7 Early Common Orthodontic Problems We Watch for in Kids

By January 21, 2021 January 27th, 2021 Orthodontics
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When should kids visit an orthodontist for the first time? The American Association of Orthodontists recommends children have their first orthodontic evaluation by age seven. We know, we know, that seems super young, but seven isn’t just a random number that was picked out of a hat. There are several reasons behind the recommendation, including the fact that we can see certain emerging orthodontic problems in their earliest stages. So, what is our Papillion orthodontist watching out for when he examines your kiddo? Read on to find out! In this post, we’ll be covering the common red flags, as well as the basics of early orthodontics in general. 

Why Should Kids See an Orthodontist at Age Seven?

As we said, age seven isn’t just an arbitrary number. By age seven, most children have their first permanent molars. These grown-up molars establish the back bite and since a lot of kids will also have their permanent incisors, Dr. Hawley is able to get a glimpse into how their bite is shaping up as a whole. He can also evaluate the side-to-side and back-to-front tooth relationships. 

Even if your child’s teeth look really straight, there can be subtle issues that only an orthodontist like Dr. Hawley can detect. By pinpointing problems with the jaw, facial structure or teeth when your child is young and still growing, we can use appliances to guide their facial growth and development, which is known as dentofacial orthopedics, in order to prevent more serious problems from occurring. 

Is Early Orthodontic Treatment Always Necessary?

Do early visits automatically mean appliances or braces for children? No, not at all! About 15 to 20% of children this age can benefit from early orthodontic treatment, but in the majority of cases, appliances and braces for children aren’t necessary at this point. 

Once Dr. Hawley has a chance to examine your child, if he doesn’t see any issues, your kiddo will begin an observational period. They’ll come back in for the occasional complimentary check-up over the years so that Dr. Hawley can determine the ideal time for them to start orthodontic treatment.

What is the best age to get braces or Invisalign Teen if early orthodontics isn’t necessary? It really depends. However, by age 12, kids will have most, if not all, of their permanent teeth, aside from the wisdom teeth, and orthodontic concerns will be evident, making 12 or 13 the best age to get braces for some kids. 

What are the Common Bite Problems in Kids?

So, what are the red flags we watch for in little ones and which issues could warrant phase 1 appliances or braces for kids? Here are the common orthodontic problems in children that Dr. Hawley keeps an eye out for:

1 – Crossbite
A crossbite is when some of the bottom teeth sit in front of the top teeth when the mouth is closed. If the back teeth are involved, it’s referred to as a posterior crossbite, or back crossbite. If the front teeth are the offenders, it’s called an anterior crossbite, or front crossbite. When a child has a crossbite, they tend to shift their jaw to one side to compensate, which can cause permanent changes in their facial structure, jaw joints and teeth alignment.

Sometimes, with a mild crossbite, especially if it’s a single-tooth crossbite, we can hold off on treatment until the teenage years and still get amazing braces or Invisalign results. Other times, however, intercepting the problem early with phase 1 orthodontic treatment will allow Dr. Hawley to prevent facial imbalances and keep your child’s jaw development on track.

2 – Crowding
Teeth crowding occurs when there isn’t enough room in the jaw to accommodate all of the teeth. In order to fit in the limited space, teeth may overlap, twist or become blocked out of line. Crowded teeth are harder to keep clean, which can lead to an increased risk of tooth decay and gum disease.Again, if a patient has crowded teeth, we might be able to hold off on treatment and get excellent braces or Invisalign results in the teenage years. However, if Dr. Hawley sees that crowding will be severe, he can guide jaw growth with appliances like an orthodontic expander to ensure the jaw will be the correct size to fit all of the teeth.

Another consideration is baby teeth falling out too early. When a primary tooth is lost before its natural time, whether due to injury or decay, the remaining teeth have a tendency to shift to fill in the space. This shifting will result in crowding and can prevent the underlying permanent tooth from erupting into its ideal space or, in extreme cases, lead to the tooth becoming impacted. In these instances, we can use a dental space maintainer to prevent shifting, reduce future crowding and save space for the permanent tooth to come in. Dental space maintainers are effective, well tolerated and much more affordable than fixing excessive crowding later in life.

3 – Open Bite
An open bite is just what it sounds like: The teeth don’t meet at all when the mouth is closed, leaving an opening or space between the upper and lower arches. An open bite makes it hard for kids to bite into food and chew properly. It can also lead to speech problems. In some cases, using phase 1 braces or appliances for children can close the open bite, allowing kids to bite and chew their food, while also helping with speech development, as well as facial development.

4 – Overbite
When a child has an overbite, or deep bite, the upper teeth are too far forward in relation to the lower teeth. Nearly everyone has some degree of an overbite but when the space is too large, it can lead to jaw pain, chewing difficulties and uneven wear, and make the front teeth more susceptible to injury.A minor overbite or one that is more related to tooth position, as opposed to jaw position, may not require phase 1 orthodontic treatment. However, if the overbite is due to the size or position of the jaw and will likely be moderate or severe without intervention, dentofacial orthopedics could be indicated. Dr. Hawley can use orthodontic appliances, sometimes in conjunction with phase 1 braces, to guide jaw growth and, depending on whether the issue is with the upper or lower jaw, shift the lower arch forward or the upper arch back.

5 – Underbite
An underbite is when the lower teeth are in front of the top teeth when the mouth is closed. An underbite is often skeletal in nature and early detection is key to preventing the need for corrective jaw surgery and extensive treatment when a patient is older. If not treated, an underbite can lead to chewing problems, uneven wear, jaw pain, a facial imbalance and other issues.

