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When do you start Orthodontics/Braces in a child ?

Posted on 14th, Jul 19

One of the most frequent and common questions asked by mothers is, What is the best age to start Orthodontic treatment ? Is it at a young age of 8 years when the child still have half of their baby teeth or is it at a later stage as a teenager (13-16 yrs) when all their adult teeth have erupted.

The answer to this depends on the type of malocclusion (malrelation of the jaws, teeth or both) the child presents with.

A Large Overjet/Overbite problem

A child with a severe overjet, which most parents like to call overbite involves the upper teeth overlapping the lower teeth in the horizontal by a large amount. Usually a normal overjet is 2 mm, however some children have overjets between 6-10 mm. Children with a large overjet usually have their upper front teeth sticking out which makes them more susceptible to fracture when they fall, it also make them self conscious when they smile and could be a victim of bullying.

I have always said treatment in such children always depends on what the child thinks about his teeth. If the child feels that it is not a problem and that they are happy with their teeth and smile then we could wait and defer treatment until before puberty, 10-11 yrs in girls or 12-13 yrs in boys approximately, there are other methods to assess prepubertal growth spurts which the Orthodontist would explain to you. However if the problem is psychologically affecting them then it is an indication for early treatment. Any correction achieved through early treatment has to be revisited until growth is complete to make sure that the results are stable and the parents have to understand that the child might require a short second phase of treatment as a teenager.

There is enough evidence that proves early treatment works, however treatment started just before the pubertal growth spurt begins could also be equally successful.

The large overjet is reduced, by a combination of dentolaveolar adjustment with minimal jaw growth. Some clinicians like to say that they can grow the mandible, however there is enough evidence to suggest that mandibular growth or skeletal changes is minimal and is more a dentoalveolar adaptation. The upper incisors move back a little (retrocline) and the lower incisors move forward (procline) a little and with approximately 15-20% of mandibular growth the overjet is reduced to 2-3 mm in the final result and is facially acceptable. Parents need to know this and should not be misled in assuming that the child’s lower jaw is actually growing.

An Underbite or a negative overjet overbite problem

An underbite is usually characterised by the lower teeth overlapping the upper teeth in the horizontal and the vertical. This malocclusion gives the appearance of the lower jaw sticking out. Malocclusion such as these have a very strong genetic predilection (either parent may have it) and there is a strong evidence that suggest that the earlier the treatment the better. These problems have to be monitored into adulthood as they have a tendency to relapse due to continued growth. Not treating it however could inevitably result in the  patient needing surgery to the jaws as an adult. Early treatment minimises this. In short better to start early in patient with an underbite

The appliances used to treat the above problems will be explained by the clinician at your consultation visits. If your child is suffering from a similar problem feel free to call us on 97235757 and make an appointment for an initial consult.

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