Children and Orthodontics

If your child has crooked teeth or a misaligned jaw, it may be time to pay a visit to an orthodontist.

An orthodontist specializes in perfecting smiles using orthodontic appliances, such as:

  • Bands
  • Brackets
  • Wires
  • Headgear
  • Rubber bands
  • Retainers

WebMD takes a look at common forms of orthodontics and gives you the facts you need to make an informed decision about orthodontic treatment.

Types of Braces and Other Appliances

There are a number of dental appliances used today. But braces are still the primary means for straightening teeth and correcting misaligned bites in children. Braces work by applying pressure to the teeth and jaws to move them into a desired position.

Braces are not the shiny mouthful of metal of years past. Many more options are now available.

Teeth used to be fully banded. But today, brackets are bonded directly to each tooth's surface. In some people they're placed behind the teeth, making them less noticeable.

Braces are made of materials such as:

  • Stainless steel
  • Ceramic
  • Plastic
  • Combination of materials

This can give a clear or tooth-colored appearance to the braces. When appropriate, the wires can be made of materials such as nickel-titanium or copper-titanium. These materials may be longer lasting and require fewer adjustments than stainless steel wires.

Clear, invisible "trays" are now available. These can straighten teeth without using traditional braces and wires.

Invisible trays may be an option for some people who require simple orthodontic work. This method uses custom-made, clear, removable trays that put pressure on the teeth, moving them gradually into their correct position. This treatment often costs more than traditional braces.

Other appliances used in orthodontics include:

TADs: Temporary anchorage devices (TADs) are mini-screws ranging from 6 to 12 millimeters in length and 1.2 to 2 millimeters in diameter. When needed they may be temporarily fixed to bone in the mouth to provide a fixed point from which to apply force to move teeth. TADs allow for more predictable tooth control. They are becoming more common in orthodontic treatment.

Rubber bands: Rubber bands are also called elastics. They are used when more force is needed to move the teeth and jaws into the desired position. You can choose your favorite color. Many kids choose their school colors or decorate their mouth during holidays (for example, orange and black for Halloween).

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Headgear: Some people can benefit from using headgear. The appliance is attached to the braces from the back of the head and can be removed. As with rubber bands, headgear are used when extra force is needed to move the teeth and jaws. If a headgear is needed, it usually only has to be worn at night while sleeping or at home.

Retainers: Retainers are used to keep teeth in place once braces are removed. It takes time for your teeth to settle into their new position. By wearing a retainer, you can prevent your teeth from shifting. Some retainers may be removable. Others are fixed -- bonded behind your teeth. Some retainers are made of clear plastic and metal wires. Others are made of rubber. And like braces, retainers can make a statement if you choose. There are glow-in-the-dark retainers or retainers customized with a picture.

Can a dentist provide orthodontic treatment instead of an orthodontist?

Yes. Many dentists have training in orthodontics. However, if more extensive orthodontic work is needed, it may be best to see an orthodontist. An orthodontist has two to three years of advanced orthodontic education and training beyond dental school. He or she specializes in straightening teeth, correcting misaligned bites, and jaw problems.

When should my child see an orthodontist?

Your dentist can tell you when to seek evaluation from an orthodontist. The American Association of Orthodontists and the American Dental Association recommend all kids be evaluated for orthodontics by age 7. By this age, the orthodontist can detect subtle problems with jaw growth and emerging teeth. Most kids begin active treatment between ages 9 and 14.

Orthodontists recommend you correct dental problems while your child is still growing. Once they stop growing, treatment may take longer and require more extensive work.

What's the youngest a child can get braces?

There is no set age when children require orthodontics. The treatment plan will depend on individual needs. For example, kids with cleft palates get orthodontic appliances before their first teeth erupt.

Other kids may benefit from starting treatment as early as age 6 or 7, even if they have not lost all of their baby teeth. The goal of early treatment is to prevent further problems from developing. It will create a better environment for the permanent teeth to erupt, or grow, into.

Most kids who require early orthodontics will still need braces or additional work later to complete the tooth and jaw alignment process. But the amount of work may be significantly less if orthodontic treatment was completed early.

