Braces for Children’s Teeth: What Parents Need to Know

The American Association of Orthodontists recommends that children be seen for an initial orthodontic screening by the age of seven. Why so early? As you’ll see, early intervention is key regarding pediatric dentistry.

Though it may seem a little early, the main reason is because that’s when permanent teeth typically start to erupt. That’s not to say that any type of treatment will begin at that time but there are things that can be evaluated in a child at that age.

Typically, a dentist is looking for proper eruption of the teeth. A dentist wants to make sure that the baby teeth are falling out or are going out on their own as they should. They want to observe if there is significant routing where teeth are having problems come in. They also want to make sure that the growth of the upper and the lower jaw is symmetric as it should be. Overall, pediatric dentists won’t do a lot of interceptive treatment unless it’s necessary.

There are certain indications that it’s necessary to do orthodontic treatment at a young age and that’s where we can work with Dr. Johnson. He can identify those patients but typically, we want to see them at around the age of seven, and then treatment’s indicated, we can certainly go ahead and do some limited or phase one treatment as we call it. If not, we’ll see the patients back about every six to 12 months to continue to monitor the eruption and growth until they’re ready for full braces, usually around the age of 12 to 13, when all the permanent teeth are in.

Does every child need braces?

Not necessarily. If a child has well-aligned teeth and they have a stable functional bite, there’s not necessarily a need for braces. If a child does have an overbite or crowding, those things can be corrected with orthodontic treatment.

Though a specialist in Orthodontics takes over with the movement of the teeth, making a smile perfect for a child, a pediatric dentist will still maintain their hygiene, seeing a patient more often if they’re:

• Getting food stuck in their braces
• Prone to cavities because of the food

In addition, x-rays can shown if a tooth is not coming in right. If so, a pediatric dentist may want to get that tooth out of the way to prevent it from getting stuck; something pretty common with canine teeth.

Good Hygiene Practices: From Child to Adult

Some experts say you should use mouthwash before you brush your teeth everyday. Some say to use it after the fact. Some say for adults, gargle with hydrogen peroxide. Some will say that’s a bad idea. The definitive answer? It varies.

Dr. Jarod Johnson, pediatric dentist of Arctic Dental offers advice. “It definitely varies. I think like the ADA. My license plate is actually “two minutes twice a day,” so that’s like the big push – to brush your teeth twice a day for two minutes as an adult.”

He continues on regarding children. “With kids, it’s a little different. You’re not going to have a kid sit there in front of you and brush their teeth for two minutes, so what I tell parents is I say, “Hey, I guess you’re busy. I would love it if you would brush your child’s teeth in the morning and at night.”

It’s obviously really, really important that during this time, that kids, adolescents and adults that have braces do an extremely good job of keeping teeth clean. Sometimes, a prescription toothpaste that has more fluoride in it can help because they may not be brushing two minutes twice a day as recommended.

Regarding mouthwashes, there’s mixed evidence out there. In the field of dentistry, certain mouthwashes regularly used at the same time with toothpaste bind to the fluoride. It just depends on the product that you’re using. If a patient has questions, the recommendation is to take the bottle to your dentist and get their opinion.

Usually with mouthwash, that’s something that can wait until around age six when the child can spit and use under adult supervision. Some of them do contain alcohol that may cause a burning sensation. Alcohol-free versions exist, but still discuss with a dentist any concerns.

Preparing for Getting Braces

If a child is getting ready for braces, being in communication with a dentist is key, just to see if they’re a good candidate for braces. Not everyone is a good candidate for braces. In that respect, if they:

• Don’t have good hygiene
• Have plaque over their teeth
• Aren’t brushing their teeth
• Have gingivitis

A dentist will usually decide NOT to put braces or appliances in their mouth because they’re not going to be able to keep those clean either.

Dr. Tanner Clark, of Clark Orthodontics tells his patients, “I’d rather you have crooked teeth then perfectly straight teeth with cavities.” His dental team does a great job on educating patients and parents on proper oral hygiene techniques.

He continues, “We always stressed to the patients and parents that you still need to see your dentist or pediatric dentist, to see Dr. Johnson every six months, even when you have braces on. It’s important to go in for your routine exams or your routine dental cleanings just to make sure the gums are healthy, the teeth are healthy and there are no cavities developing. There are certain things that we can use or have the patients use, Dr. Johnson mentioned like an ultrasonic or Sonicare-type toothbrush, electric toothbrush, that can help patients that maybe have some difficulty getting places in the mouth that are hard to get, but they still have to use it.”

Typically, patients are recommended to brush after every meal and before bedtime. At appointments, dental technicians do have certain things that can be used to get in between the teeth or in between the wires of the braces. They’ll show them throughout treatment, to help decrease the chance for cavities or gum disease. Bottom line, education is really important; continually educating the patients and parents on the importance of maintaining the health of your teeth while receiving orthodontic treatment.

When a Child May Expect to Receive Braces

It’s all based upon the patient’s severity. If patient’s teeth are severely crowded or they have a severe discrepancy with their bite, those types of treatment will take longer. If a new patient comes in and they’re a mix between the permanent dentition and the early dentition or the primary dentition (a mix between baby and adult teeth) an orthodontist may opt for a limited type of treatment; for example, maybe moving one tooth out of cross-bite or doing an expander to expand their upper teeth and upper jaw.

Typically, this limited type of treatment may take anywhere between six to 12 months. It’s not going to negate the need for full braces later on. It can make a smaller problem not develop into a larger problem when they get into their permanent dentition.

Regarding teenagers or adults, when they have all their permanent teeth, the average treatment time is usually around two years with braces. Again, that can vary based upon the severity of the patient’s crowding or their bite.

Adjusting to Braces

Having this hardware in their mouth takes a bit of adjustment. Patients will have some mild discomfort for the first week when the braces or appliances are placed. That’s because the teeth are just starting to move. They’ve never been accustomed to having anything in their mouth typically before.

The inside of the cheeks, the lips; those areas are going to be sore. It can be a little bit rough but typically, it’s recommended to take ibuprofen as needed. A dentist can provide patients some wax to cover up some of those areas that may be rough or sharp. After a week or so, patients have pretty well adjusted to having the appliances in place and really don’t have a problem after that.

After the braces or appliances are place, orthodontists will typically see patients back anywhere between every four to eight-weeks. Those appointments are usually shorter and usually involve changing rubber bands, wires and making small adjustments to the alignment of the teeth and of the bite.

Do most insurances cover braces?

Insurance does cover a portion of braces. Typically, orthodontic insurance is a separate benefit than dental insurance. Usually, people will have a separate amount to use towards orthodontic treatment, and that’s all based upon the insurance plan.

Other options include flex spending accounts and health savings accounts. It’s always best that patients or parents know their benefit before they begin treatment and to discuss their available options with their dentists.

---

Getting braces for children can be quite involved but armed with the right information, parents can prepare their kids and give them the best possible chance for a healthy smile.