The Tooth About Braces
Orthodontists say that the proper time for braces varies from child to child.
July 19, 2007 — -- The question of the proper age at which a child should get braces and other orthodontic work is one that has irked parents for decades.
Take Marguerite Cronin. Wednesday morning, when she brought her 9-year-old son, William, to Manhattan orthodontist Margot Jaffee's office, she was told that her son would need a metal plate in his mouth to adjust his palate.
William's too-narrow palate must be widened to ensure that his teeth come in properly. Later on, he will need an appliance to adjust his overbite, and braces.
When Cronin's 12-year-old daughter, Caitlin, started with her braces at an older age, she had several teeth correctively removed. While her palate was fine, her mouth was not large enough to accommodate everything.
So, which approach is correct? Both, apparently.
According to an article published this week by the Cochrane Library in the United Kingdom, children with overbites can have equally successful treatment whether they start late or early. Orthodontists say that it reinforces what they have felt all along — that treatment needs to be tailored to the individual.
After having teeth removed in the course of her own orthodontic treatment, Cronin sees this approach as a positive.
"Dr. Jaffee is an excellent orthodontist," she said. "She just doesn't do automatic intervention — she just does each case at a time."
"As long as you're treating somebody that's growing, it doesn't matter if you treat them early or late — it will lead to successful treatment," said Don Joondeph, a Seattle-area orthodontist and former president of the American Association of Orthodontists.
Joondeph explained how orthodontic treatment for overbites generally involves two processes: one with an appliance — like headgear — designed to slow growth of the upper jaw, and the second with braces, to align the teeth.
An orthodontist should base the decision of when to start the treatments on the severity of the overbite for starting the jaw positioning treatment, and when a child has his or her adult teeth, for braces, Joondeph said.
