Author: Dr. Chris Eitzen
One of the most commonly asked question of us as orthodontists during examinations is whether all patients need early orthodontic care. The short answer is “no”. So, what determines if a child needs orthodontic care? What exactly are we, as orthodontists, looking for during an initial examination at age 7-8? Here’s a few things we screen for in every child’s examination.
Missing or extra teeth/permanent teeth
Population research indicates that nearly 4% of the population are born with either a missing or extra permanent tooth. Identifying these situations early allows us to be proactive and conservative in the management of these teeth.
With headgear in the dust bin of history there are many modern options on how to address growth related issues. The most critical aspect of any treatment to address these issues to tailor them to the time they will be most effective for your child (Hint: It’s not headgear).
Airway related issues
Evaluation of a patient’s airway has become a standard in the modern orthodontic examination. While we think of sleep apnea as a problem primarily for adults, many early signs of breathing difficulties can be visualized during our exam. In many cases, this frames our treatment options because protecting the airway is critical. Dr. Aaron will be following up specifically on this important topic in a future blog.
Many of us had permanent teeth extracted because of what we would consider mild/moderate crowding in todays terms. This leads to a narrow smile esthetically as well as a narrow arch which can force our tongue to encroach on our airway. Esthetically, extracting permanent teeth often leads to a flatter lips. Early orthodontic care will allow us to create space to maintain all of the permanent teeth which leads to improved dental and facial esthetics in addition to protecting our airway.
Habits – thumb/finger sucking, tongue thrusting
While oral habits are common for infants (hey, parents need sleep) when they persist beyond the age of 3 there can be long term dental changes. Early assessment of these situations will allow us to partner with you in coaching your child through these habits and prevent future problems.
Functional problems (difficulties with speech, eating, mouth breathing)
So much of our oral function is dictated by the positions of our teeth. As an example, proper “s”, “t” and “d” sounds require our tongue to fit behind our upper incisors. Should these teeth be severely out of place proper speech may not be possible even with speech therapy. This not only affects speech, but can make it hard to eat and cause mouth breathing. If your child has difficulty with otherwise normal function, an early orthodontic evaluation is warranted.
Early loss of baby teeth
In addition to chewing, instances where a child has lost a tooth early either because of tooth decay, crowding or trauma can lead to significant changes that either alter or prevent permanent teeth from coming in. Most importantly, this does not automatically mean that permanent teeth will need to be taken out. However, establishing a game plan early is critical to preventing future problems.
While this can be a controversial topic the reality is that many children can experience bullying or other self esteem issues as they relate to the appearance of their teeth. An extended amount of treatment time is usually not required to address these problems and therefore, early orthodontic treatment can be a significant gift for kids experiencing these issues.
As with all of our orthodontic care, early orthodontic treatment doesn’t mean the same for every patient. There is no orthodontic playbook which means during our evaluation together we will tailor a treatment plan specific to your child’s needs.