Orthodontics as a Child or Teenager: Which is best?
Many people are confused by the timing of orthodontic treatment in the young people they know. It seems that some children have braces in Primary School and others in High School. Some get the on, have them taken off and then put back on again.
The timing of treatment largely depends on the individual’s problems but there are some issues, that if addressed early can make treatment as a teenager much simpler or unnecessary.
- If Children lose baby teeth out of the normal sequence, they may develop severe crowding.
This may require extraction if space isn’t held for the permanent teeth to come through.
Sometimes it is possible to regain space in the mixed dentition. (Some baby teeth and some permanent teeth.) - While the patient is growing, it is possible to harness this to correct large overbites (Class II)
and underbites (Class III). - If the lower back teeth bite on the outside of the upper back teeth, this is called a cross bite
and should be corrected to allow proper development of the upper dental arch. This type of
problem is treated with an expander to widen the roof of the mouth. - Mouth breathing and even sleep apnoea can be addressed and improved. If a child always
breathes through their mouth then they can develop a long face and front teeth that do not overlap or even touch. (Open bite.) - Habits such as thumb sucking, lip sucking or tongue thrusting can also effect jaw growth and
development and should be addressed early.
If jaw development is addressed early (before all the permanent teeth are present and in a patient who is still growing) many problems can be resolved and treatment as a teenager may simply involve straightening teeth.
With the option of Invisalign First, many early treatments can be done with little discomfort to our young patients. This new treatment is made possible with the advent of Digital scanning. We simply take a digital scan, instead of messy and unpleasant impressions. Kids could just not cope with these, thankfully now they don’t have to.
If development of the jaws is proceeding normally and a young person has some crowded or crooked teeth, then treatment as a teenager, when all the permanent teeth are through, may be all that is required. Either conventional braces can be used or Invisalign. I have found that 90% or teenagers are very compliant and get great results.
Before / After Slider 1: This patient was treated with Invisalign when all her permanent teeth had erupted.
Before / After Slider 2: This patient had Invisalign First.
In the photos below, you can see that the space where 2 permanent teeth need to come up, is only big enough for 1 and ½.
She did have to have a few attachments glued to her teeth and she did wear elastic bands during the Invisalign treatment, but it’s quite remarkable, what a sequence of pieces of plastic can achieve.
From the photos above, the change is obviously straighter teeth, but that wasn’t the main reason for treating at the age of 9.
Everything looks very constricted.
The changes that have been made with about 6 months of aligners will now mean the teeth have room to come through.
Back to Invisalign First. The crooked teeth on upper arch have been straightened out. They were at increased risk of an accident when one was sticking out.
Below is an example of how we used to do it. Springs and wires and breakages meant discomfort.
Luckily, kids are pretty tough.
He had a second round of braces as a teen and it all worked out well.
So both Invisalign and braces work well. It’s usually a question of timing and then patient
preference.
Dr Danneil Wood.