Can pediatric dental care prevent the need for braces?
In the US, getting braces is often considered a rite of passage. That’s hardly surprising, given that orthodontists estimate 45% of children could benefit from braces due to bite problems, and as many as 75% could gain some benefits from wearing braces to straighten their teeth and improve face shape. Those are some big numbers, but there are some who think these interventions might be avoidable. By ensuring children get comprehensive dental care from an early age, these experts contend that many could avoid needing braces down the line.
Pediatric dentistry is a comprehensive field, encompassing everything from treating cavities and preventing gingivitis to talking to children and their family about developing good oral health habits. Most also recommend that children see a dentist for the first time by their first birthday, although very few families meet this goal. Rather, many children first see the dentist around the time they start school or because parents are concerned about habits like thumb sucking and pacifier use that could potentially cause crooked teeth or issues with mouth shape.
When parents bring children to the dentist with concerns about bite or tooth alignment, the dentist may refer them to the orthodontist. Orthodontists are specialists concerned with innovative and even artistic oral health treatment. They know that carefully examining a child’s skull shape early on can help them predict what’s ahead for that child, in terms of overall oral health. And they know that, while braces may be their bread and butter, performing earlier interventions, such as placing a palate expander for a child with a narrow mouth, may help them avoid braces later on.
Early intervention has become even more important for children than they were a few decades ago because of an interesting development: our skulls are evolving to have narrower mouths which can lead to airway obstruction, as well as crimped nasal passages and bite problems. An overly narrow mouth not only risks airway issues (and can cause sleep apnea in young, otherwise healthy children), but also crooked teeth because there isn’t enough room for the full adult set in the shrinking space. This evolution is also one of the reasons that impacted wisdom teeth are so common – otherwise, they would have represented a much more serious problem in centuries past.
Palate expanders and other early orthodontic treatments can help address serious structural issues, but there are also smaller, simpler steps that parents and dentists can take to prevent the need for braces later on. For example, many children suffer from cavities due to poor oral hygiene and diets full of processed, sugary foods. Left untreated, cavities can turn into serious damage that necessitates extraction – and in young children, extractions require careful management. Their teeth can shift and become misaligned while they wait for their adult teeth to come in, leading to the need for braces later on.
Ensuring that children receive proper dental care, including having their teeth cleaned and getting cavities filled promptly, can give children an advantage in terms of mouth and jaw structure later on. They may be able to treat minor misalignments with less invasive methods and make appropriate referrals based on the child’s age and the complexity of their problems.
Some children will inevitably need braces. Their families may have a long history of poor tooth alignment or other oral health problems. For others, though, braces might really be optional – but if skulls keep changing the way they have in recent years, that might not be the case in a few decades. It’s certainly an issue to watch.