When should my child see the orthodontist?

Short answer:  Any time you have a concern about the bite or smile.

The real question should be…” What are the indications for early orthodontic treatment?’  There is no quick answer to this, but I’ll try to make break this down  by chronologic age.

 I have to tell you that this is my opinion and that you should check with your dentist or local orthodontist about any concern you have.  Individuals may vary in their dental age, sometimes significantly.  Dental age must be established by a panoramic x-ray(more about this  important x=ray later).

AGE 0-3

Unless your child has a cleft, you worry too much.  Have a glass of wine and don’t hover . It’s your first child right?  Seriously, if your child has a cleft or craniofacial anomaly you should already have contact with a team at your local medical center. You already know more than me.

Age4-5 

This age is too early for most kids, unless they have a bite issue. Have a glass of wine and don’t hover. It’s your first child, right? However, if your child has a crossbite accompanied by a functional shift he/she should be evaluated now.  A functional shift is defined as a jaw that deviates upon closure by the premature contact of the teeth which forces the jaw to slide or shift into a more lateral or anterior position. Hopefully your dentist knows what I’m talking about, sadly many don’t.  The functional shift can be responsible for abnormal jaw growth- leading either an asymmetry  of the jaw or to excessive growth forward.  This needs to be treated when it’s identified. 

The most common reason that parents seek an orthodontic evaluation at this age(4-5) is due to oral habits- finger or thumb sucking. The habit has resulted in an open bite . The child is unable to touch the front teeth together when the back teeth are touching. I don’t get too excited at this age because I know that when the habit stops, the open bite will close down.  Some kids need the extra security of having something on which to suck.  A potential consequence of finger or thumb sucking is a narrow upper jaw. By the time this becomes apparent, your child is probably taking a trip to Expanderville anyway. Don’t sweat it, but if a thumb or finger habit is a concern, have it evaluated. I’ve seen open bites close just by using an appliance which keeps the digit out of the mouth (a Habit Appliance). Other times we need braces to augment the Habit Appliance.  A child’s desire to stop goes a long way.
To be continued...