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Getting the 'brace face' at a younger age

Halloween came early for me this year. About a month ago, I took my elementary-schooler to the orthodontist, and -- and hour later -- she emerged looking like a tween, her new brackets decked out with green rubber bands. All she needed was a copy of "Twilight" and she would have been indistinguishable from kids at the middle school down the block.

My daughter is at the younger range of children who need braces, but there was no doubt that we were going to have to spring for early orthodontia. At her routine dental visit, the dentist noticed that her molars were coming in at an odd angle, preventing the normal emergence of her adult teeth. I showed the x-rays to my father and brother -- both dentists -- and they just laughed. There was no watch-and-wait, they said. She need braces, and it wouldn't be fun.

My daughter is the only one in her class, so far, to visit the orthodontist, but the Associated Press suggested this week that more and more kids are getting their metal mouths early. According to the experts, there are cases when that makes sense, such as underbite. But there's no advantage to starting early for standard-issue overbite. For the most common reason for braces, crowded, crooked teeth, getting braces early usually means that a second round of treatment as a teen will be required.

I was in braces as a kid. I had the then-cutting-edge clear ones, which didn't do anything to diminish my look as a gawky junior high kid. Still, it wasn't overly traumatic, and I was in no rush to get my children in brackets. For those of you with teens (and orthodontist bills): When did your kids start with the brace face, and would you have started earlier if you could?

By Brian Reid |  October 28, 2009; 7:01 AM ET  | Category:  Elementary Schoolers , Health , Tweens
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Comments


We have no one with braces, but a thumb-sucking 3 year old for whom I am sure they will be necessary. My cousin and neighbors with similar problems all seemed to get their expanders at around 7 or 8 with braces following shortly. I will say I remember that as a kid people would often have braces for years, now most of the kids I know get them off rather quickly. I am interested to hear what other people have to say...

Posted by: thosewilsongirls | October 28, 2009 7:30 AM | Report abuse

"I showed the x-rays to my father and brother -- both dentists "

Brian's father is a dentist? I had the distinct impression that Brians' father was a blue collar worker... Did you get some find of discount?

"When did your kids start with the brace face, and would you have started earlier if you could?"

No braces required for my kids.

Posted by: jezebel3 | October 28, 2009 7:32 AM | Report abuse

Correction: Did you get some kind of discount?

Posted by: jezebel3 | October 28, 2009 7:34 AM | Report abuse

Two of four had braces; the other two never needed them. (Nor did I, although DW did.) No advantage to starting young, in our case - it would just mean a second round of treatment later on; it was easier on the kids to wait until they were teens to start.

(One orthodontist we visited early on wanted to pull SEVEN of middle DD's baby teeth so he could start the orthodontia two years earlier. We found another orthodontist, this one sane and sober. :-)

Posted by: ArmyBrat1 | October 28, 2009 8:17 AM | Report abuse

Yeah, this seems to have changed big-time when I was a kid. I didn't get braces until 14 -- a little later than my friends because my teeth were slow coming in, but not that out of the ordinary. Of course, that meant I had them until my senior year of high school. And that really, really sucked.

But with DD, she was told by her dentist a year ago (at 7) that she'd be ready for braces within the next couple of years. And one of her friends already has them! Seems very weird to me; I mean, is the jaw even fully-grown by 8 or 9 or 10?

Posted by: laura33 | October 28, 2009 8:22 AM | Report abuse

Yeah, when I was a kid my dentist convinced my parents to take me to an orthodontist, who convinced them that putting braces on my baby teeth would likely result in the adult teeth coming in straighter (my baby teeth were terribly crooked- I think I was in 3rd or 4th grade when I had them on, so I did have some of my permanent teeth). Did it work? Nope! I ended up having them twice- in elementary and again in middle school a few years later. It was awful- I feel like orthodontists aren't honest with parents and kids about how much this hurts. I had to go in for a tightening every 4 or 6 week (hard to remember now), and after every visit I was unable to eat anything but very soft food for two days and could barely sleep because my jaw would hurt so much. And dealing with it twice was just ridiculous. I know my parents feel like they were "taken" by these guys and wish they had just waited in the first place.

I hope my kids don't need braces, but I will be putting it off until they are in high school at least. Plus, I know so many people who had braces and then refused to wear their retainers and now have crooked teeth again. If I'm going to bother to shell out the money for braces, I want to make sure my kids want the results enough to take care of the maintenance later once the braces are off.

