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Pediatric Health


How Important is Childhood Dental Care?


Early Intervention Key to Orthodontic Success



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August 01, 2010
While people typically associate orthodontic visits with teenagers, kids should see an orthodontist well before their teenage years. In fact, the American Association of Orthodontists recommends being evaluated by an orthodontist by age seven.

Between the ages of eight and 12, orthodontists are better able to influence or correct jaw growth and development. After age 12, it's more difficult to correct certain conditions.

"Like with most medical and dental conditions, the earlier that problems are detected, the greater the likelihood of being able to treat them—and possibly prevent or lessen the severity of future problems or procedures," says Ronald R. Hathaway, DDS, MS, medical director of the Craniofacial Center at Peyton Manning Children's Hospital at St.Vincent.

For example, if a child with tooth crowding receives early intervention, then space can often be made in the mouth before all of the adult teeth come in. And by expanding an upper or lower jaw in a young child, an orthodontist may also be able to prevent future extractions.

In addition to guiding jaw growth, early orthodontic intervention can lower the risk of trauma with protruding teeth, prevent future orthodontic work, as well as help fix bad childhood habits, such as thumb or finger sucking, sucking on a pacifier, fingernail biting, and mouth breathing.

Wide scope of orthodontics

Orthodontists treat a number of inherited mouth problems as well, including tooth size and jaw size, both which often lead to crowding of teeth or spacing of teeth. Other inherited problems include overbites, underbites, extra or missing teeth, and irregularities of the jaws, teeth and face.

In addition to those common problems, orthodontists treat problems caused by accidents, dental disease or the premature loss of either the primary or permanent teeth.

Signs of teeth trouble

Some common signs of teeth trouble include:

• Crooked teeth

• Gaps between the teeth

• Overlapped teeth

• Early or late loss of primary teeth

• Difficulty in chewing or biting

• Finger or thumb sucking habits beyond age 5

• Speech difficulty

• Biting the cheek or roof of the mouth

• Protruding teeth

• Teeth that don't meet in a normal matter, or don't meet at all

Additionally, parents can do two quick "at home" assessments to determine if a child may be in need of an orthodontic evaluation:

1. Ask your child to bite all the way down, keeping the lips open. Do the front top teeth line up with the bottom? Do the top teeth protrude out away from the bottom teeth? Do the top front teeth cover more than 50 percent of the bottom teeth? Are the top teeth behind the bottom teeth? If you see any of these conditions, an orthodontist should evaluate your child.

2. Look at the alignment of your child's jaw. Does the jaw shift off center when your child bites down? If you see any malalignment or shifting of the jaw, your child may have a skeletal problem.

One of the most valuable things early orthodontic work can do is help build confidence. "It's important not to underestimate the importance of how a child sees him or herself," Dr. Hathaway says. "A child's teeth and smile can be a big part of that."

Ronald R. Hathaway, DDS, MS, medical director of the Craniofacial Center at Peyton Manning Children's Hospital at St.Vincent. Located in the Zionsville-West Carmel area, the center provides orthodontic, cleft lip and palate, orthognathic surgery, and craniofacial surgery. Call (317) 344-1370 for an appointment.

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Questions to ask at the first orthodontic evaluation

Like with any medical specialist, visiting an orthodontist for the first time—particularly if it's with your first child—can be overwhelming. Dr. Hathaway recommends asking the following questions during your first visit:

• What will happen to my child's mouth if we don't do anything?

• When is it time to intervene?

• Will additional treatment be required later on (as a teenager)?

• Can you explain the nature of the treatment? (Tip: Ask to see visual examples of devices.)

• How many times have you performed this particular procedure?



Dr. Hathaway also encourages parents to put their child at ease by explaining prior to the visit what they can expect. For example, while Dr. Hathaway will look at a child's mouth, he spends the majority of the first visit getting to know the child. In fact, Dr. Hathaway has been known to grab children by the hand and walk around the office showing them the chair and rooms to make them more comfortable with him and future treatment. "It's important to gain their confidence, first," he says.

Tags: Health

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