Orthodontic Services and Types of Braces for Juniors

Many people associate orthodontists and braces with the teenage years—mistakenly believing that a child’s first trip to the orthodontist isn’t needed until middle school. However, the American Association of Orthodontists (AAO) and the American Dental Association (ADA) recommend that children receive an orthodontic screening no later than age 7.

Interceptive Orthodontics Corrects Developing Problems

Although the majority of kids won’t begin active orthodontic treatment until the ages of 9 to 14, children as young as 6 or 7 can benefit from interceptive orthodontics (also known as Phase I treatment).

The goal of interceptive orthodontics is to intercept and correct developing problems and create a better environment for permanent teeth. Most Phase I treatments focus on fixing an improper bite and guiding jaw growth. These treatments are achieved through the use of various orthodontic appliances, such as braces, bonded expanders, banded expanders, space maintainers, and protraction facemask appliances.

Early intervention is critical because orthodontists will be able to achieve results that won’t be possible once the face and jaw have finished growing. Also, permanent teeth and supporting structures can be damaged by incorrect bites before all of the permanent teeth have erupted. Youth receiving early orthodontic treatment may still need braces or additional work later. However, the treatment is usually shorter and less extensive.

What to Expect at the First Visit to the Orthodontist

A child’s first visit to Burke & Redford Orthodontics will include an introduction to the staff, an office tour, and a full clinical exam, including photos and x-rays. This exam will allow Dr. Burke and Dr. Redford to determine whether the patient would benefit from interceptive orthodontics.

Most kids won’t require orthodontic treatment after this first visit. In this case, the doctors will recommend waiting for more teeth to erupt before determining if orthodontic treatment is necessary. The child will be asked to return periodically for check-ups. This allows the doctors to monitor growth and development so that treatment, if needed,  can be started at the optimum time.

If Phase I treatment is recommended, the doctors will explain their diagnosis, the recommended course of action (including which appliances may be needed), and when treatment should start. The start of treatment will depend on each patient’s needs.

Conditions That Require Interceptive Orthodontic Treatment

 The following conditions require Phase I orthodontic treatment.

• Underbites (also known as Class III malocclusions) occur when lower teeth bite ahead of upper teeth. Often, underbites are best treated by age 7 or 8 when an orthodontist can modify jaw growth. Protraction face mask appliances are used to correct underbites.
• Crossbites occur when dental arches are misaligned laterally. A posterior crossbite is caused by a narrow upper jaw and results in the top back teeth biting down inside the bottom back teeth. An anterior crossbite occurs when the upper front teeth sit behind the lower front teeth. Crossbites should sometimes be treated early but not before the age of 5. Bonded expanders and banded expanders help correct crossbites. Crossbites are most problematic if they cause the jaw to shift when biting down.
• Protruding front teeth (also known as “buck teeth” or excess overjet) must be moved because the teeth risk being fractured or injured in an accident (such as a fall). Protruding front teeth can also create a misaligned bite. An overjet can be treated with Damon braces or ceramic self-ligating braces, certain types of expanders, and even removable or permanent retainers.
• Early loss of baby teeth (due to an accident or tooth decay) is a problem because the body closes up the space where the teeth were lost, creating a lack of space for permanent teeth to erupt. This can sometimes require permanent teeth to be removed later. Space maintainers are used to preserve the space where baby teeth were lost until the permanent teeth can erupt.
• Crowding of teeth in the upper and lower jaws should be evaluated before all baby teeth are lost to reduce the risk that removal of permanent teeth will be needed later. Crowding affects how adult teeth grow in and may increase the risk of gingivitis. Self-ligating braces and a pendulum appliance can be used for treatment.
• Problems caused by thumb sucking include an open bite and a crossbite. Although most kids stop sucking their thumb by six months old, some children persist in the habit and this can create severe bite problems. A variety of orthodontic appliances are used for treatment.

Orthodontic Appliances Used for Treating Juniors

Burke & Redford Orthodontics treat patients with a wide variety of orthodontic appliances. Some of the ones commonly used during Phase I treatment include the following.

• Pendulum Appliance. This device expands the upper jaw and moves the upper back teeth backward at the same time. It is primarily used to correct crossbites and make space.
• Expanders are used to expand the upper jaw of young patients and come in different types. Bonded expanders are bonded (glued) to the posterior (back) teeth and cover the inside edges, the outside edges, and the biting surfaces of the back teeth. Banded expanders are fixed to first molars or first premolars using orthodontic bands (stainless steel rings). The Quad-Helix appliance is a mild type of expander that can help retain the expansion achieved with the bonded or banded expanders.
• Space Maintainers. As the name implies, these devices preserve or maintain space in the mouth. Two common types are the Nance Arch and the Lower Lingual Holding The Nance Arch is a fixed space maintainer used on the upper dental arch to prevent molars from moving forward. It is usually used after a pendulum appliance. The Lower Lingual Holding Arch is a fixed lower appliance used to maintain space before all permanent teeth have erupted.
• Protraction Facemask Appliances apply forward and downward traction on the upper jaw to move the upper jaw forward. It is worn mostly in the evening for 12-14 hours per day. This interceptive orthodontic treatment helps to correct Class III (underbite type) bite problems.
• Habit Appliance. This fixed device helps patients to stop chronic thumb or finger sucking habits by interrupting the habit routine.

Braces and Retainers for Juniors

Children can benefit from wearing braces and retainers during Phase I treatment. “Kid braces” are more comfortable than in the past—primarily due to technological advances called self-ligating braces.

Self-ligating braces are placed on the teeth much like traditional braces but use brackets and clips (or doors) instead of brackets and wires. The clips help the archwire move the teeth into place with less discomfort and shorter orthodontist visits. This type of braces doesn’t always require the use of elastics (rubber bands).

Choices include traditional metal and self-ligating clear braces, which are made from transparent or tooth-colored ceramic. After braces are removed, retainers are used to prevent teeth from shifting.

Although not always required, many junior patients enjoy using elastics to “decorate” their braces. By letting them choose a favorite color, school colors, or holiday colors (e.g., black and orange for Halloween), kids feel more involved and in control of their orthodontic treatment.

To schedule your child’s first orthodontic screening, contact Burke & Redford Orthodontists in Temecula or Lake Elsinore by calling our main office at (951) 699-8011. You can also fill out a consultation form on our website anytime, and we will contact you to make an appointment that works with your schedule.