I did read once in one of the Dr Sears books that there was a large study that showed that kids who were breastfed as babies (I think for a year or more)need 40% less orthodontia than bottle-fed babies since the action of nursing promotes better development of the facial muscles and jaw. Interesting if it's true. I know that all 3 of my kids have reasonably straight (though not perfect) teeth, and my husband and I (never breastfed, and only breastfed for 5 or 6 months, respectively) both had awful teeth.

Posted by: floof | October 28, 2009 9:11 AM | Report abuse

I have noticed how kids with braces are getting younger and younger and from experience, (as a former brace face with crooked teeth) I figured it was probably not a good idea in many cases.

As for pulling a lot of baby teeth, we had the exact opposite advise from our dentist. My daughter has lost her baby teeth very slowly, up until this summer she had only lost 8 and she is 11 years old. I kept thinking the Dentist would want to start yanking them, but her attitude was - they will come out when they are ready and her x-rays look fine. Sure enough in the span of a week she lost 4 more teeth. Her teeth look straight, no warnings that she'll need braces. On the other hand, the boy looks like he is taking after his mother.

Posted by: cheekymonkey | October 28, 2009 9:12 AM | Report abuse

It does hurt. My ortho was crazy and tried to tell me a little Tylenol would deal with tightenings' pain. I was on two Motrin half an hour prior every 4-6 weeks when I went, and I *still* hurt afterwards and had trouble eating or sleeping.

Better than the periodontia my mom is dealing with now, but three years of that SUCKED.

Posted by: forget@menot.com | October 28, 2009 9:16 AM | Report abuse

In 3rd grade my daughter was put into a retainer first to protect the tooth that stuck out so far, but it quickly was deemed that she needed braces so she was in braces by the end of 3rd grade. Due to a move and change of orthodontists she remained in braces through 8th grade. She is very good about wearing her retainers (a clear plastic deal) and has beautiful teeth now she's in college.

We thought it was really young at that time to be in braces, but I see more and more kids at church in upper elementary sporting braces. I guess people are more conscious about how their child looks and it drives the market.

Posted by: peonymom | October 28, 2009 9:18 AM | Report abuse

Forgot to mention one other thing- I am 32 and have been dealing with receeding gums since my late 20s. I asked my dentist why this was happening to me, since I am very good about taking care of my teeth, and he asked if I had braces. I told him yes, twice, and he nodded and said that was probably why. Apparently orthodontia is linked to gum recession later in life- I guess having the teeth moved around so much has a bad effect on the gums. I probably would have had the braces anyway (once, not twice) since my teeth were just terrible, but it would have been nice to know that was a potential side effect.

Posted by: floof | October 28, 2009 9:26 AM | Report abuse

The idea behind the first round of braces or an expanding retainer at seven or eight is that if the jaw is expanded slightly then, there is more room for secondary teeth to come in and it's less likely that the kid will need permanent teeth pulled (as they used to do routinely) to fix crowding later. The idea behind pulling the baby eye teeth is that the permanent ones don't come in until 10 or 11, so the front permanent teeth have more room to grow in the first place.

I found an orthodontist who is very good about distinguishing between problems which will cause damage, and what is just cosmetic.

Kid #1 had a baby tooth that wouldn't fall out. The secondary tooth grew in behind it and after a year of a dentist saying, "It's fine, Mom," it wasn't fine. She ended up with a top tooth trapped behind the bottom tooth--you have to fix that or it damages both teeth and the gumline. Once that was fixed the ortho said wait until high school for the rest because it's just cosmetic.

Kid #2 has an overbite so severe she has difficulty eating and speaking clearly, and is at risk of chipping or knocking out her protuding front teeth if she falls off her bike or whatever. Absolutely I will have that fixed rather than have her go around like that for another six or seven years.

Posted by: di89 | October 28, 2009 9:48 AM | Report abuse

I wore braces from my freshman to junior year of high school and then wore my retainer religiously. I am now 28 and my teeth look as though I never wore braces. I have a bridge due to an adult tooth that never formed and a crown due to a malformed adult tooth. These two together have pushed my teeth back into their original positions. I think the dentist that I had at the time didn't do the best job with my bridge and crown. I'll have to have both replaced this year.

