Orthodontics is a specialized area of dentistry focusing on diagnosing and treating alignment issues of the teeth and jaws. Braces are the most recognized appliances used in this field, consisting of brackets, wires, and bands that work together to gradually move teeth into better positions. For children, getting braces is often a proactive measure to correct a developing misalignment and establish a healthy, functional bite. The treatment aims to enhance both the mechanics of chewing and the long-term health of the entire mouth structure.
Resolving Malocclusion and Misalignment
The most frequent reason children receive orthodontic care is to address malocclusion, a term describing an improper relationship between the upper and lower teeth when they close together. This misalignment can manifest in several ways, often involving the physical position of the teeth within the dental arches.
Overcrowding occurs when there is insufficient room in the jaw for all permanent teeth, causing them to overlap, rotate, or push against one another. Conversely, some children experience spacing issues, where gaps appear between teeth due to a tooth-to-jaw size discrepancy or missing teeth. These alignment problems are classified as Class I malocclusion, where the overall bite relationship is acceptable, but the teeth themselves are crooked or spaced. Braces apply constant, gentle pressure to the teeth, allowing the surrounding bone structure to remodel and shift the teeth into their correct positions.
Other common alignment problems relate to the front-to-back relationship of the bite. An excessive overbite (Class II malocclusion) features the upper front teeth significantly overlapping the lower teeth. Conversely, an underbite (Class III malocclusion) occurs when the lower front teeth protrude beyond the upper front teeth. Correcting these positional issues ensures the teeth meet efficiently, which is necessary for proper chewing and preventing uneven wear patterns.
Guiding Jaw Development
While many issues involve the position of individual teeth, a separate set of concerns centers on the underlying skeletal structure of the face and jaw. Orthodontics addresses discrepancies in the size and relationship of the upper jaw (maxilla) and the lower jaw (mandible) while the child is still growing. This is often referred to as interceptive, or Phase I, treatment, which typically begins earlier than traditional comprehensive bracing.
One appliance frequently used for skeletal correction is the palatal expander, which gently widens a narrow upper jaw. A narrow maxilla can cause a posterior crossbite, where the upper back teeth bite inside the lower back teeth, leading to uneven jaw growth if left uncorrected. Similarly, specialized appliances, such as certain types of headgear or functional devices, can be used to influence the growth trajectory of the jaws to manage severe overbites or underbites.
This approach takes advantage of the flexibility of the developing skeletal system to guide the jaws toward a more harmonious relationship. By correcting a skeletal imbalance early, the orthodontist can create adequate space and a stable foundation, potentially simplifying or reducing the duration of later treatment once all permanent teeth have erupted.
Improving Oral Health and Function
Beyond aesthetics and basic mechanical alignment, obtaining a proper bite with braces contributes significantly to a child’s long-term oral health. Teeth that are severely crowded create difficult-to-reach areas where plaque and food debris accumulate, regardless of diligent brushing. This increased difficulty in cleaning significantly raises the risk of tooth decay and the development of gum disease.
An improper bite can also lead to abnormal wear on the enamel of certain teeth because the forces of chewing are not evenly distributed. Over time, this uneven pressure can cause premature wear, chipping, or even fractures on specific teeth, potentially leading to sensitivity and the need for future restorative work. Furthermore, a severe misalignment can impact speech, sometimes causing lisps or difficulty pronouncing certain sounds due to the position of the tongue against the teeth.
Fixing misaligned teeth also reduces the risk of dental injury, particularly for children with significantly protruding upper front teeth. These teeth are more vulnerable to trauma from falls or sports accidents, and aligning them reduces their exposure. Finally, a proper bite supports the temporomandibular joint (TMJ), ensuring that chewing forces do not strain the jaw muscles, which can otherwise lead to discomfort, headaches, or pain.
Timing the Orthodontic Evaluation
The American Association of Orthodontists (AAO) suggests that children have their first orthodontic evaluation no later than age seven. By this age, a child typically has a mix of baby and permanent teeth, providing the orthodontist with enough information to assess the growth and development of the jaws and teeth. This early examination does not automatically mean that immediate treatment is required, but it serves as a screening tool.
The purpose of this screening is to identify any structural problems, such as a developing crossbite or a significant skeletal imbalance, that would benefit from interceptive treatment while the child is still growing. Interceptive treatment, or Phase I, is usually limited in scope and focuses on correcting major structural issues before all permanent teeth have emerged. For many children, the orthodontist will simply monitor their progress with periodic check-ups, reserving comprehensive treatment (Phase II) for later adolescence once most or all permanent teeth are in place.
Early evaluation allows the doctor to establish a baseline and determine the optimal time to intervene, ensuring that any necessary treatment is provided at the most effective stage of development. Addressing issues like severe crowding or jaw discrepancies early can lead to a more successful and potentially shorter comprehensive treatment later on.