FAQ’s for Parents

It is usually difficult to know if your child will need orthodontic treatment until your child is about 8 years old and his/her permanent teeth have started to come in. We recommend that you bring your child in when your child is 8 to evaluate whether treatment will be needed. If your child needs treatment, the orthodontist will take corrective action to avoid costly and painful treatment later on.

Well, it is always better to consult a professional. Still, there are some warning signs that you can look for to help evaluate whether your child needs orthodontic treatment. The top teeth should exactly line up with the bottom teeth, and there should be no spaces or gaps. If your child’s teeth look perfect, your child probably will not need orthodontic treatment.

First ask your child to open their mouth, and let you look at their teeth. Are all of their teeth straight? Do any of the teeth slant to the side? Are there any gaps between your child’s teeth? Do any of your child’s teeth overlap? If you see any signs of crooked teeth, gaps between your child’s teeth or overlapping teeth, your child may need orthodontic treatment.

Next ask your child to bite down. Does the center of the front top teeth line up with the center of the front bottom teeth? Do your child’s top teeth protrude out the front of their mouth? Does your child have bucked teeth? Do the top front teeth cover more than 25% of the bottom teeth?
Are any of the top teeth behind the bottom teeth? Do the teeth come together smoothly, or are there any gaps? If your child’s teeth do not come together smoothly, or if any of your child’s teeth do not lining up properly your child may need orthodontic treatment.

Now look at the alignment of your childs jaw. Do all of the teeth come together smoothly, or does your child’s jaw shift off center when your child clenches their teeth together? If you see any misalignment or shifting of your child’s jaw, your child may need orthodontic treatment.

If you see any of the above symptoms, or if you are not sure, bring your child in for orthodontic treatment. Do not wait hoping that the problems will go away.

Usually, if you wait, orthodontic problems will almost always get worse. If a few teeth are crooked or crowded, the orthodontist can realign the crowded teeth them easily. However, if you do not treat the crowding right away, the crooked teeth will encroach onto your child’s other teeth and push the other teeth out of alignment too. As a result if you wait, your child’s orthodontic problems will usually get worse.

Further, as your child gets older, orthodontic treatment becomes more painful. As you child ages, fibers grow in to anchor your child’s teeth to your child’s jaw. It takes more force to move the fibers as your child ages so treatment is more painful. Also the bones in the roof of their mouth harden as your child ages, which makes treatment more difficult.

If you avoid needed treatment when your children are teens, the children will usually need more painful treatment later in life. Isn’t it better to take care of the problem when it is first discovered rather than waiting until the problem gets worse?

It is hard to see into the future, to tell how the lack of orthodontic treatment will affect your child. Certainly, a child who needs orthodontic treatment but does not get it will have problems with the teeth for years to come; so much so that many adult patients are now going back for orthodontic treatment. The difficulties with not getting needed orthodontic treatment include:

• Teeth that wear unevenly leading to weak enamel and tooth loss.
• Teeth that are difficult to clean, leading to gum problems and eventual tooth loss
• Difficulty chewing
• Periodontal (gum) problems as you child gets older

The health issues go well beyond good oral hygiene. For example, an orthodontic procedure called palatal expansion may help improve the air passages in the nose, correcting breathing problems.

Also, chewing is the first step in digestion. If your children cannot chew their food properly, their digestive system will not work as well. Besides, your child will look wonderful after they get orthodontic treatment. Orthodontic treatment can make your child’s smile look wonderful and improve their self-esteem. Wouldn’t you like your child to have great self-esteem?

Unfortunately no. Remember that your child’s permanent teeth do not grow in all at once. As your child’s mouth grows, more permanent teeth grow in too. The additional teeth take up all of the extra space created when your child grows. If you wait orthodontic problems will almost always get worse and your child will have to endure more painful treatment to correct the problem.

There are two parts to orthodontic treatment, interceptive or Phase I orthodontic treatment and Phase II or Comprehensive orthodontic treatment. Interceptive orthodontic treatment is usually done at around age 8. Comprehensive orthodontic treatment usually starts at age 12.

The objective of interceptive orthodontic treatment is to make room in your child’s mouth for your child’s permanent teeth. Your orthodontist may expand your child’s palate, and try to start to correct overbites and underbites. As noted above orthodontic problems arise because human teeth do not grow at the same rate as human mouths. Your children’s mouth will be growing a lot between ages 8 and 12. It is important to make sure that there is room for your children’s permanent teeth.

Other aspects of interceptive treatment include treatment for finger sucking habits, correcting protruded (buck) teeth that can get easily damaged or hurt and space maintenance therapy.

It varies a lot according to the complexity of the case. Interceptive orthodontic treatment can take anywhere from 3 to 14 months.

We do not recommend waiting. If your child gets interceptive orthodontic treatment when they are 8, and their palates are growing rapidly, the treatment will be uncomfortable, but not tremendously painful. By time the child is 12, the bones in the top of the child’s mouth will have hardened, so palatial expansion will be much more painful. If you wait until your child is 20 to do palatal expansion, your child will need major surgery to correct a palatal problem.

The objective of full orthodontic treatment is to correct your child’s bite, and to make sure that their teeth are in proper alignment.

First there are a series of appointments where the orthodontist examines your child’s mouth and figures out what is needed.

Next the orthodontist installs braces in your child’s mouth.

