Orthodontic FAQs

Your child won't keep his or her first teeth forever, but that doesn't mean those tiny pearly whites don't need conscientious care. Maintaining your child's dental health now will provide health benefits well into adulthood, as primary (baby) teeth serve some extremely important functions.

Kids developing jaws and teeth.

For one thing, primary teeth serve as guides for the eruption of permanent (adult) teeth, holding the space into which these new teeth will erupt. The crowns (tops) of the permanent teeth actually push against the roots of the baby teeth, causing them to resorb, or melt away. In this way, the adult teeth can take their proper place.

What's more, your child's primary teeth will be there for most of childhood, helping your child to bite, chew and speak. For the first six or so years, he or she will be relying on primary teeth exclusively to perform these important functions. Until around age 12, your child will have a mix of primary and permanent teeth. You will want to make sure those teeth stay healthy and are lost naturally — when it's time.

Your Child's First Teeth

Kids mouth anatomy.

Your child's 20 baby teeth will begin to appear usually between six and nine months, though in some cases it may start as early as three months or as late as twelve months. The two lower front teeth tend to erupt first, followed by the two upper ones, these teeth are called the central incisors. Then the neighboring teeth called lateral incisors will erupt too. The first molars come in next, followed by the canines (eyeteeth). And finally, the last teeth to erupt are the two-year molars. Sometimes your baby can experience teething discomfort during this process. If so, there are courses of action to help make your child more comfortable.

Your infant's gums should be gently wiped after each feeding with a water-soaked gauze pad or damp washcloth. As soon as the first tooth erupts, establish a daily brushing routine with a small, soft-bristled toothbrush and no more than a thin smear of fluoridated toothpaste. Your child may need your help with this important task until about the age of 6.

Your Child's First Dental Appointment

Age one dental visit

The American Academy of Pediatric Dentistry recommends that your child see a dentist by his/her first birthday, or as early as the first tooth erupts. Though this may sound early, learning proper pediatric oral hygiene techniques, checking for cavities, and watching for developmental problems is extremely important.

There are a number of forms of tooth decay that can affect babies and small children. Early Childhood Caries (tooth decay) can develop rapidly, progressing from the hard, outer enamel layer of a tooth into the softer, inner dentin in six months or less.

Most of all, it's important for your child to have a positive experience at the dental office as he/she will be a regular visitor for years to come.

Pediatric Dental Treatments

There are a variety of dental treatments offered to prevent tooth decay in children, or to save or repair teeth when necessary. They include:

Topical Fluoride — Fluoride incorporates into the enamel of teeth, making it harder and more resistant to decay. Although there is a small amount of fluoride in toothpastes and in some drinking water supplies, a higher concentration can be applied professionally to your child's teeth for maximum protection.

Dental Sealants — A plastic coating can be applied at the dental office to prevent cavities by sealing the little grooves on the chewing surfaces of back teeth known as “pits and fissures.” These little crevices become the perfect environments for decay-causing bacteria. Immature tooth enamel is more permeable and therefore less resistant to tooth decay. Dental sealants are easy to apply and provide years of protection (Watch Dental Sealant Video).

Root Canal Treatment — Perhaps you have had a root canal treatment yourself, to save an injured or severely decayed tooth. Well, sometimes children need root canals, too. In children these are called pulpotomies or pulpectomies. As mentioned above, baby teeth are important guides to the permanent teeth that are already forming beneath your child's gums. Therefore, saving them from premature loss can help prevent a malocclusion (“mal” – bad; “occlusion” – bite) that requires orthodontic treatment.

Bonding — Chips and minor fractures to front teeth — common childhood occurrences — can be repaired with tooth-colored bonding materials. These lifelike resins made of plastic and glass can be used on baby teeth as well as permanent teeth and last until the youngster has completed facial growth (Watch Bonding Video).

Orthodontic Concerns

Orthodontic Problems.

By around age 7, most malocclusions have become evident. Interceptive orthodontic treatment around this time can help direct proper tooth positioning and/or jaw growth, eliminating or simplifying the need for later treatment. There are many orthodontic problems that can be detected early and are examples of why a trained professional should evaluate your child during his/her growth and development.

