When Should Your Child See an Orthodontist?

Dr. Clinton Emerson, local orthodontist, answers questions about orthodontic treatment

Dr. Clinton Emerson of Emerson Orthodontics in Broken Arrow answers questions regarding the best orthodontic practices for ensuring normal growth patterns in a developing mouth and creating ideally aligned and straight adult teeth. An orthodontist is specifically trained to handle tooth alignment and bite functioning problems.  After four years of dental school, a licensed orthodontist completes another two to three years of specialized orthodontic training at an accredited university.

TK: What is orthodonic treatment?

Dr. Emerson: Orthodontists use devices to correct the bite, getting all of your upper and bottom teeth to fit together ideally.

TK: Why is it important?

Dr. Emerson: Research shows the smile is important in making a great first impression. Also, having aligned teeth makes cleaning easier. Oral bacteria, plaque in the bloodstream, is tied to heart disease and diabetes.

TK: What are the early warning signals of orthodontic problems?

Dr. Emerson: If a child’s teeth are perfect when they are little, crowding will occur when the adult teeth come in. Adult teeth need more space.

TK: When should a child see an orthodontist?

Dr. Emerson: The American Association of Orthodontists recommends the first appointment occur by age 7, this is when the four top and bottom permanent teeth are coming in. The purpose is to address abnormal growth and development patterns and to get a baseline x-ray. Ninety-five percent of kids will not need treatment at this time.

TK: What dental and jaw conditions usually need orthodontic treatment?

Dr. Emerson: Crowding, an overbite or underbite and misaligned teeth.

TK: Why do some children get braces in elementary school and then again later?

Dr. Emerson: There are two phases of orthodontic treatment. The first phase occurs when both baby and adult teeth are present. This treatment creates a template, so a spot is open for the remaining adult teeth to come in. The main focus is not to create a cosmetic smile, but a normal development pattern of the teeth, gums and bone.

Phase one may require an expander to increase the upper jaw’s width, for example, back to the width it was before a thumb sucking habit; a habit appliance, for kids who have an active habit such as thumb sucking; limited braces, for example, braces on a few teeth to reposition the teeth so there is room for more teeth to come in; and/or head gear, worn at home.

The first phase better ensures all treatment options are open, for example, keeping all of the teeth, should a second phase of treatment be needed. (There is no way to know whether or not a second phase will be needed.)

Phase two treatment occurs when all permanent teeth are present. The main goal is to align the upper and lower teeth, and the benefit is mainly cosmetic.

TK: Are there habits such as pacifier use or thumb-sucking that cause children to need braces or is that a myth?

Dr. Emerson: Every child is different. Rarely are there long term effects associated with pacifier or thumb sucking during ages 2 or 3. However, when 6-, 7- or 8-year-olds have a thumb- or finger-sucking habit, or any type of habit involving their mouth, changes to the roof of the mouth occur —  the bone changes to the shape of whatever is put inside of it.

TK: What are some of the latest practices in orthodontics?

Dr. Emerson: Incognito, which are braces placed behind the teeth, and Invisalign (clear aligners).

TK: Any new research parents should know about?

Dr. Emerson: Seventy percent of those who have orthodontic treatment get scar marks; new toothbrushes, new glue and other prevention methods are being researched.

TK: Any other tips?

Dr. Emerson: If your child has to have a baby tooth removed, ask the dentist about using a spacer. The adult teeth may not come in for a couple of years and the baby teeth may shift and cover up that space. Once the teeth slide around in the bone, it is hard to get that space back, and later on may even result in extraction of teeth. Every tooth needs a reservation spot when it comes in.

Also, a referral is not needed from a dentist to see an orthodontist. Every orthodontist is trained to treat children, teens and adults. Some cater more to one group or another.

Sarai Burris is a local freelance writer

When to see an Orthodontist

If you recognize any of these signs or concerns in your child or yourself, it might be time to schedule a consultation with an orthodontist.

• You want a beautiful smile
• You feel a great smile will improve your self-esteem and self-confidence
• You want the best for your family
• Early or late loss of baby teeth
• Difficulty chewing or biting
• Mouth breathing
• Sucking the thumb or fingers, or other oral habits
• Crowded, misplaced or blocked-out teeth
• Jaws that shift, make sounds, protrude or are recessed
• Speech difficulty
• Biting the cheek or biting into the roof of the mouth
• Protruding teeth
• Teeth that meet in an abnormal way or don’t meet at all
• Facial imbalance or asymmetry (features out of proportion to the rest of the face)
• Grinding or clenching of teeth
• Inability to comfortably close lips

Source: The American Association of Orthodontists