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At what age should my child see an orthodontist?
The American Association of Orthodontists recommends that a child see an orthodontist at approximately 7 years of age when most children have a mix of primary and adult teeth. Some orthodontic problems are easier to correct if they are spotted earlier. It is not necessary to have a referral from a general dentist.
What can we expect when we visit your office?
The initial exam appointment is completely complimentary - we do not charge for the visit or the x-ray. We will take a panoramic x-ray and possibly facial and oral photographs which are necessary for Dr. Habern to make a complete and thorough evaluation. You may bring a recent panoramic x-ray from your general dentist if they have taken one. Bitewing x-rays are of no value to us for an orthodontic diagnosis.
Dr. Habern will review the x-ray with the parent(s) and child as well as perform an oral exam to evaluate the need for treatment, either now or in the future.
If treatment is recommended at this time, our Treatment Coordinator will discuss what to expect during treatment and the fee for orthodontic treatment. Usually, the initial consultation appointment will take a little more than an hour.
Because I bring my child to your office for an orthodontic evaluation,
does this mean that the doctor will automatically recommend treatment?
No — each patient is evaluated to determine their individual needs. "Early" treatment may be recommended if your child exhibits a great deal of crowding, excessive protrusion of the upper front teeth, or has a crossbite. Certainly, there are other conditions which would warrant orthodontic treatment, but these are just a few examples.
If Dr. Habern does not feel your child would benefit from orthodontic treatment at this time, we will place him/her in our recall/observation program to be re-evaluated at a later date. While sometimes we identify an orthodontic problem early, we may elect to wait to treat it due to growth and development or other issues; however, it is important to periodically monitor the patient to determine if the problem is getting better or worse as time goes on. We do not charge a fee for our periodic orthodontic recall examination appointments.
What do you mean by "early treatment?"
In the past, orthodontists usually waited to treat patients after all of the permanent teeth erupted, and many times, had to extract permanent teeth to resolve crowding. This usually meant braces into high school for many individuals. It is generally acknowledged that most individuals look better, fit better and function better with all of their permanent teeth. It is our goal now to only extract teeth when absolutely necessary. When we see a child whose mouth is moderately crowded, we can treat the crowding early by placing upper and lower expansion appliances to expand the dental arches to create a better environment for the erupting adult teeth. However, this process is ideally done early while we still have soft flexible bones and cartilage to work with.
Once a child is age 12 or older, he/she may be too old for expansion, or we may not achieve as good of a result if we had started earlier. A 14 year old with moderate to severe crowding is too old for expansion and will most likely need to have permanent teeth extracted in order to resolve the crowding.
But if my child undergoes "early" treatment, does this mean he/she may need braces later or twice?
Yes, possibly. When we do early or Phase I treatment on a younger child, we realize that the child is in mixed dentition (has a mix of baby and adult teeth) and that it will be a few years before all of the permanent teeth erupt. The unerupted permanent teeth are in bone and we cannot control them or their eruption except to create a better environment for them to erupt into. The goal of early treatment is to create more room for the already erupted crowded permanent teeth, to create more room for the unerupted teeth, to avoid extraction of permanent teeth, to correct any crossbites, and to improve appearance and self-esteem.
The first phase of treatment may take anywhere from a few months to 14-18 months, depending on the severity of the problem.
Usually, there is a "resting phase" following the early phase of treatment when the child may need to wear a retainer at night to hold the orthodontic result just achieved. In the meantime, the child will continue to lose his/her baby teeth and adult teeth will erupt.
Following a successful Phase I or early treatment, the permanent teeth should erupt straighter, but this does not mean they will erupt in a perfect position. Sometimes the permanent teeth will erupt slightly rotated or somewhat out of position, thereby necessitating further treatment after all of the permanent teeth have erupted. Usually, Phase II, or full braces on all or some of the permanent teeth is to perfect the dentition and may involve correction of the bite, as well.
The orthodontic fees for Phase I and Phase II, if needed, are separate, however, Dr. Habern's office does pro-rate the Phase II fee.
What do you mean when you say "correct the bite?"
Orthodontic treatment is divided into two categories — the first is teeth — are they crowded or spaced? The second is the bite — how do the upper and lower jaws fit together? Each is a separate problem and are treated very differently.
Braces move the teeth around but do nothing to correct the bite. Bite correction usually involves braces and elastics (rubber bands) or an appliance to influence jaw growth and direction.
It is important to know if your child has a "bite problem" as there are very specific times to correct this. Generally, a bite is easily corrected in a growing individual. When growth has ceased, it is impossible to correct a bite to any significant degree. Older teenagers through growth and adults need to have jaw surgery to surgically move the bones around if they require bite correction. So you can see the importance of correcting a bite in a growing individual. Also, the ideal time to correct a bad bite is when the child is undergoing rapid growth and when the lower jaw in particular is growing the fastest. This is usually near or during puberty when all of this rapid growth is occurring.
That's why so many children in middle school have braces — the permanent teeth are erupting and this growth is happening.
How much does orthodontic treatment cost?
Fees for orthodontic treatment range greatly due to the type, severity, and length of treatment. Fees for treatment are determined on a case by case basis and can range from $1000 to $6000 or more. For example, a Phase I treatment which consists of upper and lower expansion appliances, partial upper and lower braces, and retainers will cost approximately $3000, however, additional treatment may possibly be needed later on. Full treatment which might consist of full upper and lower braces, elastics, and retainers for approximately 20-24 months will cost approximately $4800-$5200. If expanders and/or a bite correction appliance is needed in addition to the braces, the cost would increase from there.
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