I am often asked the question by parents, “At what age is my child ready for orthodontics”? The American Association of Orthodontics recommends most children be seen by age 7 for an orthodontic screening. While children don’t need comprehensive orthodontics or “braces” at age 7 there is still good reason to have them screened at an early age.
From around age 6- 12 there is a lot of growth and development that takes place in the mouth and face. For example at about age 6 the primary teeth begin to be replaced by permanent teeth. In some cases when the front teeth erupt they come in sideways or crooked. This is an early sign that there will likely not be enough room in the mouth to fit all the larger permanent teeth. This is usually the result of the jaw being too small. These patients can benefit from expanders to help broaden and make larger the jaw or bony platform to help allow all the permanent teeth to come in straighter and erupt in the right place. I see this really as early orthopedics, not as much orthodontics because we are helping to develop bone, not teeth. We are trying to prevent the crowding problem later on by early intervention. In the past when kids were too crowded they would simply just remove permanent teeth to create more room, however this leads to a smaller narrow smile, and less favorable treatment outcomes, whereas expanding to create more room leads to a larger broader smile (which culturally we deem more aesthetically pleasing) as well as better treatment outcomes. However, if children’s permanent teeth come in crowded and they do not have expanders and early intervention, extracting permanent teeth may be the only solution.
Crowding and narrowness of the upper jaw is one of the most common types of malocclusion (improper fitting together of the upper and lower teeth). This leads to the lower jaw being trapped back and not allowing it to grow to its full and proper position, which causes a small chin, prominent nose type of facial profile, and often leads to TMD (sometimes referred to as TMJ) later in life. The way the teeth fit together dictates the position of the lower and upper jaws. When the upper jaw is narrow, the lower jaw has to function in an unnatural posterior position to enable the teeth to come together. And because eating is essential to our existence, they will stay this way until something changes. Expanding the upper jaw in these cases allows the lower jaw to come forward to its appropriate and natural position, solving many of the above-mentioned problems. This is not only very predictable but also a much more holistic approach than other alternatives such as surgery.
Another area of concern among young patients is tonsils and adenoids. These are lymphatic tissue in the back of the mouth and in the throat. They are there primarily to help fight infection when we are younger, but can become problematic, and need to be removed if they become enlarged or infected. Enlarged they can hinder proper growth and development of the face and jaws. This is much more common than most parents realize. My own daughter had her tonsils and adenoids removed at age 9 due to them being enlarged and causing problems. She was always winded in sports, excessively so, was snoring, breathing out of her mouth and her speech was nasally. Sound familiar? If you had two meatballs stuck in the back of your throat you would sound the same. It blocks the airway, and prevents sufficient breathing through the nose, so these patients compensate by opening and breathing out of their mouth all the time. Like food, oxygen is important as well. Untreated this has adverse effects on proper facial growth and development.
This article discusses only a few of the important aspects of early orthodontic screening and intervention. Other benefits may include self-confidence through healthy teeth and proper facial profile, increased self-awareness and ownership for their oral health at a young age etc. Simply put the importance of an early screening and appropriate early intervention cannot be over stated. Most dentists and orthodontists offer free screenings so do your kid a favor and go in for a quick visit.
Dr. Jared Pope DDS
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