“The most important thing is to be able to provide a tailored treatment plan for
your child based on their needs and capabilities,” advises Dr Steffen Decker, Specialist Orthodontist at Happy Kids Dental. Five key factors play a role in the decision-making process: lifestyle, comfort, aesthetics, time and cost. In order to address all of these issues the orthodontist should be able to offer a selection of different treatment options, says Dr Decker.
There are certain problems that your orthodontist may recommend treating when a child still has some baby teeth, says Moira Wong, Consultant Trained Orthodontist at Moira Wong Orthodontics.
“Look out for very crowded teeth or excessively spaced teeth. Or an underbite, when the lower front teeth are ahead of the upper front teeth, or a crossbite – when the jaw shifts on to one side,” says Dr Wong. While some of these problems can be inherited, others may be a result of accidents or dental disease.
“Phase 1 orthodontics at age 8–10 will diagnose what will happen to your child in terms of growth and development over the next 5 years. If we catch any problems early it is far less likely to result in teeth out or jaw surgery,” advises Dr Wong. “Early treatment is varied depending on the patient but could be a fixed or removable ‘appliance’ which is used to move teeth, change the position of the jaw or keep teeth in place until the adult teeth arrive,” says Dr Wong. Read more about early Orthodontic Treatment in our Orthodontics for Kids article.
“Early/Phase 1 orthodontic treatment is provided for children between the ages of 7 and 10. This is when they still have some baby teeth and their jaws are developing,” says Dr Decker. The main goals of Phase 1 treatment are to positively influence jaw growth, correct and stop any habits e.g. thumb sucking, improve aesthetics and self-esteem. At this phase the orthodontist will also look to improve the width of the jaw to prevent permanent teeth extractions later, avoid trauma to protruding teeth and provide space for the adult teeth to erupt.
Phase 2 treatments take place once the adult teeth are fully erupted. Treatment options include fixed metal braces or ceramic braces on the outside of the teeth, braces on the inside surface of the teeth, lingual braces (which are not visible from the front) and of course flexible plastic ‘aligners’ such as Invisalign Teen.
“We give the kids and parents the choice of the most suitable options because the brace that is chosen needs to fit in with the age of the child and his or her lifestyle i.e. if they play rugby then an inside lingual brace would be the safest option,” says Dr Decker. Teenagers who tend to be more self-conscious may prefer ceramic braces, lingual braces or to have Invisalign rather than the traditional metal braces.
BRACE FITTING, TIME & COST
Having a fixed brace fitted for the first time can be painful. My daughter took some painkillers just beforehand, which helped, and ate soup and soft food for a few days. Expect your mouth to be a bit sore for 3–5 days afterwards and for a few hours after each time the brace is adjusted. Treatment usually takes between 12–30 months depending on the individual.
All children under 18 are eligible to have an orthodontist assessment under the NHS. However, the NHS will only pay for the more severe cases. Hence, my daughter’s slightly ‘wonky’ teeth weren’t covered!
The cost will very much depend on the type of treatment that is tailored to your child. Metal braces are the cheapest and cost about £2,500– 3,000. Most orthodontists will allow you to spread the cost over several months. Ceramic braces, which blend in with the natural tooth colour, generally cost 10–15% more. Aligners, such as the Invisalign brand are a further 10–15% more expensive, says Dr Majid Alimadadian Principal and Specialist Orthodontist at Orthosmile.
KEEP TEETH CLEAN WITH A BRACE
If your child is starting to wear a brace it’s a good idea to have a tooth-brushing session with your hygienist to learn how to make daily brushing and flossing simple and effective. “There are flossing products designed for braces such as TePe brush. It’s a good idea to see the hygienist every three months to have them professionally cleaned,” says Dr Nicole Sturzenbaum at Toothbeary.
“My top tip is to find a time of day to have a really good brush. I find it easier if they do this when they get home from school or just after their dinner,” suggests Dr Sarah Good, Consultant Orthodontist at Evelina Children’s Hospital and Elite Orthodontics.
Then they can do their normal brush in the morning and perhaps a fluoride mouthwash before they go to bed. “I’m doing this with my 13-year-old daughter at the moment who is in braces, and it seems to work well.”
You can eat normally with braces except for hard or really sticky things. Keep sweet things to a minimum, especially between meals. “If your son or daughter is very active, put a toothbrush or travel mouthwash in their kit bag and the Change4Life app (to let them know how much sugar is in foods and drinks) on their phone. They often have lots of sports drinks and sugary snacks at sports meetings!”