While there are some occasions where early orthodontic treatment isn’t necessary, many times, when we see an existing or emerging underbite in a young patient, we will want to use orthodontic appliances to encourage proper jaw growth.

6 – Protruding Front Teeth
When a child’s front teeth stick out, or protrude, the teeth are a lot more likely to be injured because they’re in harm’s way. In cases of significant protrusion, interceptive orthodontic treatment could be beneficial to shift the teeth back and keep them safe.

7 – Spacing
Spacing, often called gap teeth, is when the teeth don’t fill out all of the space in the jaw and there are gaps between one or more teeth. Spacing can lead to an increased risk of tooth decay and gum disease and the deterioration of the bones that support the teeth.

The good news is, it’s pretty rare that we’d recommend phase 1 braces or appliances to treat spacing since we can usually close the gaps and get the desired braces or Invisalign results when a patient is a teenager, or even an adult. However, there are cases, such as when it’s due to a baby tooth being lost early, that intervention would be recommended.

In addition to the common orthodontic problems we watch for in kids mentioned above, some other issues we’ll ask about or look for include:

  • The early or late loss of primary teeth
  • Harmful oral habits like thumb sucking or tongue thrust
  • Mouth breathing
  • Sleep apnea, snoring or other indicators that there is a problem with airway development 
  • Jaws that pop, click or shift
  • Teeth grinding or clenching
  • Difficulty chewing or biting
  • Biting the roof of the mouth or the cheek
  • Facial imbalance or asymmetry
  • Speech problems

What Happens During Phase 1 Orthodontic Treatment?

Early orthodontic treatment, also known as early interceptive orthodontic treatment or phase 1 orthodontic treatment, is usually the first phase of a two-phase treatment plan. During phase 1 orthodontic treatment, we use appliances like an orthodontic expander, Herbst appliance or even limited braces for kids to guide the growth and development of their face, jaw and teeth. At Hawley Orthodontics, we always aim to finish phase 1 orthodontic treatment in 12 months or less. 

When we’re done with your child’s phase 1 treatment, they’ll have a resting period while their remaining baby teeth fall out. Around age 12 or 13, we’ll then start phase 2 orthodontic treatment where we use braces or Invisalign Teen to shift the teeth into their ideal places and finetune your child’s bite. 

Is Early Orthodontic Treatment Worthwhile?

Dr. Hawley takes a conservative approach to early orthodontics. We don’t recommend phase 1 braces or appliances to every young patient who walks through our door. Instead, Dr. Hawley reserves early orthodontic treatment for cases where intercepting a bite problem early will clearly prevent it from becoming a much larger problem when the patient is older. 

There are times early orthodontic treatment is worthwhile and the payoff will be huge for your child. The benefits of early orthodontic treatment can include:

  • Avoiding corrective jaw surgery later in life
  • Preventing the need for extractions of permanent teeth
  • Making Invisalign Teen or braces affordable, less extensive and faster in the teen years
  • Minimizing the risk of trauma to protruding teeth
  • Correcting facial asymmetries 
  • Letting the permanent teeth erupt correctly 
  • Preventing tooth impaction (tooth getting stuck under the bone)
  • Alleviating crowding
  • Fixing crossbites, underbites and other types of malocclusion (improper bites) 
  • Allowing kids to chew, speak and, sometimes, even breathe properly
  • Boosting kids’ confidence and self-esteem!

As you can see, there are important benefits of early orthodontic treatment when it is necessary. If phase 1 treatment is indicated for your child, Dr. Hawley will walk you through his diagnosis using x-rays and pictures. He’ll also explain your options, answer your questions and go over the early orthodontic treatment pros and cons, so you can make an informed decision about your child’s care.

How Much Does Phase 1 Orthodontic Treatment Cost?

The phase 1 orthodontic treatment cost depends on a number of factors, including the severity of your child’s issue, the problem we’re correcting and the appliance we use. Once Dr. Hawley has developed a treatment plan, a Hawley Orthodontics team member will chat with you about your insurance, your phase 1 orthodontic treatment cost and our flexible financing options. We strive to make interceptive treatment with appliances or braces affordable and efficient. Ultimately, the reasons why so many families decide early orthodontic treatment is worthwhile is because it saves time and money on treatment when a child is older and ensures they can get the braces or Invisalign results they want in order to achieve a healthy, beautiful smile.

Key Takeaways:

  • Kids should visit an orthodontist for the first time by age seven. An orthodontist is trained to identify certain issues that could benefit from early orthodontic treatment, or phase 1 orthodontic treatment.
  • Common bite problems in kids that we look for include crossbite, overbite, underbite, protruding teeth, open bite, crowding and spacing.
  • Most kids won’t need early treatment and Dr. Hawley will simply monitor them over the years and let you know when the time is right to start treatment, typically at around age 12 or 13.
  • Occasionally, if a bite problem will become serious and difficult to treat when a child is older, intercepting it while they’re still growing with phase 1 orthodontic treatment is the best course of action.
  • If early intervention is needed, Dr. Hawley can use appliances or braces for kids to guide facial growth (dentofacial orthopedics) or create a more favorable position for the permanent teeth. This can prevent the need for surgery, lengthy treatment or extractions down the road.

If your child is seven years old or exhibits any of the common bite problems, schedule a complimentary consultation at Hawley Orthodontics today. Whether early orthodontic treatment is necessary or not, at our fun, kid-friendly office, we make visits positive and enjoyable for children and parents alike.

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