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Does Your Child Need Treatment?
A young child with straight baby teeth set close together will often require some kind of treatment, specialists say. Adult teeth are larger than baby teeth and when these come in there is bound to be too little room for them, orthodontists say. In that case, devices to widen the jaws to make room are often recommended. And these devices, the orthodontist organization argues, are best installed when the jaw is still growing.

Although patients as young as 7 years old still have some baby teeth, they have usually gotten their molars and incisors. These markers allow orthodontists to predict crowding and other common problems, such as an overbite (a protrusion of upper teeth over the lower teeth) or a cross bite (a condition in which the molars of a too narrow upper jaw bite into the lower jaws).

“What you want to do is catch problems while the growth potential of the jaw is still there,” said Dr. Karen Hughes, an orthodontist at New York Presbyterian Hospital in Manhattan. “When children are younger the jaw is more malleable.”

New Techniques Reserved for Adults
The basic technology to straighten children’s teeth has not changed too much in recent decades — a period when braces evolved from metal bands that wrapped around teeth to less obtrusive devices that are glued to the surface of the teeth, joined by wires and moved by pressure. The same is true for retainers that hold the teeth steady and palatal expanders, which widen the jaw.

New technologies, such as braces that sit on the backs of the teeth out of view, are recommended only for adults, since these “lingual brackets” are more expensive and far more difficult to install. Invisible braces, or disposable retainers, also are not available to children. The braces are designed using computer simulations, which can be done only on non-growing patients since the programs cannot anticipate growth.

Six months after Garcia’s son began treatment, she couldn’t be happier with the work, which is estimated to cost about $3,000 when completed in spring 2001. Christopher now wears devices designed to widen and move his upper jaw forward — giving his teeth more room to grow in properly.

Garcia says she can already see a positive change in his facial structure. “He sees the difference and so do I.”

Christopher said, “I like my teeth better because they’re pushed out more in front now.”

Although Christopher is the only child in his fourth grade class with braces, he says it’s worth it. When his friends start getting braces in their early teens, his treatment is expected to be all but over.

Of course, no treatment will be effective without a child’s cooperation, orthodontists agree. To bring children along, most orthodontists offer such things as brightly colored rubber bands — green and red for the holidays, blue to match an outfit, clear to reflect a more minimalist sensibility.

Retainers and palatal expanders can also be customized with pictures of a favorite rock star or soccer player. Do these gimmicks boost compliance? “Absolutely,” Smith said. “Kids need to feel ownership and when they do they’re more willing to participate and cooperate. It’s a two-way street.”

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