Orthodontic Headgear

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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Child wearing orthodontic headgear.

Sometimes, braces alone aren't enough to move teeth into a better position, or to correct trouble with the bite or remedy problems in the growth of the jaws. In those situations, special appliances may be recommended. Orthodontic headgear is the general name for an appliance, worn partly outside the mouth, which creates just enough force to move the teeth properly and guide the growth of the face and jaws.

There are several different types of orthodontic headgear, each designed to work best in a specific situation. A treatment program will be designed to address your individual needs, and select the most appropriate type of headgear; you will also be instructed on its use and care. It's important for you to follow instructions carefully so that you can achieve the best results from your treatment.

Types of Headgear

One common type of headgear is called the cervical pull type. This appliance has a U- shaped wire that attaches to the bands on your back teeth, and a strap that is worn behind your neck. A similar device is the high-pull headgear, which also has a wire connecting to the teeth, plus a strap that goes behind and over the head.

Overjet and Underbite.

These types of headgear are typically used to correct an excessive horizontal overbite (technically called an “overjet”) in children, by holding back the growth of the upper jaw. They can also be used for adults who need help maintaining a proper bite and correct tooth spacing after tooth extraction. Generally, these types of headgear are designed to be worn from 12-14 hours each day.

Another type of headgear is the reverse-pull or “facemask” type. This appliance is generally used to correct an underbite. It gently pulls the upper jaw forward (instead of back), which allows it to catch up with the lower jaw. It consists of two pads — one resting on the forehead, the other on the chin — connected by a vertical frame. Elastics or wires, which connect from the frame to the braces, exert the pulling force. It may be necessary to wear this appliance from 14-16 hours daily.

Making Headgear Work Depends on You

Whichever type of headgear you're wearing, there are some important things you should know. Probably the most essential one is this: In order for it to be effective, you must carefully follow instructions about wearing your headgear — that means putting it on each day for the time specified. If you wear headgear at night and you miss one night, you must make up the time the following day — otherwise, everything you've accomplished in the previous seven days of wear could be wiped out!

It's normal to feel some discomfort as you get used to wearing orthodontic headgear. Fortunately, if you wear it faithfully, the discomfort generally goes away in a few days. An over-the-counter pain reliever like Ibuprofen, and/or a soft diet, may be recommended to help you adjust.

From time to time you may also experience some soreness when chewing, or even a little looseness in the first molars. This is normal, and it shows the appliance is working. However, if you have unusual pain, notice that the anchor band on your first molar (the one the headgear attaches to) has come loose, or find that the headgear suddenly seems not to fit correctly, it could signal a problem that requires immediate attention.

Maintain Your Headgear — And Your Oral Health

To keep your orthodontic headgear working as it should — and to maintain your overall oral health — it's important that you follow all instructions about care and cleaning. It's also important that you learn to put headgear on and take it off properly and safely. Remember to bring it with you every time you have an orthodontic appointment — but leave it behind when you're playing sports, or even horsing around in the living room!

Wearing orthodontic headgear may seem like a big adjustment — and nobody would deny that it takes some getting used to. When everyone works together, it's possible to achieve your goal: a beautiful smile that you'll have for your whole lifetime.

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