Sports & Your Child's Teeth

If your child is active in sports, a custom-made mouthguard is a highly recommended safeguard. According to the American Dental Association, an athlete is 60 times more likely to suffer dental harm when not wearing one of these protective devices. A custom mouthguard is made specifically for your child using a model of his or her teeth. This will offer greater protection than an off-the-shelf model. It's an investment that pays off highly in the form of reduced pain, suffering — and dental expenses down the road!

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What do orthodontists do?

Orthodontists are dental specialists who diagnose and treat problems with the position, alignment or spacing of the teeth, and related irregularities in the face and the jaw. A number of special treatments, including braces and other oral appliances, are used to correct these problems.

Why should I (or my loved ones) get orthodontic treatment?

The magic of orthodontics video

There are two good reasons: aesthetics and function. Having an attractive smile not only changes the way people see you — it enhances your own self-image as well. Orthodontic treatment also allows your teeth to function better and makes it easier to keep them clean, which can improve your overall health.

When should orthodontic treatment be started?

You're never too old to begin orthodontic treatment — but if you start at an earlier age, your problems may be easier to treat. The American Association of Orthodontists recommends that a child who may need orthodontic treatment should come in for a first visit around age 7.

How can I recognize a potential bite problem?

Teeth that are protruding, crowded together or erupting out of position are clear indications that treatment is needed (View Examples). Less obvious signs are mouth breathing, frequent biting of the cheek or palate, speech difficulties, and thumb sucking that goes past 3-4 years of age. If teeth don't meet properly when the mouth closes, or if jaws make sounds or shift as they move, this may also indicate an orthodontic problem.

Does getting braces hurt? What about wearing them?

Having braces put on is generally painless. Some people experience minor aches and pains in the first couple of days or so, as they adjust to wearing their appliances; periodic adjustments may sometimes cause soreness as well, though it typically lasts only a short time. Over-the-counter pain relievers can be used to alleviate any discomfort, but are usually unnecessary.

How long will treatment take?

It's different for each person, but generally the active stage of treatment (that is, wearing braces or other appliances) may take from 6-30 months. After that, a retainer is worn for at least several months more.

How often will I come in for an appointment?

It depends on what's being done, and how often you need to be monitored. During active treatment, you'll typically visit the office once every 4 to 10 weeks.

Will I need to have any teeth extracted?

If your teeth are severely crowded (because your mouth is too small to properly accommodate all of them) — or if you have impacted teeth (teeth that are trapped beneath the gum line by other teeth) — then extraction may be necessary. In the case of younger patients, early treatment may make extraction unnecessary.

Will I have to watch what I eat?

Yes — you should pass up the types of foods that could damage or become trapped in your braces. Some of these include raw vegetables, hard candy, caramel, taffy and ice cubes (fortunately, ice cream is OK). You will receive a list of foods to avoid.

Will I be able to play sports/ play my instrument?

In a word: Yes. Of course, whether you wear braces or not, we recommend you wear a mouthguard when playing most sports. Musicians are generally able to play their instruments just as they did before, but they may need a short adjustment period after getting braces.

Do I still need to see my regular dentist while I'm getting orthodontic treatment?

You do — in fact, it's more important than ever! Keeping teeth free of plaque (and potentially, decay) can be challenging when you're wearing braces. Your dentist can help you avoid these problems with frequent cleanings and exams.

Will I wear a retainer when my braces come off?

Almost always, the answer is yes: If you don't wear a retainer, your teeth can rapidly shift out of position — and then all the effort put into your treatment is lost! Your retainer helps you maintain that good-looking smile for a lifetime.

Is orthodontic care very expensive?

Orthodontic care is a long-term investment in your health and well-being. Yet its cost hasn't increased as fast as many other consumer prices, and many financing options are available that make orthodontic care affordable. Weighed against the true cost of living with problem teeth, however, orthodontic treatment can be a wise investment indeed.

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