The Straight Truth About Orthodontia for Kids
Something you don’t realize when you first become a parent is how much of your daily existence will be taken up with concerns about your child’s mouth. First there’s the nursing and teething, then dental hygiene and loose teeth and the Tooth Fairy and finally, the granddaddy of them all—orthodontia. If you just involuntarily gasped and grabbed your wallet when you read that word, you know exactly what I’m talking about.
My boys are 11 and 13, and we’re already very well acquainted with our orthodontist. (And not just because he’ll probably buy a sports car after we’re done with our treatment.) Our doctor has thoroughly explained the boys’ tooth-straightening process to me along the way, but there are still a few things I wish I’d known before we began treatment. So if you’re just beginning the process, here is my handy guide to getting started:
What age should my child first visit the orthodontist?
The American Association of Orthodontists recommends children be screened around the age of seven. However, there’s also the school of thought that it’s okay to wait until kids are nine or ten and they have more of their adult teeth. Both of my boys first went at age nine, and that was at the recommendation of their dentist who saw potential issues with alignment, crowding, bite and jaw growth. My advice is to ask your dentist what they think, starting when your kids are six or seven.
OK, but what problems can I look for for myself?
Per our orthodontist: “If the child still has only baby teeth, the teeth should ideally be slightly spaced. Baby teeth that are have no spacing, or that already have some crowding, generally mean that the permanent teeth will also be crowded. Other indicators of early orthodontic problems include underbites and crossbites. An underbite is when the lower front teeth are in front of the upper front teeth. A crossbite is when the lower back teeth are on the outside of the upper back teeth. Both bite problems usually indicate a skeletal growth problem that might need to be corrected at an earlier age.”
In my experience, even if their baby teeth are gorgeous, it’s a whole new ball of wax once their adult teeth start to come in. We didn’t expect our oldest to have any issues since he didn’t ever suck his thumb or drink from a bottle, but he still wound up with an overbite that needs major correcting.
Why see an orthodontist if my kid’s teeth seem straight?
As mentioned above, crooked teeth aren’t the only reason orthodontia may be needed. In fact, there are a whole host of other reasons that may not be visible at all. Bite, including over and under and cross, crowding, too much space between teeth, and alignment are just a few of the issues that may need to be corrected before braces are even discussed. For example, my oldest son wore a removable “palatal expander” for 18 months to stop the tongue thrust that made his front teeth jut out. Doctors are eager to fix certain problems before puberty, while the jaw and mouth are still growing, because it’s harder when kids get bigger.
What will the first visit entail?
The doctor will examine your child’s mouth, and may also take X-rays, photos and a mold of their teeth. (This may take a few tries if your kid has a strong gag reflex like my oldest.) It’s important to mention any chewing issues, or if the jaw popping the child may have. The doctor will then say everything looks good, or recommend a treatment plan. And while it should be taken seriously, of course, the treatment plan also needs to be carefully considered because not every insurance plan covers more than one orthodontic issue.
What insurance issues should I be aware of?
If you have orthodontia insurance, good for you. Any bit helps when you’re looking at expenses in the thousands. (Full disclosure: My oldest’s braces are $5,500.) However, before you start any type of orthodontia—even a small retainer—take a good look at your insurance policy because some of them only cover a child’s treatment once. Friends of mine had a small device for their daughter paid for by insurance when she was nine. Now she’s 13 and needing more expensive braces, and it’s not covered because they already used their one payment. Check to see how much is covered, then carefully compare it to your child’s treatment plan.
You should also find out if there are any other limitations in your orthodontics insurance, such as age of the patient, maximum amount, deductibles etc.
What can we do if we don’t have orthodontic insurance?
There are certainly plenty of “low-cost dental plans” out there to use, but an internet search for them can prove to be a bit overwhelming. Plus, most of them look a little fishy, at least to me. Your best bet is to talk to your orthodontist’s office and see if they can recommend a plan. Chances are, they’ve worked with many of them and know which one is the best. Many practices will also let you make a down payment on the braces, then you can continue with monthly payments.
Should I wait until middle school? Why the rush?
When I was a kid, nobody had braces until they were at least 12 or 13. Now you see kids in grade school already wearing braces. This seems to be because some doctors don’t feel the need to wait until baby teeth are lost. In fact, many doctors will pull out teeth so they can get the process started early. If you’re okay with this, then go ahead. Our doctor wanted to wait until most of my oldest’s teeth fell out on their own before putting on braces, so he didn’t get them on until he was 13. This means that he’ll probably still be wearing them when he’s 16, but I feel okay with the decision. Again, talk to your doctor and if you don’t like what he/she is saying, either let them know or find someone else to handle your child’s needs.
Of course, I have plenty more to say about the actual devices, braces and incredible fun you’ll have repeatedly telling your kid that he can’t have popcorn for three or more years, but that will have to wait for my next post. If you have any of your own orthodontic advice, please feel free to share!