic Information Page, www.bracesinfo.com.
Questions to Ask
· Can you fix my child's problem, and how often do you treat this condition?
· How long will the treatment take?
· Will my child need to have teeth extracted?
· Will my child have any limitations due to the braces or appliances?
· Will you provide a written treatment plan?
· What kind of payment plan is available? Is all treatment from start to finish included in the costs?
· Are you board certified in orthodontics?
· How many children do you treat annually?
· How long can I expect to be in the office at each appointment?
Retainers for Life?
After orthodontics is completed, patients are required to wear a retainer. Worn primarily during sleep, a retainer will hold the teeth and bite in the proper "after braces" position.
Orthodontists now recommend patients wear their retainers almost permanently. "I tell my patients to wear it one or two nights per week indefinitely," says Brehnan.
Surprisingly, teeth have a memory - and this practice will prevent them from shifting into their old position.
Halloween & Braces
Did braces
or retainers take a beating at Halloween? Are there any "safe"
treats for trick-or-treaters with braces?
CLICK
HERE
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