As for my kids, my oldest is 7 (2nd grade) and has only lost one baby tooth. None of my children had any teeth before 11 months old, so I think they may be late to lose them as well. But his teeth are straight and are nicely spaced (leaving room for adult teeth). His next youngest sister is 5 and hasn't lost any teeth yet, but her teeth are just as pretty as his. My youngest two are 3 and 1 and are both thumbsuckers. Both are already exhibiting crowding and crookedness, so I think they will likely need some braces in the far future.

Posted by: MEALmama | October 28, 2009 9:48 AM | Report abuse

I also had an orthodontist suggest pulling six permanent teeth to make room for the rest and fortunately we moved before he got to do that. Second orthodontist said it would take time (3.5 years), but he could work it to give me straight teeth with all. Small town, everyone went to him, almost everyone in class had braces (the huge silver bands around the teeth type). No big thing. I think I should have kept the bottom permanent retainer for a few more years, teeth have shifted over time.
DSD has had braces for almost three years now with no end in sight for her, she got them much younger than I did. Most of her classmates have them, so it's no big thing (other than picking the right colors for your bands each time). Fully expect DD and DS to go through it as well.

Posted by: StrollerMomma | October 28, 2009 10:40 AM | Report abuse

I had horrible teeth as a kid. I had 5 teeth pulled, another one surgically removed that wasn't coming in the right way, and have a tooth implant to fill a gap where a tooth never came in. I had braces for 3 years starting in 6th grade and got them off the last day of 8th grade. Every time they tightened them my teeth would be sensitive for about a week. After going through all that I did not want my teeth to move back so I have been wearing my retainer every night since and that was 24 years ago. My dentist told me the ligaments that hold your teeth never forget where your teeth originally were so your teeth will move back if you don't prevent it by wearing a retainer.

My husband didn't get braces until he was an adult because his teeth were mostly OK and he got the Invisalign type which are clear plastic trays that you can take out when you eat. They cost way more than regular braces but you can barely see them. So if you can afford it, and your teen is balking at the idea of having metal mouth, that would be one option. We planned ahead and then put money aside for it in our Flexible Spending Account which allows you to use tax free money to buy them. However, if you go the Invisalign route, the teen would have to be responsible enough not to lose the trays. I remember I lost my retainer several times when I was in high school after I got my braces off. Also with Invisalign you don't have to go to an orthodontist, but you can get them from a dentist that has the right training- that is what my husband did. You wear one tray for 2 weeks and then wear the next one in the series for 2 weeks, etc. The trays are designed by the computer to move your teeth where they need to go.

My kids are too young (3 and 1 year old) to need braces but the older one sucks his thumb and if he has my genes he will probably need them. We'll have to wait and see.

Posted by: StatsMom | October 28, 2009 10:56 AM | Report abuse

I'm 49. I had braces for jr/sr years in high school, and wore the retainer as instructed. About 10 years ago I noticed a slight movement of the teeth going back toward the pre-brace positions and mentioned it to my regular dentist, who said teeth would eventually shift to original positions. They never mentioned that in 1978! Well, I went to an orthodontist and got a new retainer, and wear it every night. Teeth are staying put now.

Posted by: webbrats | October 28, 2009 11:02 AM | Report abuse

Do braces have any impact on oral sex? Ouch!

Posted by: jezebel3 | October 28, 2009 11:23 AM | Report abuse

OT - moxiefamily might be moving to MD. What do people think of Gaithersburg as a place to raise a family? We are looking for a community that has a real sense of community.

Posted by: moxiemom1 | October 28, 2009 11:29 AM | Report abuse

I am very grateful that my parents decided to take me to the orthodontist for the first time when they did (at age nine). I had a tiny top jaw, combined with a severe overbite. Kids at school used to joke that I was a vampire because I could fit my lip in between my front teeth on top and the two next to them, so I could have those two teeth outside my mouth with my mouth closed. After two and a half years of an expander, braces, and an appliance to lengthen my lower jaw, my mouth is about twice as large as it was, and there's still barely enough room for all my permanent teeth. I was told that I was almost too late because the bones had already started to harden, so if my parents hadn't gone ahead with it then, I would have been like my brother, going through jaw surgery in his senior year to fix the problem. Expanders and headgear are often used during elementary school for that reason: the bones are still growing, and so they can still be stretched and the problem corrected. I much prefer years of fairly mild pain to surgery and months of wired together jaws. My sister and mother, who were not effectively treated for the same condition, have jaw problems to this day. Floof, on the breastfeeding note, all seven of my mom's kids were breastfed, and five have had at least two years of orthodontic work done. Another has a noticeable gap, but it's a cosmetic issue only (it's not going to cause him any problems later on), so it hasn't been fixed.

