Child / adolescent orthodontics
AGE AND TYPES OF TREATMENT
There are generally 4 main categories of orthodontic treatment which are done at different ages:
✪Interceptive treatment(between 7-10 years old)
✪ Interceptive treatment followed in some cases by a second phase of treatment
(7-10 years then a second phase after 11 years)
✪ The complete treatment(in one step after 11 years)
✪Theadult orthodontics withor without jaw surgery
We can add as a recent distinction theinvisible treatments ( LingualandInvisalign ) as opposed to conventional, visible treatments using conventional braces
What treatment at what age?
The choice of the age for starting treatment is very important. Dr Benguira chooses according to the specific needs of each patient in order to achieve the most effective treatment possible, at a time when the patient is most likely to remain motivated.
There are typically two moments when the question of the need to intervene arises!
Indeed, in children's orthodontics we have 2 categories depending on the age of the child:
1. Around 7-8 years old: one can intervene to redirect growth, and the correction can be stabilized by permanent teeth.
2. Around 11-12 years old: we have 3 key elements so that thetreatmentiscomplete all the permanent teeth are present, there is still growth and the patient is generally cooperative.
IT IS URGENT TO CONSULT FOR THE FOLLOWING COMMON PROBLEMS:
1. Deviation of the jaws or upper jaw too narrow
In the absence of early treatment, bone asymmetry may develop.
Orthodontics alone will no longer be able to resolve the anomaly andsurgeryadditional may be required in late adolescence.
Anearlytreatment allows better nasal breathing and thus better growth of the upper jaw.
2. Prognathism of the upper jaw and / or retrognathism of the lower jaw
In the absence of early treatment, the risk of fracture of the upper incisors is increased if the upper jaw is too far forward relative to the lower jaw.
3. Retrognathism of the upper jaw and / or prognathism of the lower jaw
If the lower jaw is in front of the upper jaw and the child does not benefit from a treatment early, orthodontics alone cannot resolve the anomaly and a surgery jaws (maxillofacial surgery) will very often be necessary at the end of adolescence orwhen he is an adult.
4. Open bite (Lack of contact between upper and lower teeth)
May be caused by thumb sucking or mouth breathing or by pushing the tongue against the teeth if the child keeps swallowing like infant or has a tongue thrust.
We will often recommend speech therapy in addition to orthodontic treatment to re-educate the language.
5. Lack of space and malposition
Unesthetic , brushing is difficult , and the risk of caries of gum disease is higher
6. Severe overbite
We note that the upper teeth completely cover the lower teeth, promoting their wear during tooth sliding movements, and increasing the risk of trauma to the gums (palate behind the upper incisors) and in front of the lower incisors.
7. Excess space
ORTHODONTICS FOR CHILDREN
The children from 7-8 years old cooperate very well in their treatment. Their growth potential is significant. Oral maturation usually settles well (because they usually stop sucking the thumb, pacifier). This is an ideal time to correct the gaps between the jaws in terms of width and position. We intervene to try to obtain optimal growth BEFORE the arrival of the 12 remaining permanent teeth around 12 years. The fact of being able to maintain the correction with the interdigitation of the permanent teeth makes it possible to guarantee the stability of the correction without retainers. In accordance with the recommendations of American Association of Orthodontists, each child must be seen by an orthodontist at the age of 7, to check if the growth of the jaws and the dental eruption is done in a harmonious way in the opposite case,
otherwise, screening at 7 years allows us tointercept a developing problem and totreatit in a simpler way. For most patients treated early we can avoid dental extractions orsurgeryof the jaws which might have been necessary if they had consulted later.
Very often no orthodontic treatment will be started unless thechild presents a malocclusion requiring a first phase oftreatmentit is usually a short (about 9 to 12 months) to avoid problems that will be more difficult to manage later.
The second growth check appointment is done at the age of 10 to ensure the good development of the permanent canines.
Theoverall treatmentwill start at the end of mixed dentition, between 10 and 14 years old.
The children3 to 6 year olds normally have baby teeth. They are too small for a correction made at their age to remain stable.
Among the problems commonly detected by the practitioner and identified by parents, thumb suckingthat persists beyond kindergarten is a frequent cause of first consultation.
Visibly, the teeth take a bad position (teeth too far forward) and the jaw deforms; less visibly thumb sucking also causes tongue dysfunction. The tongue adopts an incorrect position at rest and during swallowing. This incorrect position aggravates the deformation already caused by the thumb.
Now thumb sucking comforts child, it is therefore difficult for him to stop. When the practitioner considers that thechildhas sufficient psychological maturity, a consultation is organized to bring him to stop the thumb of his own free will.
Too early intervention can lead tochildfailure and disturb the child psychologically; on the other hand too late an intervention will favor the installation of the deforming habit.
When thechildhas abandoned thumb sucking, wearing a simple and well-tolerated appliance corrects deformities of the jaw in 12 months or more while limiting the malposition of the teeth.
If afterwards thechilddoes not put his tongue back in a good position, a few sessions of lingual rehabilitation with a speech therapist are prescribed.