Why are Kids in Braces So Young Nowadays?

by Brandon Comella, DDS, MS

It may seem to you that kids are starting orthodontic treatment at a much younger age than when we were kids. You'd be right! There are several reasons to start orthodontic treatment before all the permanent teeth are in, and the benefits can be significant. 

Why Start Orthodontic Evaluation So Early?

Early evaluation provides both timely detection of problems and better prospect to achieve an effective treatment.

Some benefits of early treatment that parents can expect are:

• Correction of harmful habits, such as thumb sucking
• Improved speech
• Reduction of time in fixed braces
• Improvement of nasal breathing
• Development of the arches leading to beautiful, broad smiles
• Elimination of grinding of the teeth at night

When should my child be evaluated?

The American Association of Orthodontists recommends all children receive a check-up from a dentist or orthodontic specialist no later than age 7.

Many parents are surprised to hear that the American Association of Orthodontists recommends that children see an orthodontist for an orthodontic check up by the time they are 7 years old. "Why so young?" they ask. "When I was a kid, I didn't see an orthodontist until I was 13!" Orthodontic treatment of the past most often included the removal of several teeth, the use of a headgear, and much longer treatment times. Newer technology now allows us to use patients' early growth to help correct and more importantly, prevent orthodontic problems as the child's permanent teeth begin to come in.

At age 7, any growth or eruption issues are easily detected. The orthodontist can then determine whether the child will have room for their permanent teeth, and if the child has a harmful bite or harmful habits.

If the orthodontist notices narrow growing jaws, impacted teeth, or an overbite that will necessitate extractions in the future, for example, he or she can now utilize orthopedic techniques to train the bones to grow correctly. Re-establishing the proper jaw size in this way makes extractions (teeth removal) virtually unnecessary. With this earlier intervention, treatment time in braces is now usually much shorter and more comfortable.

What are the main reasons for orthodontic work?

1.  Crowding:  Teeth need room in the mouth to be able to erupt (that's the word dental professionals use to indicate that teeth become visible in the mouth).  If there is not enough room, you can wait well past the normal age of eruption before realizing the room should have been created already.

2.  Crossbites (in which one or more upper teeth fit behind the lower teeth instead of in the proper position): It is extremely important this condition be identified and corrected because it can alter skeletal growth. The upper teeth should overlap the lower teeth horizontally in the front and back of the mouth.  If they are in crossbite in the back, more often this leads to the crowding scenario mentioned above.  If they are in crossbite in the front, this may indicate improper growth of the skeletal jaw.

3.  Bad habits: Habits are detrimental if continued past the age of eruption of the permanent front teeth. Thumb or finger habits are most common, but sucking on blankets or tongue thrusting will also cause problems with tooth position and the formation of the bone that houses the teeth.

4.  Excessive overbite or "buck teeth": This may be caused by a habit of the posture of the lower lip which can tip the upper front teeth forward during eruption. Bucked teeth are often are prone to fracturing during rough play or accidents.

5.  Delayed eruption:  The lower two front teeth erupt near age 6 and the upper two front and the two adjacent lower teeth generally are 6 months later.  The two adjacent teeth in the upper arch should appear by age 7-7.5.

The benefits of early evaluation

Orthodontists are trained in growth and development of the face and facial structures.  By age 7, we can recognize growth patterns that will cause problems with eruption of teeth or even facial disharmony.  Early treatment, which we call “Phase I treatment,” is accomplished between ages 7 and 10, and lasts generally 8-12 months.  It will often not yield a perfect bite when all the permanent teeth erupt, because we cannot guide eruption of teeth that are not yet in the mouth.  However, the benefit is to create an environment for all the permanent teeth to erupt without difficulty and to alleviate any detrimental problems prior to eruption. 

If there are no problems that can be remedied by early intervention, your child will not need braces until the permanent teeth have completely erupted, typically around age 11.

Orthodontic devices typically used with younger kids

Palatal Expander: A Palatal Expander widens the upper jaw so upper teeth line up better with the lower teeth.

Thumb Sucking appliance: A Thumb Sucking Appliance is used to help stop the habit of thumb sucking, which can be detrimental if still done when permanent teeth are growing in. The device is cemented into place by the orthodontist on the child's upper teeth, and usually stops the habit within 21 days of use. It does not need any adjustment and has no moving or removable parts. It is one of the simplest, yet most effective, orthodontic devices.

©2012, 2019 Brandon Comella

Dr. Comella is the owner of Comella Orthodontics, with offices in Victor & Brighton, NY. If you are in the Rochester, NY area and you would like an evaluation for your child, call Comella Orthodontics at (585) 271-7515.