Posted by: reb5 | October 28, 2009 11:34 AM | Report abuse

OT- To Moxiemom RE Gaithersburg

Gaithersburg has a variety of areas and I think it greatly depends on where you are looking. The part between Clopper Rd and 355 I think has crime issues. Also I wouldn't live in Montgomery Village or parts of Germantown for that reason.

I live right next to Gaithersburg in an older neighborhood (built mid-70s to mid 80's) and have been very happy with the sense of community. There is a park with play equipment, tennis courts, basketball courts, a baseball field, and walking paths. Because it's an older neighborhood, the houses aren't crammed together like in the Kentlands which is newer and more upscale. My house is surrounded on three sides by a creek and woods but it's a mile from Quince Orchard HS and the Kentlands so you have seclusion like you're in a rural area but are still only 15 minutes from Shady Grove Adventist Hospital and Rockville going down Darnestown Rd. so I don't have to use I-270 to commute which is great.

Here is a link to our neighborhood's web site: http://qokca.org/

I have also heard good things about the neighborhoods near Jones Lane as far as having good community spirit.

Good luck!

Posted by: StatsMom | October 28, 2009 12:55 PM | Report abuse

Moxiemom, I live in Gaithersburg also (actually just north of the city limits, backing up to Montgomery Village on our east side). Our neighborhood is backed by Seneca Creek State Park, so it's surrounded by woods and is very quiet although we are in the middle of everything. Gaithersburg has lots of nice neighborhoods, but I'll agree with StatsMom to avoid certain areas because of crime statistics. Of course, crimes can occur everywhere, even in Potomac, so just do your homework before signing on the dotted line.

Welcome to the area in the near future! :)

Posted by: lsturt | October 28, 2009 1:15 PM | Report abuse

We had two children who got the full braces treatment.

The way it was explained to us, with many impressive drawings was that the first round would take advantage of a natural growth spurt to reshape/expand the jaw and provide more room. The second round focused more straightening the teeth.

Unfortnately by the second round son #1 was in the middle of early adolesence and was not very cooperative. He took at least a year longer than he should have to get it all done because he had so many broken wires.

I think getting as much done when they are younger and easier to deal with is wise.

It was a long haul but both boys now have nice looking teeth.

Posted by: RedBird27 | October 28, 2009 1:22 PM | Report abuse

Thanks Statsmom and Isturt - it all looks nice online, but you never know. When we lived there last (many moons ago) we lived in Arlington and had no kids, so its all very different for us now. I truly appreciate the advice and input!

Posted by: moxiemom1 | October 28, 2009 2:46 PM | Report abuse

All three of us had braces. My parents started young with us given their issues with their teeth. I had a retainer in elem. school and braces for two years. I wore the retainers for a few months, as I was told to. Then the teeth shifted a bit. I had the second round of orthodontia about 10 years ago (15 years after the first). Now I have two retainers, by another orthodontist, cause well, teeth shift.
When I was about 7/8, I had two surgeries to remove baby teeth that wouldn't come out. In the second surgery they took out three adult teeth (it would have been four, had the fourth one been there, but it wasn't...all for the best).

So, my kid is 7 1/2 and lost his first tooth in July. The adult teeth were coming in, so we talked with the dentist and he said: go talk with the orthodontist. He referred me to the ortho I'm already going to - convenient huh. So, the ortho said to remove three teeth, by the time we got back to the dentist, one had already fallen out, so it was only two. Ortho said see him in 6 months. He indicated that my 7 YOs top teeth (adult) aren't in yet - so he's got a year before he loses those. The adult teeth ALSO (along with coming in before baby teeth are out) don't have enough room to grow in. Both kids' baby teeth are way too close together (for normal kids, there are spaces, since adult teeth are bigger than kid teeth, so there's room for them). We're looking at braces for both kids, then.

