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Braces for Children
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At Smiline we recommend that children see an orthodontist by age 7. This is
because some orthodontic problems are easier corrected when the child is
younger. Waiting to get braces or starting orthodontic treatment after all
permanent teeth have erupted may lead to difficulty in correcting some types of
orthodontic problems. By age 7, most children will have begun growing in some
permanent molars (back teeth) and incisors (front teeth) so that our
orthodontist can evaluate if there is an existing problem.
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What causes crooked teeth?
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Most of the time, having crooked teeth or a malocclusion (bad bite) can be
traced to genetics. This means that many orthodontic problems in children are
usually inherited from their parents. Some common orthodontic problems found in
children are crooked teeth, cross bites, large overbites, deep bites, open
bites, underbites, and jaw growth problems. Other malocclusions stem from
environmental factors. For example, harmful habits such as thumb sucking, finger
sucking,or abnormal swallowing patterns may cause protruded upper teeth, narrow
jaws, or a large “overbite.” Early or late loss of baby teeth, mouth breathing,
and accidents can also cause bite problems.
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Where do you begin? |
For every patient, there is an ideal time to start orthodontic treatment and our
orthodontist will help you determine when that ideal time is. Depending on your
child’s orthodontic needs, the goals of treatment will vary and may include
making space for the permanent teeth to erupt, straightening crooked teeth,
closing spaces between the front teeth, decreasing trauma risk associated with
protruded, buck teeth, guiding jaw growth, correcting harmful habits, or
improving self-esteem.
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How does your child get braces?
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To straighten teeth, our orthodontist may place orthodontic braces on some of
the erupted permanent teeth. In early treatment, the most common teeth that
braces are put on are the first permanent molars in the back and the four
incisors in the front. This is commonly called a 2x4 and is pronounced “two by
four” because of the two bands and four brackets that comprise the braces.
Sometimes additional baby or adult teeth may be included in the braces to
provide additional support for tooth movement. Limited treatment of a child
still with many baby teeth remaining is often called Phase One or early
orthodontic treatment. Phase Two treatment typically occurs when all baby teeth
have fallen out. Since many goals of Phase One early treatment include jaw
modification, our orthodontist may recommend a special jaw modification
appliance for your child. Some orthodontic appliances are fixed which means that
they are permanently cemented in the mouth until we determine that it is time to
have it removed. Other orthodontic appliances are removable and so it is the
patient’s responsibility to place and remove the appliance.
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ORTHODONTIC APPLIENCES COMMONLY USED IN CHILDREN
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Bionator
An acrylic appliance which fits on the upper and lower teeth, and postures the
lower jaw forward. A bionator is used to encourage lower jaw growth.
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Bite Plate
A fixed or removable appliance used to open a deep bite (decrease the vertical
overlap of the upper and lower incisors)
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Bonded RPE
A palatal expander which in addition to the metal framework, contains plastic
over the biting surfaces of the back teeth. This type of expander is used to
minimize bite opening during expansion.
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Forsus
A system of push-rods and springs used to posture the lower jaw forward and
encourage lower jaw growth.
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Haas Expander
A palatal expander which addition to the metal framework, contains plastic
shelves which contact the palatal tissue.
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Headgear
A removable appliance worn to restrict growth of the upper jaw and improve
overjet (“overbite”) problems. It normally consists of a facebow that attaches
to the teeth and a strap that fits around the neck or head
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Herbst
A fixed appliance that improves “overbite” by encouraging lower jaw growth
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Lip Bumper
A wire or piece of plastic connected to the lower molars which serve to preserve
or create space for other teeth.
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Lower Lingual Arch
A fixed appliance used to keep the lower molars from moving forward
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Miniscrew (Temporary Anchorage Device)
A metal screw placed in the palate or gum areas that serve to provide additional
stability when moving teeth. The screw is removed after the desired tooth
movement has occurred.
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Nance
A fixed appliance used to keep the upper molars from moving forward.
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Nightguard (Splint)
A removable plastic piece worn at night to minimize harmful effects of bruxism
(grinding).
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Pendulum
An appliance that moves the upper molars backward. A pendulum is used for
creating space to align the upper teeth and for improving overjet problems.
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Positioner
A removable appliance used to finalize tooth movements after the braces are
removed
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Quad-helix
A fixed appliance used to expand the upper or lower arch
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Rapid Palatal Expander (RPE)
A type of palatal expander. The RPE usually has a screw which the patient or
parent turns to widen the upper jaw.
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Reverse-Pull Headgear (Facemask)
A removable appliance worn to encourage growth of the upper jaw in order to
correct a negative overjet (“underbite”).
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TPA
A fixed appliance used to keep the upper molars from moving forward and down.
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Tongue Crib
An appliance used to prevent the tongue from thrusting forward
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Tongue Spurs
Pointy metal spurs that are used to control a tongue-thrusting habit. Tongue
spurs can be bonded to the teeth or soldered onto an appliance such as a lingual
arch
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Thumb Appliance
An appliance used to curb a thumb or finger sucking habit. The appliance makes
it difficult for the patient to keep the digit in the mouth.
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Twin Block
A two-piece appliance which consists of upper and lower pieces with ramps that
guide the lower jaw forward when the patient closes down. The twin block is used
to encourage lower jaw growth
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Rapid Palatal Expander (RPE)
A type of palatal expander. The RPE usually has a screw which the patient or
parent turns to widen the upper jaw.
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TEEN AND ADULT ORTHODONTICS
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Since most permanent teeth erupt by age 13, most teenagers are ready for full
orthodontic treatment. If there is a significant jaw problem involved, our
orthodontist may want to time orthodontic treatment so that it coincides with
the growth spurt to maximize the effects of jaw modification treatment.
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Causes of crooked teeth |
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Most of the time, having crooked teeth or a malocclusion (bad bite) can be
traced to genetics. Some inherited orthodontic problems are crowded teeth,
spacing, or having a crossbite, large overbite, underbite, deep bite, or open
bite Other malocclusions stem from environmental factors. For example, harmful
habits such as thumb sucking, finger sucking,or abnormal swallowing patterns may
cause protruded upper teeth, narrow jaws, or a large “overbite.” Early or late
loss of baby teeth, mouth breathing, tongue habits, poor oral hygiene, and
accidents can also cause bite problems.
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Treatment Options |
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When you are seen for an initial orthodontic exam, we will examine your teeth
for any crowding, spacing, bite, or jaw problems and discuss with you the
possible orthodontic treatment options. Dental braces are the most common
treatment used for teens or adults to straighten teeth. Sometimes top only
braces or bottom only braces will suffice, but most of the time you will need
braces on the upper and lower teeth. If you are concerned about looking like a
“metal mouth,” there are esthetic orthodontic options available such as clear
braces or lingual braces which are attached to the lingual (tongue) side of the
teeth. Though jaw modification appliances such as headgears, palatal expanders,
and functional appliances are used frequently on children, they are used less
frequently for teenagers and even less for adults. However, sometimes, in
addition to braces, other orthodontic appliances may be used to improve bite
problems or move teeth. Although most problems may be treated with dental
braces, for some people, braces alone cannot fix the problem. In cases where the
upper and lower jaws are not in balance together, the jaw disharmony may require
a surgeon move the jaws into a more harmonious position with a procedure called
orthognathic surgery or jaw surgery. Braces are usually required, with the
surgery taking place in the middle of the orthodontic treatment. |