When to consult

When to consult

There are  generally 4 major categories of orthodontic treatments are at different ages:

• The interceptive treatment  (7-10 years)
• The interceptive treatment followed by a second treatment phase  (7-10 years then a second phase after 11 years)
• The full treatment  (In a single step after 11 years)
• Orthodontics for Adults with  or without surgery

We can add a  recent distinction with the invisible treatments   ( Lingual  and Invisalign ) As opposed to conventional, visible treatments by metal braces.

What treatment at what age?
The choice of the age of onset of treatment is very important. Dr Benguira  chooses according to the specific needs of each patient in order to achieve the most effective treatment possible, at a time when the patient will most likely stay motivated.

There are typically two times when we often need to intervene:

1. At 7-8 years  : One can intervene to redirect the growth direction, and the correction can be stabilized by permanent teeth.
2. To 11-12 years  : It has 3 key elements for the treatment  to be comprehensive ie.  all permanent teeth are present, there is still growth and the patient is generally cooperative.

When to start treatment?
Children aged 3 to 6 years old normally have only baby teeth. They are too small for a correction performed at that age to remain stable.

Among the common problems detected by the practitioner and  identified by parents is  thumb sucking  that persists beyond kindergarten, it is a common cause of first consultation.

Visibly, the teeth are a bad position (teeth are pushed forward) and the  jaw is deformed ( narrow and V shaped), a less visible thumb sucking effect is dysfunction of the tongue. The tongue adopts an incorrect position at rest and during swallowing. This incorrect position worsens the already bad position of the teeth caused by the thumb sucking habit.

Psychologically, thumb sucking comforts the child , It is difficult to stop. When the practitioner considers that the child  has sufficient age and mental maturity, a consultation will be organized to bring the child to stop  the thumb habit voluntarily.
Too early intervention can lead to failure and be psychologically disturbing whilst a  too late intervention will encourage the installation of  the habit  with deforming consequences on the teeth and bones.
When the child agrees to  abandon thumb sucking, wearing a simple device and well tolerated corrects in about 12 months the  deformations of the jaw while limiting malposition of teeth.
If subsequently the child   does not replace his tongue in a good position, a few  sessions with a speech therapist can prescribed.

Orthodontics in Children

The children  aged 7-8 years work very well in their treatment. Their growth potential is important. Oral maturation settled well (stop thumb sucking, pacifier). This is an ideal time to correct the discrepancies between the jaws in terms of width and position. We intervene to try to get optimum growth before the arrival of the remaining 12 permanent teeth. The ability to stabilize the obtained correction with the  interdigitation ofposterior  permanent teeth permits us to use simple retainers if any. Following the recommendations of the American Association of Orthodontists Each child should be seen by an orthodontist at age 7 years , To verify if the growth of the jaws and tooth eruption is happening normally.

Screening at 7 years old allows us to intercept  a problemwhile it is still develloping and treat it  in a simpler way.Often by treating early we can avoid dental extractions or surgery of the   jaws that would have been necessary if they had consulted later.
Orthodontic treatment is only offered to young children in whom a short treatment phase  (about 9-12 months) can help avoid problems that are more difficult to manage in the future.
The second very important screening time  is at the age of 10 years to ensure proper development of permanent canines.
The comprehensive or complete treatment  begins in late mixed dentition between 10 and 14 years.

It is urgent to check for the following common problems

1. Deviation of the lower jaw or upper jaw is too narrow



Without an early  treatment , bone asymmetry can be installed. Orthodontics alone can not solve the problem and a surgery   may be required at the end of adolescence. An early  treatment allows for better nasal breathing and thus better growth of the maxilla. Note the mismatch of the dental midlines due to the deviation of the lower jaw to the right and the narrowness of the palate which explains that on the right side the upper teeth are more inwards than the lower teeth (abnormal and less functionnal).

2. Prognathism of the upper jaw and / or lower jaw retrognathism



in the absence of early treatment, the risk of fracture of the upper incisors is increased if the upper jaw is too far forward relative to the lower jaw.

3. Retrognathism of the upper jaw and / or lower jaw prognathism



If the lower jaw is in front of the upper jaw and the child  does not receive an early  treatment , orthodontics alone cannot solve the problem and a surgery of the jaws (maxillofacial surgery) will be added often necessary in late adolescence or as an adult to fix this situation.

4. Open bite (Absence of contact between the upper and lower teeth)



Can be caused by thumb sucking, mouth breathing or by the pressure of the tongue against the teeth if the child keeps has a tongue thrust.
We often recommend speech therapy in addition to orthodontic treatment to rehabilitate the tongue's position in these cases.

5. Lack of space and malpositions



Unsightly, brushing is very difficult, the patient is at risk of caries and gum problems.

6. Severe overbite or Deep Bite



We note that the upper teeth completely cover the lower teeth, making teeth more prone to wear with loss of enamel and tooth structures, and increasing the risk of injury to the gums (the palate behind the upper incisors) and in front of the lower incisors

7. Excess space