OT - similar to Moxie's Q: What does anyone know about Columbia, MD?

Posted by: atlmom1234 | October 28, 2009 3:33 PM | Report abuse

And Laura: sometimes you start young so that you can make changes as the kid's bones/jaw is growing...so that you 'catch it' before it 'sets.'

:)

Posted by: atlmom1234 | October 28, 2009 3:36 PM | Report abuse

Thanks, atlmom. That makes sense. I kinda wish that they'd known that when I was a kid -- I had to live with a giant spacer bar across the top of my mouth for six months, cranking it a couple of turns every night, to widen my upper jaw so the top teeth fit over the bottom teeth, instead of inside. NOT one of my favorite memories. Gotta wonder if some of that could have been a lot easier if they started earlier back then.

Moxie, why did I think you already lived around here?

atlmom, are you back to thinking you might move back up? I live about 5 miles N of there.

Posted by: laura33 | October 28, 2009 3:45 PM | Report abuse

"OT - similar to Moxie's Q: What does anyone know about Columbia, MD? "

What do you want to know - I work in Columbia and live in Ellicott City (the next "town" north)? Schools are great, but a little crowded. Nice range of housing options, from apartments to condos; townhouses to McMansions. In Columbia itself you've got all the restrictive covenants/architectural committees/etc. Outside you're not bound by such things; it's really a matter of whether you prefer "none of my neighbors can do bad things to the property" or "I can do what the heck I want, within reason". You're convenient to both Baltimore and Washington. Traffic's bad, but not as bad as NoVA. Not much mass transit to speak of. Not much culture in the county, but see that part about Balt. and DC.

Posted by: ArmyBrat1 | October 28, 2009 3:56 PM | Report abuse

AB, you in "old" or "new" Ellicott City? I always grew up thinking of EC as that nice little strip of Frederick Rd a few miles down the road from me. Felt really old when I moved back and discovered there was a whole new big "town" that grew up around there!

Posted by: laura33 | October 28, 2009 4:05 PM | Report abuse

Laura - okay, if you want to be picky I'm closest to Daniels. How's that for a Google search? :-)

"Old" EC was the part on Main Street by the train station, but it surrendered its city charter a long time ago and now doesn't exist as a "city", just a "census designated place." Rte 108 is the dividing line - if you're north of 108 you're "EC" and south you're "Columbia," until you go far enough west to be in "Woodstock" or "West Friendship." Since it's not a "city" they can extend it to include whatever the heck they want.

(For those not familiar with MD politics - there are only something like 29 or 30 incorporated "cities" in the state. So Frederick is the second largest city in MD, even though Columbia is almost twice the size of Frederick.)

Posted by: ArmyBrat1 | October 28, 2009 4:17 PM | Report abuse

I have really enjoyed viewing all of your comments... they are all very good. These "horror" stories of yesteryear are typical in orthodontics. It is true that the AAO (American Association of Orthodontists) recommends that children get an initial orthodontic consultation as early as age 7. Not all children begin treatment then, but the orthodontist can monitor and guide the growth and development of the oral cavity. There are some things that the doctor can do to facilitate and minimize the need for orthodontics but Mother Nature stays in control. View my blog on orthodontics weekly at www.appleorthodontix.wordpress.com

Posted by: cpackard | October 29, 2009 9:38 AM | Report abuse

Hi! I was just thinking about this because I went to the dentist and she mentioned I would have to be very careful of my front teeth, since the roots are very short-- she could tell that this was because of braces. I wish we had been told about potential side effects. I'm now 41.
I had: retainers, springs, palate splitter, headgear with a wire that went around my head, and then braces, and 3 baby teeth pulled.
I'm not sure all this was necessary. I only had one tooth out of place. Why was this such a big deal??
What I would plan for my kids-- and ped dentist says DS "probably will need them" since baby teeth are very crowded:
NO TEETH PULLING ever!
Second opinion for everything.
Those "invisalign" trays or retainers instead of braces.
Seriously consider not doing anything. I know several people with crooked teeth, and one seriously "snaggle-toothed" and I don't see why it's such a big deal!
People always tell my I have unnaturally straight teeth, especially when I go to other countries, and it makes me feel uncomfortable!!
Why do we do this to our kids??!!!

Posted by: liziko | October 30, 2009 12:45 AM | Report abuse

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