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How Young Is Too Young for Orthodontics?

Migdalia Garcia was 27 when she finally decided to close the broad gap in her smile. Her teeth were grown fully and her facial bones set. And she was long past the bouts of self-consciousness that plagued her teen-age years.

But she spent $3,000 and three years trying to improve her smile anyway, with mixed success. If she could do it again, she would have corrected her teeth a lot sooner.

That explains her reaction when she noticed the crooked teeth of her 8-year-old son Christopher: She couldn’t get him to an orthodontist fast enough.

Forget the price; forget Christopher’s tender years. He was going to have straight teeth, no matter what.

“I wanted him to get help early, while his bones and teeth are still growing and easier to fix,” said the Manhattan mother of two boys. “I’d never seen braces on a child so young, but I knew Christopher needed them.”

The Sooner the Better
In leaping at a decision parents once pondered for years, Garcia joined millions of others who, flush with cash and intent on making life easier for their children, are seeking out orthodontists sooner than ever before. Each year, 4 million children and teens under 17 receive orthodontic care in this country. The majority of children who receive care are between 9 and 14.

Not too long ago orthodontists rarely treated pre-adolescents. Now they routinely see children 7 years old and younger.

The American Association of Orthodontists applaud the trend, saying early attention often leads to shorter, less expensive treatment. Sometimes early monitoring eliminates the need for care altogether by allowing doctors to watch a child’s development.

“Sometimes I see kids for several years on a recall basis” without doing any orthodontic work on them, says Dr. Vincent Smith, an orthodontist in Syracuse, N.Y. “Certain problems correct themselves with age.”

Ulterior Motives?
There’s no question the early treatment approach is controversial. Critics argue that pushing younger children into care is simply a way to get patients paying for care sooner. They point to two studies that suggest children with certain dental conditions reap little benefit from early orthodontic treatment.

Dr. Camilla Tulloch, a professor of orthodontics at the University of North Carolina, is spearheading a 10-year study examining the benefits of later and earlier treatment of children whose top teeth jut out over the bottom teeth — a condition more commonly known as buckteeth.

Her research thus far has found that getting to the problem early rarely shortens the treatment and it may lengthen it for some. “Parents need to understand that the pre-adolescent years are not the only chance for treatment,” Tulloch said. “Our study shows that the chance for success is the same in younger as in older children.”

Another study at the University of Florida in Gainesville suggests that children who start orthodontic treatment earlier generally stay in treatment longer, with children younger than 10 in treatment for three years and those older than 10 staying in treatment for two years.

Nevertheless, Dr. Timothy Wheeler, who is leading Florida’s research team, is convinced that orthodontic treatment is absolutely necessary for some younger children and should not be delayed. “There are some severe conditions that absolutely have to be corrected early,” he said. “Starting a child on orthodontic treatment is a tough issue for parents. It really boils down to an issue of trust in your orthodontist.”

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