In an age where information is so readily available and right at our fingertips, many parents and orthodontic patients want to learn as much as they can on their own before consulting with an orthodontist. While there are many credible resources available online, sometimes online research or word of mouth can lead to misconceptions about how complicated or invasive orthodontic treatment really is.

Most often, parents are surprised to learn that all children should have their first orthodontic exam starting at age seven, when most have a mix of adult and baby teeth. In years past, a dentist would wait to refer a child to an orthodontist until age 12, or until they had all of their permanent teeth in place. Although this was thought to be the appropriate time for referral, it did not allow the orthodontist to catch growth and development problems that are best treated with early intervention. 

Another comment that parents say is that their child’s teeth were straight, so they didn’t bring them in for an exam. Braces aren’t just about straight teeth. We want straight teeth, but it’s more important for the actual health of the teeth for them to fit together properly. A bite that is properly functioning will yield the best aesthetic results. 

Although most treatment can be accomplished in one phase and is typically started during adolescence (when there is still growth potential remaining), treatment is sometimes broken up into two phases. This proactive approach is called “interceptive treatment,” and is reserved for more moderate to severe cases, when it is very important to start early to prevent more aggressive and costly treatment from being needed in the future. 

Most often, treatment is not needed at this early age, but early screening and examination gives the orthodontist plenty of time to gather information and pick up on problems that, if left unseen until the teenage years, would require much more extensive and aggressive treatment. The goals of interceptive treatment are to:
– Improve growth discrepancies between the upper and lower jaws;
– Correct immediate dental problems that may be present (crossbites, open bites, severe crowding, etc.);
– Correct harmful oral habits;
– Improve appearance and self-esteem.

Typically, when a child has treatment needs that are moderate or severe enough to warrant interceptive treatment, the second, more comprehensive phase of treatment should be expected. The need for phase II treatment depends on the size and position of the teeth that erupt and the manner in which the teeth fit together.

Another common misconception is that third molars (wisdom teeth) are the major cause of late adolescent/early adult crowding. There is an abundance of research showing that wisdom teeth play a very little role, if any, in this type of crowding. It is not plausible for wisdom teeth, which develop in the spongy interior cancellous tissue of the bone, to push or move other teeth that are implanted and rooted to the bone. Moreover, many orthodontic crowding cases occur in patients who have congenitally absent wisdom teeth, or even after a patient has had his or her wisdom teeth removed.

The cause of crowded teeth (officially known as Malocclusion), is most often hereditary. Variations in size or structure of the upper or lower jaw may affect its shape and result in overcrowding of teeth or in abnormal bite patterns. Other causes of Malocclusion include:
– Childhood habits such as thumb sucking, tongue thrusting, pacifier use beyond age three, and prolonged use of a bottle;
– Extra teeth, lost teeth, impacted teeth, or abnormally shaped teeth;
– Ill-fitting dental fillings, crowns, appliances, retainers, or braces;
– Misalignment of jaw fractures after a severe surgery;
– Tumors of the mouth and jaw.

Simply put, your doctors are eager to address your questions and ease your concerns about treatment. So, while it is important to be knowledgeable and proactive about your or your child’s dental health, remember that the most credible resource for information is an initial consultation with your orthodontist.