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By Ruchel Louis Coetzee
Posted On Aug 03, 2017

Ruchel Louis Coetzee

If you visit any middle school at recess, chances are you will see tweens wearing braces. This is almost a rite of passage for those students with overbites or crooked teeth but when you hear of 7-year-olds wearing braces, heads turn and questions are asked. Do 7-year-olds really need braces? According to  Dr. Jamie Reynolds, an orthodontist, and author of World Class Smiles Made in Detroit (www.AskDrReynolds.com ), it is pretty unusual to put braces on a child that young. However, he is a great proponent of taking your child to an orthodontist at an early age. In fact, the American Association of Orthodontists recommends children make their first visit to an orthodontist no later than age 7. Dr. Reynolds went further and also offered what an orthodontist should look for in a child so young as well as his own comments to the reason behind those questions:


Are the jaws growing properly? You would think the upper jaw and the lower jaw grow pretty much in tandem, but you would be wrong. The upper jaw stops growing around age 8 while the lower jaw keeps on growing like the rest of the body. That means orthodontists can spot problems with the upper jaw earlier and recommend treatment if it’s needed.
Is there enough room for the teeth to grow in? Sometimes permanent teeth don’t have enough room to grow in properly, possibly because a baby tooth is in the way. Generally, baby teeth fall out on their own, but occasionally a stubborn one needs to be pulled so that the permanent tooth doesn’t start growing in an awkward direction and become impacted. Removing a misbehaving baby tooth is often the simplest and best solution to a problem that could become much bigger.


Are there too few or too many teeth? One of the things an orthodontist would do when examining a young child is to make sure the correct number of permanent teeth are forming. Extra teeth can be removed, but if a child is a tooth or two short, the orthodontist will wait until all the permanent teeth are in before starting any treatment. Before I went to dental school, I assumed everyone had the same number of teeth – 32. But it’s not unusual at all to see people with missing teeth or with extra teeth.


Does the child snore? Snoring is a potential sign of sleep apnea, a condition in which a person stops breathing while sleeping. It can cause serious health problems and has been diagnosed in children as early as 4 or 5 years old. One common and treatable type of sleep apnea is obstructive sleep apnea, in which the airways become partially or completely blocked by the tongue or fatty tissues of the throat. An orthodontist can widen the child’s palate so the upper jaw expands, and that expands the nasal passages. It also provides more room for the tongue so it rests on the roof of the mouth and not the bottom.


“Usually, orthodontists offer complimentary exams so it really is a good idea to have your child checked out by an orthodontist at age 7,” added Dr. Reynolds, “The odds are that no treatment will be necessary. But if problems are starting to develop, early detection could make a big difference.” So with that in mind, we had several additional questions for Dr. Reynolds.


Is it not a traumatic experience for a 7-year-old to wear braces in school? What is your advice for that child if he/she requires braces?

Actually, most 7 to 10-year-old kiddos are really excited to get braces. Whatever it is about their minds at that age, the idea of getting braces and being able to pick the colors to go along with the braces is really exciting to almost all of them. In fact, many kids that visit the office for early screenings are disappointed to find out they don’t need braces. For a 17-year-old, that’s typically another story. However, with newer esthetic treatments, people at any age can be excited about improving their smile or the health of their bite.


What age do you recommend a child first visit the orthodontist and why?

The American Association of Orthodontics (AAO) recommends that a child’s first visit to an orthodontist happen at age 7. Most people will not need treatment at age 7, however, for those that do, an orthodontist may be able to prevent a smaller problem now from developing into a larger problem later with an interceptive round of orthodontics. The key here is to find a trustworthy orthodontist and follow their guidance as to when treatment would be ready.


Can you give us an example of a young patient who has benefited from advice from their orthodontist at an early age?

There are many reasons why early treatment benefits certain children. A common example is underdevelopment of the upper jaw. Modern pollution and allergies often create large tonsils and adenoids. This results in a child needing to breathe through their mouth as their nasal airway becomes blocked. In order to breathe through your mouth, you need to position your tongue further back in your throat rather than up on the roof of your mouth. This ultimately results in underdevelopment of the palate and, subsequently, more difficulty in breathing through the nasal passages as well as crowding of the teeth in the upper jaw. A palatal expander (often called a RPE or RME or a “spacer”) becomes necessary to correct this condition. Palatal expanders work best in children under the age of 10, as the growth plate that allows expansion begins to close around 10 years old. There are also many other reasons to consider breaking treatment into two parts (one early and one later) rather than waiting and doing everything else at once later.


Is there a right way and wrong way to teach children how to brush their teeth?

Most children brush the “tooth” part of their teeth. However, the place that gets the dirtiest, and is of the most concern, is the place where the tooth and gums meet. Picking a circular or back and forth stroke is far less important than the simple act of brushing the right part of your teeth and gums. When you don’t brush along the gum line, the food that is leftover is colonized by bacteria and creates a gum infection. This infection results in inflammation of the area and subsequently, when brushing, the gums bleed easily. Many people—especially kids—assume they are doing something wrong if the gums bleed when they brush. So, they avoid brushing that area which only worsens the problem. Counterintuitively, if your gums are bleeding when you brush or floss an area, you should likely brush that area more and not less.


When does the lower jaw stop growing?

The lower jaw stops growing at different ages in different people. For some people with significant overbites, the lower jaw stops growing in the early teens. For others with an under-bite growth tendency, the lower jaw can continue to grow into the late teens and early twenties. The key is early identification and monitoring of a person’s jaw growth pattern so they can receive the appropriate treatment.