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When almost every second kid either has or needs orthodontic treatment these days, it’s important to understand what it all entails. Here are the answers to all your FAQ’s about braces and more.

Did you know? Orthodontics is the speciality of dentistry focused on the diagnosis and treatment of dental and associated facial irregularities.

Who needs orthodontic treatment?
Children who experience dental crowding, too much space between teeth, protruding teeth, extra or missing teeth and sometimes jaw growth problems are candidates for braces. If any of these problems are noted, regardless of age, it is advisable to consult an orthodontist.

Signs or habits that may indicate the need for an orthodontic examination:

  • Early or late loss of baby teeth
  • Difficulty in chewing or biting
  • Mouth breathing
  • Thumb sucking
  • Finger sucking
  • Crowding, misplaced or blocked out teeth
  • Jaws that shift or make sounds
  • Biting the cheek or roof of the mouth
  • Teeth that meet abnormally or not at all
  • Jaws and teeth that are out of proportion to the rest of the face

What age do most kids need to get braces?
For each patient who needs treatment, there is an ideal time for it to begin in order to achieve the best results and one’s orthodontist has the expertise to determine when the treatment time is right. According to Dr Derek Coetzee, most kids who need braces will get them around age 12 for girls and 13 for boys. “The reason that they get them at that stage is because it is when most of the permanent teeth have erupted and they are getting their second molars,” he explains.
In some cases, your orthodontist might find a problem that can benefit from early treatment. Early treatment, which can begin in children as young as 7 years old, may prevent more serious problems from developing and may make treatment at a later age shorter and less complicated.

Early treatment gives your orthodontist the chance to:

  1. Guide jaw growth
  2. Lower the risk of trauma to protruded front teeth
  3. Correct harmful oral habits
  4. Improve appearance and self-esteem
  5. Guide permanent teeth into a more favourable position
  6. Improve the way lips meet

Why do most kids have braces today?
The teeth of children of this generation are no different to that of their parents or ancestors, yet the standards that have been set for what is considered “ideal” are a lot higher than what they were going back a few years. “While having crooked teeth may not have been a problem growing up in the 70s, today it goes against the accepted dental standards as far as aesthetics is concerned,” says Dr Derek Coetzee. Another reason is because the latest research has shown that it is better to get braces as a child because the bones are still growing and the teeth are not as stable as those in adults.

Why do baby teeth sometimes need to be removed?
Removing baby teeth may be necessary to allow severely crowded permanent teeth to come in at a normal time in a reasonably normal location. If the teeth are severely crowded, it may be that some unerupted permanent teeth (usually the canine teeth) will either remain impacted (teeth that should come in, but do not), or come in to a highly undesirable position. To allow severely crowded teeth to move on their own into much more desirable positions, sequential removal of baby teeth and permanent teeth (usually first premolars) can dramatically improve a severe crowding problem

How can a child’s growth affect orthodontic treatment?
Orthodontic treatment and a child’s growth can complement each other. A common orthodontic problem to treat is protrusion of the upper front teeth. Quite often this problem is due in part to the lower jaw being shorter than the upper jaw. Upper teeth may also be the primary cause of the protrusion if they stick out too far. While the upper and lower jaws are growing, orthodontic appliances can be beneficial in reducing these discrepancies.

Can having braces affect a child’s playing sport or music?
“It can”, says Dr Derek Coetzee. “I had a patient whose braces I had to take off because he couldn’t play the trumpet and he had a scholarship to go to a very private school, based on his ability to play.”
It can also be dangerous to have braces when participating in contact sports, such as rugby, kung fu or boxing, and while it is not to say that children with braces shouldn’t play such sports, it is very important that they wear a specific mouth guard if they do.

How long is the average need for braces?
While 20 months is the average, treatment can last anything from 6 to 30 months, depending on age and the severity of the orthodontic problem. Patients grow at different rates and will respond in their own ways to orthodontic treatment. The orthodontist has specific treatment goals in mind, and will usually continue treatment until these goals are achieved. Patient cooperation, however, is the single best predictor of staying on time with treatment. Patients who cooperate by wearing rubber bands, headgear or other needed appliances as directed, while taking care not to damage appliances, will most often lead to on-time and excellent treatment results.

Is there anything one can to do to avoid needing to have braces?
“Common childhood habits such as thumb sucking and finger sucking need to be stopped,” says Dr Derek Coetzee. Also having a dummy for longer than necessary can cause problems in jaw alignment, so by avoiding such habits in early childhood, it can lessen the need for your child to require braces as a necessity.

Budgeting for braces
Normally orthodontic treatment is spread out over a period of 20 months and there is an initial amount that needs to be paid upfront, followed by a monthly fee as treatment progresses. A lot of insurance schemes will cover the cost of braces – some that are really good and others that are bad. There are certain insurance schemes that will cover the cost of braces completely for children, but not in adults, so it is important to do your research on dental cover before you take out a policy, particularly if you have kids or even if you are just thinking of starting a family.

What about pain management?
According to Dr Derek Coetzee, pain is not usually related to having braces on the teeth, but is due to the inflammation that can result in the gums due to the braces working. “Therefore, taking an anti-inflammatory is usually the best solution for treating any discomfort and avoiding unnecessary pain,” he says.

Foods to avoid with braces
The obvious “no’-no’s” include chocolates, toffees and hard sticky sweets, but whole fruits, such as apples, are also best avoided. This is because the brackets are only stuck onto the teeth with a tiny piece of glue and the pull required to bite into an apple can cause them to snap off. “Always cut foods into small pieces and chew slowly, especially if you are new to braces,” advises Dr Derek Coetzee. “Popcorn is okay as long as it is popped – but be aware of the uncooked kernels,” he warns.

What are the trends towards making orthodontics seem more fashionable?
While many children still have to deal with traditional “railroad track” braces, they are certainly becoming more fashionable. Elastics for children’s orthodontics are now available in virtually any colour of the rainbow and the brackets themselves are also changing as many of them are now made of composites that come in different shapes including stars, flowers, and sports themes. See-through braces with see-through wires are popular choices for those who wish to be more discreet and some patients can even choose to have braces fitted on the inside of the teeth!

On a closing bite
It must be remembered that successful orthodontic treatment depends on a joint effort between your orthodontist and child. Remind your child to carefully clean his or her teeth, floss daily, wear rubber bands, avoid foods that might damage braces and keep appointments as scheduled. Regular visits to the family dentist must also continue during orthodontic treatment to keep teeth and gums healthy. Give your child positive reinforcement by complementing on the progress and improvements. Before long, you’ll be thanked for all your trips back and forth with a beautiful smile!

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We also highly recommend www.drcoetzeebraces.co.za for any orthodontic treatments. Dr Coetzee is based in Douglasdale, Sandton, Johannesburg. His contact number is 011 462 8400