Gone are the days when the advice was to wait until all the permanent teeth have arrived at about age 11–13. It is far better to catch any problems early. Find a paediatric orthodontist on the British Orthodontic Society website bos.org.uk
“Children should generally be seen for their first orthodontic assessment by a specialist orthodontist around the age of 8,” says Dr Sarah Good, Consultant Orthodontist at Evelina Children’s Hospital and Elite Orthodontics.
There are some occasions when a child will need to be seen even sooner. Their dentist may have highlighted a problem, a crossbite, for example, or a difference
in the way in which the teeth are developing, says Dr Good, adding that dentists are very good at picking these issues up, especially in patients they see regularly.
WHY EARLY INTERVENTION?
Early treatment is primarily used to prevent and correct ‘bite’ irregularities. If the problem is with the growth of the jaw, it is usually treated with a removable brace often called ‘an expander’ to be worn a few hours a day before the adult teeth arrive and while the child is still growing. “Several factors may contribute, including genetics, the early loss of primary (baby) teeth, and damaging oral habits (such as thumb sucking and developmental problems),” says Dr Nicole Sturzenbaum, Paediatric Dentist, Founder and Principal of Toothbeary.
It’s important for your paediatric dentist to keep a close eye on your child’s development as some problems can be treated much more efficiently at a younger age. “As we get older our jaw bone stops growing and hardens and so orthodontic treatment, while still possible, can be more difficult and alternative solutions sometimes involve surgery or the removal of teeth,” advises Dr Sturzenbaum.
EARLY OR LATE LOSS OF BABY TEETH
Losing baby teeth too early or too late can cause problems. Most baby teeth are lost between the ages of 5 and 14. If a baby tooth is lost too early, perhaps because of decay or an accident, then it is helpful to place a ‘space maintainer’ to avoid the teeth drifting into the gap, says Dr Sturzenbaum. The ‘space maintainer’ appliance is custom- made by a dentist or orthodontist in acrylic or metal and is either removable or cemented in. “Its purpose is to keep the space open to allow the permanent tooth
to erupt and come into place. It usually stays in the child’s mouth until the adult tooth starts to appear,” adds Dr Sturzenbaum.
Most kids usually stop their sucking habit by the age of 24-28 months. About half, however, will continue beyond this age which may result in an open bite, over- bite or crossbite. “At Tooth- beary we use the Muppy® – a sort of replacement dummy, which promotes the self-healing of existing anomalies and helps eliminate speech defects.
It corrects malfunctions of the tongue and reduces mouth breathing,” explains Dr Sturzenbaum. Between 20–30% of all children breath through their mouths so it is important to establish the reason why.
CROWDING & BITE PROBLEMS
While there are many potential issues with teeth, crowding and bite problems (including protruding teeth), are probably the most common, says Dr Majid Alimadadian Principal and Specialist Orthodontist at Orthosmile.
Crowding happens when the adult teeth are much bigger than the baby teeth and the child’s jaw isn’t big enough to accommodate them. “With early intervention, perhaps using a removable brace to gradually expand the jaw, we can avoid extracting teeth at a later stage,” says Dr Alimadadian. Children can be referred to an orthodontist on the NHS. However, there is often a long waiting list, so children under 10 years are not a priority. This means that early intervention is often not possible unless you go privately, says Dr Alimadadian.
WHAT SHOULD PARENTS LOOK OUT FOR?
Parents should bring their children to the dentist or specialist children’s dentist every six months in order to pick up any issues early. “As a mum of three children, I would also keep an eye on your children’s teeth. Up until the age of 7, do at least one of your children’s toothbrushes each day. Make sure that all the teeth are clean, and both the teeth and the gums look the right colour – teeth may change colour if they have had some trauma,” says Dr Good. And, once a baby tooth has fallen out, whilst it can take a little while sometimes for the grown-up tooth to come through, the left and right sides of the mouth should be doing something similar!
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.