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Do braces hurt?

"Hurt" may be too strong of a word. But your child may have some discomfort when braces are first put on, when they are adjusted, or when you start using a new appliance, such as rubber bands or a headgear.

Any pain or discomfort can be relieved by taking ibuprofen (Advil) or acetaminophen (Tylenol). Also, if the wire, brackets, or bands irritate your child's mouth, your orthodontist can provide special wax to cover the sharp areas on the braces.

Is it possible to be allergic to braces?

Yes. Some people are allergic to stainless steel. When this happens, other materials can be used instead. People can also be allergic to the latex gloves used by the orthodontist and the assistants. If your child has a latex allergy, tell your dentist so that non-latex gloves can be used.

Braces can sometimes irritate a child's gums, causing this to swell. This is not an allergic reaction, but something parents still need to watch for.

What foods are off-limits for kids who wear braces?

Braces are delicate. Breaking part of the appliance can result in the teeth moving in the wrong direction and in longer treatment. Anything that is hard, sticky, or chewy should not be eaten, including:

  • Ice
  • Nuts
  • Popcorn
  • Hard candy
  • Chewing gum
  • Chewy candy, like caramel
  • Gummies

How long does my child need to wear braces?

The length of treatment varies. It depends on the problem, how well your child cooperates, and your child's growth. Typically, most people wear braces from 18 to 36 months.

How long does my child need to wear a retainer?

Ideally, your child should wear a retainer forever, even if it is only one night a week. Of course, this may not be practical. The teeth are like the rest of the body and the body changes. Once your child stops wearing the retainer, slight changes to the teeth should be expected.

On average, how much do braces cost?

The cost varies depending on the extent of work being done, the type of braces being used, and where you live. But you should expect to pay between $2,000 and $8,000.

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Most orthodontists provide different payment plans and will allow you to make payments over the course of treatment without charging interest. Some may take insurance.

Ask your orthodontist about all treatment fees and payment plans they offer before treatment begins.

If your child could benefit from braces but you can't afford it, there may be other ways to cover the cost, including:

  • Financial aid programs: Low-income families can apply to the Smiles Change Lives program. This provides access to orthodontic treatment for children between the ages of 11 and 18 years of age. If accepted, the child can receive braces for $250 to $500. To be accepted, you must meet certain income requirements (for example, a family of four cannot earn more than $40,000 per year) and your teeth must be moderately to severely crooked.
  • Medicaid: Medicaid may cover braces, especially if your child's teeth cause problems with talking, eating, or swallowing. This coverage varies from state to state.
  • Dental schools: If you live close to a dental school with an orthodontics program, you may be able to get treatment from a student (supervised by an experienced orthodontist) for a lower cost.
  • Dentists: Some general dentists provide orthodontic treatment and may be able to take care of your orthodontic needs at a reduced rate since they are not orthodontists.

Making the decision to embark on orthodontic treatment may not be easy, but an improved smile can make a huge difference in appearance and self-esteem.

There are many options available. When choosing a treatment plan, you need to consider many factors, including the orthodontic needs, cost, and primary goals of treatment. Your dentist or orthodontist can help you make the right decision for you and your child.

WebMD Medical Reference Reviewed by Michael Friedman, DDS on March 28, 2016

Sources

SOURCES:

American Dental Association web site: "Braces and Orthodontics."

American Association of Orthodontists web site: "Myths and Facts;" "All About Orthodontics;" "Elastics;" "Keeping Your Smile Beautiful After Orthodontic Treatment;" "Getting into Gear: Orthodontic Headgear;" "Temporary Anchorage Devices (TADs) for Predictable Tooth Movement;" "Two-Phase Orthodontic Treatment;" and "When to See an Orthodontist."

Nemours Foundation web site: "Why do people need braces?" and "Affording Braces."

Aetna web site: "Orthodontics Braces and More."

American Academy of Cosmetic Dentistry web site: "Orthodontics and Clear Aligners."

Leon Aronson, DDS, MS, adjunct professor of orthodontics, Medical College of Georgia; Center for Advanced Dental Education, Saint Louis University; vice president, International College of Dentists.

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