Parents can be understandably anxious about when to start worrying about their children’s crooked teeth. The conventional wisdom is to wait until all the adult teeth are through—usually as kids are hitting their teens. But another school of thought in kids’ orthodontics is that it’s best to strike while the jawbone is still malleable.
I am often asked whether there is any point in kids’ orthodontics where the patient still has their baby teeth. I do a lot of early treatment for kids—even starting from the age of eight or nine. Professional opinion is very divided on this issue, and every practitioner will view it differently.
When’s the best time for kids’ orthodontics?
While the approach of waiting until all the adult teeth are through and all the baby teeth are gone—we’re talking about an age range of between 12 and 14 years—seems to work quite well for some patients and practitioners, there is an argument for early intervention. Orthodontics can sort out problems that might be harder to fix later on.
Intervention could take the form of partial braces or plates, or it could be that they need to wear mouthguards. It really depends on the patient.
Orthodontic options for kids
When we look at kids’ orthodontics, they can fall into two categories—dental treatments and developmental treatments. Dental treatment is straightforward, obviously—it involves fixing teeth if they’re crooked. We straighten them in the right places to get a good smile.
But a lot of the treatment that we do at a young age, as part of early intervention, will actually be focused on development of the jawbone. Not necessarily the teeth themselves. We’re not interested in moving milk teeth to straighten them out. We’re really allowing for both the top and the bottom jaw to grow in such a way as to allow enough room to fit all the adult teeth in. So that’s the primary objective of early intervention.
It is not unusual in conventional orthodontics to have to take teeth out to fit everything in, because there’s not enough room. There’s nothing wrong with this, but it’s only one method. A lot of times if we make enough room when the child is young, we may not need to take any teeth out later because there’s sufficient room. This is a very big debate now, and it’s the reason why some people decide to do early intervention and some people don’t.
Children grow rapidly, so early intervention may be a shorter process than it would be down the track, when they’re teens.
Growth itself isn’t really a big factor for kids’ orthodontics. The difference in teeth movement between a 12-year-old and a 30-year-old will be more significant than the difference between a child and a teenager. But younger children have softer bones, so you can manipulate the bone a little bit more, and better, in a more controlled way. When they’re a bit older it does get more difficult. For this reason, it’s worth considering early intervention.