Your child should have their first orthodontic screening between the ages of 7 and 9. At this time a panoramic x-ray will be taken to allow us to see if the child is crowded or not. If the child is not crowded we will continue to monitor their growth and once their permanent teeth have exfoliated we will begin traditional braces to better align the teeth. Should the child be crowded we are able to intervene and treat the patient without having to remove permanent teeth and a more aesthetic and stable result is accomplished.
You might be wondering how we are able to achieve this with crowding. What the x-ray shows us is the bone size is smaller than what is required by all the permanent teeth. Fitting all the permanent teeth onto the bone requires increasing the size of the bone. This orthopedic change requires a degree of force to the bone that braces alone cannot do. This may sound frightening, but it is a simple appliance placed on the roof of the mouth attached to the molars. In the middle of the appliance is a small jack-screw that will gradually be turned over time prescribed by the orthodontist to accumulate the space required for the permanent teeth. Braces can only tip the teeth out to make space, but in order to have a stable bite it is necessary for the teeth to sit as close to the middle of the bone as possible. Extractions of permanent teeth to resolve the crowding can be avoided by increasing the total width of the bone with an Expander. Studies have shown that treatment with an Expander, in addition to braces, results in a significantly favorable long-term increases in upper and lower arch measurements.
