There are many reasons why a child might need braces. Appearance is a concern of many parents. In a society that places a high premium on looks, it can be a legitimate worry. Even if appearance isn’t a major issue, mouth conditions like crowded, turned or misaligned teeth, which makes normal oral hygiene more difficult, can pose long-term oral health risks, like tooth decay and gum disease. A “bad bite” may also cause chewing, biting or speech problems.
Some problems require braces at an early age, even when the child has mostly baby teeth (ages 5-9), although it may be best to start braces after most of the baby teeth have fallen out (ages 10-14). If your child has regular dental visits, your general or pediatric dentist will be able to determine when it is time for minor intervention or a full evaluation for braces.
Most orthodontic problems are genetic. The size of your jaws and the shape of your teeth are inherited from your parents. When the jaws don’t have room to fit all teeth, you get crowded, crooked teeth or misaligned jaws. Other issues with spacing and bite develop over time, due to prolonged thumb or finger sucking, mouth breathing, dental decay, accidents or poor nutrition.
What are the possible benefits of braces for my child?
Early diagnosis and successful treatment of certain bite problems, called malocclusions, have both short- and long-term benefits. Short term, you can get correction of problems the child might have been experiencing like difficulty biting, chewing or speaking. Improved esthetics may help your child feel better about themselves physically and personally. Long term, correcting a poor bite lessens the risk for uneven or excess wear on the teeth, eating difficulties, or jaw joint problems. Short and long-term straight teeth are less susceptible to tooth decay and gum disease. The value of setting up the right conditions for a lifetime with a confident healthy smile is perhaps the biggest benefit.
Some dental growth and development problems are best treated early, even while all of the baby teeth are still present (ages 5-9). The most important thing to do is to take your child for regular dental check-ups. Your child’s general or pediatric dentist will be able to track any potential dental issues that arise, and they can decide if, and when, your child may need minor intervention or a full orthodontic screening. They can also help you determine the best time for evaluation and treatment by an orthodontic specialist, or if one is needed. The American Association of Orthodontists recommends a first evaluation visit to the orthodontist no later than age 7.
What is the best age to be fitted with braces?
The best age varies from patient to patient. Most children can wait to start orthodontic treatment until most, or all, of their baby teeth have fallen out and the permanent teeth are mostly in place (ages 10-14). At that age, the child is still growing, and the teeth and bone move more easily. However, some dental-facial growth and development problems are best addressed early, even while mostly baby teeth are present (ages 5-9). These early corrections are often only the first phase of treatment, and final corrections are made when the permanent teeth are in place. This is often referred to as two-phase treatment. Other developmental problems are not as critical. Even adults get successful orthodontic care, although success is usually more predictable in a growing jaw. Any problem classified as a “bad bite” may be minimized with the proper orthodontic treatment.
Braces are much less noticeable than in past years. Advances in dental materials have provided more options to help the brackets and wires blend in with the teeth. In addition, techniques are available to place the braces on the backs of the teeth or to move the teeth by wearing a series of thin, barely noticeable mouthguard-like trays. Of course, these more esthetic options have greater cost and often are not available for more difficult orthodontic corrections.
The overall cost of braces depends upon the type of braces you select. Traditional metal braces cost between $3,000-$7,000, Invisalign ranges from $4,000-$7,400 (other aligners may be considerably less expensive but may not be covered by your insurance), ceramic braces span $4,000-$8,000, and lingual braces are $8,000-$10,000. Dental insurance often covers some of the cost of braces. Many orthodontists offer payment plans to make payment manageable.
Braces can create opportunities for bacteria to thrive, when not cared for properly. Food stuck in wired braces feeds bacteria, leading to tooth decay and gum disease. Children with braces should brush after every meal and floss daily to remove food particles and to prevent infections and cavities. Depending on the child’s oral hygiene and diet, professionally applied fluoride treatments 2-4 times per year may be beneficial. Certain foods can damage braces, like gum, sticky candy and popcorn, and should be avoided. Children with plastic aligners should remove them during meals. Caring for braces can prevent dental issues down the line.
Some final thoughts — Braces are expensive; there is some discomfort and pain involved; it can be a long process, especially if the treatment is done in two phases; the child must be cooperative and practice good oral hygiene or they could end up with straight teeth but cavities and gum problems. Overall though, braces can be a great long-term investment in a child’s health and well-being.
“AAO – A Beautiful Smile For Everyone” American Association of Orthodontists. www.youtube.com/watch?v=D41oX_PnAvA Accessed July 2018.
“Braces.” Mouth Healthy, American Dental Association. www.mouthhealthy.org/en/az-topics/b/braces Accessed July 2018.
Guideline on Management of the Developing Dentition and Occlusion in Pediatric Dentistry - 2014. American Academy of Pediatric Dentistry. http://www.aapd.org/media/Policies_Guidelines/BP_DevelopDentition.pdf Accessed July 2018.
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Assessment of orthodontic treatment outcomes: early treatment versus late treatment. Hsieh TJ, Pinskaya Y, Roberts WE. Angle Orthod. 2005 Mar;75(2):162-70.
Two Phase Orthodontics: There are Two Sides to Every Story. Dental Products Report. 2016 http://www.dentalproductsreport.com/dental/article/two-phase-orthodontics-there-are-two-sides-every-story?page=0,1 Accessed July 2018.