Your child will usually keep their braces in for two to two and a half years. During that time, the orthodontist’s assistant will “tighten” your child braces every three to five weeks. The orthodontist may tell your child to wear a facebow during that time.

Then your orthodontist will remove your child’s braces and give him or her a retainer. Your child will need to wear the retainer 24 hours a day as prescribed by the orthodontist, gradually cutting back to 1 or 2 nights a week.

(A more detailed description of all of the steps in orthodontic treatment is given in the FAQ for teenage orthodontic patients).

Generally, full orthodontic treatment takes between18-30 months for a typical case. Trying to rush treatment can have permanent deleterious effects on teeth. It will take longer with a complicated case or if your child does not follow the orthodontist’s instructions.

Generally, it takes two to four visits to the orthodontist for your child to start their treatment. On your first visit orthodontist’s assistant will take a medical history and do an initial examination. The orthodontist will then examine your child, and start to explain the orthodontic process.

Next your child will come in for what is called a RECORDS APPOINTMENT (this may be done on the same day as the initial appointment). The orthodontist’s staff will take x-rays and photographs of your child, and make impressions (castings) of his mouth. Further details of the procedure can be found in the FAQs for teens. However, the idea of the records appointment is to gather as much information about your child’s bite as possible.

Once the records appointment is done, the orthodontist will be able to design a treatment plan. The orthodontist will build a model of your child’s mouth and study the case. He will then draw on his knowledge and training to design a treatment plan. Once the orthodontist determines what is needed, the orthodontist will then do a “consultation” with you to discuss his/her treatment approach and his/her fees. The initial exam is usually FREE. The records appointment may cost $200-$400.

Usually about $300 more than the silver or stainless steel braces.

Extraction therapy is a technique where some teeth are removed to make room for the other teeth in your child’s mouth. This is in contrast to non-extraction therapy where one expands a patients’ jaw and shave down some teeth to make everything fit.

Years ago, everyone got extraction therapy. Now, most adolescent patients have non-extraction therapy. A gadget called a palatal expander is used to expand the adolescent’s jaw. Adult patients are still treated via extraction therapy, however, because once someone stops growing, it takes major surgery to expand someone’s jaw.

Lingual braces are a technique where braces are mounted behind a patient’s teeth. These types of braces can be effective with certain types of crowding. We often use these types of braces for parents of our patients who have lower incisor crowding. However, not everybody is a candidate for lingual braces. We can help you know if this might be an option for you.

Absolutely not. Our office adheres to the strictest OSHA standards for hygiene and sterilization.

Yes and No. One of the first steps in standard orthodontic treatment is to examine your child’s temporomandibular joint (the joint where your child’s lower jaw connects to the skull) to screen for TMJ problems. If the initial screen does not reveal any weaknesses, then the orthodontist will proceed as normal. If any weaknesses are seen in the TMJ screening, the orthodontist will modify his treatment plan to make sure that no damage is done to your child’s temporomandibular joint.

Most recent studies show that TMJ problems are not related to orthodontic treatment.

The orthodontist does x-rays to make sure that his treatment plan is going to work properly and that your child will not develop any jaw or gum problems later on. It is a part of the diagnostic process. We have all our x-ray equipment in the office and do not need to send our patients to another facility for x-rays.

X-ray shields are used to help minimize the x-ray exposure. The precision x-ray shield attaches to the orthodontists x-ray machine, and collimates the x-rays so the x-rays shine on your child’s teeth gums and cheeks and not elsewhere on their face.

It matters where you live and how complex your child’s case is. It typically ranges between $3000 and $5000 for a full case that takes two years or more, but could be much less for shorter duration cases. Also, your dental insurance may cover half or more of the cost.

Yes! Think about the cost of not getting braces. It is hard to see into the future, to tell how the lack of orthodontic treatment will affect your child. Certainly, a child who needs orthodontic treatment and does not get the treatment will have problems with their teeth for years to come; so much so that many adult patients are now going back for orthodontic treatment.

The health issues, go well beyond good oral hygiene. For example, an orthodontic procedure called palatal expansion may help improve the air passages in the nose, correcting breathing problems.

Also stomach problems are very common in people who skip needed orthodontic treatment. If your child cannot chew their food right, it irritates their stomach, and produces a lifetime problem.

We cannot predict whether your child will develop a breathing problem or a stomach problem if they do not undergo orthodontic treatment. However, lifetime orthodontic treatment costs no more than the lifetime maintenance on a car. Isn’t it worth investing as much time in maintaining your children’s teeth as you invest in maintaining your car?

Our office will allow you to pay for your children’s treatment in installments. Usually you will be required to make an initial payment when your case is started. Then you can make monthly payments for the balance at zero percent interest. Our financial coordinators will be happy to explain all the payment options.

Yes, but you need to be careful to get insurance that covers some percentage of the full cost of the treatment and really pays that amount to the orthodontist. Insurance companies are notorious for plans that do not cost the insurance companies anything. For example, they may tell an orthodontist to do a case for two-thirds of the normal fee without actually paying any portion of the fee to the orthodontist, but may still charge you a copayment. We strongly advise that if you get insurance to pay for orthodontic treatment, you be sure to get insurance that pays the usual and customary fee for the orthodontic treatment and does not insist that the orthodontist do a cheaper alternative procedure without telling you.