Thank you for your question. A dentist may advise to delay braces for a few situations, and some of the common ones include:
1) A need for growth monitoring. Some patients may present with a more prominent lower jaw or a long jaw which may continue to grow further and thus may affect the dentists' final treatment plan. Your dentist may also notice some aberrant growth such as an asymmetric jaw which may continue to change with growth. Males tend to grow for longer compared to females and some don't stop growing until their late teens or even their early twenties.
It is important to monitor facial growth as it has a direct impact on the orthodontist's treatment plan as it may involve treating the jaw as well as the teeth. A dentist may monitor facial growth with measurements of the teeth as well as serial x-rays to assess if there are bony changes during the duration of growth monitoring.
2) Monitoring eruption of teeth. A comprehensive braces treatment plan usually takes place when the patient has his full set of adult teeth. This is to allow the orthodontist to have a complete picture of the space needed for their braces treatment. Most people would have their full set of permanent teeth at about age 12-15, though there is often a variation, some earlier and some later than the norm.
If the baby teeth have not dropped out, sometimes the orthodontist may request for an x-ray to assess the presence and position of the adult teeth and prescribe an intervention depending on the particular situation.
3) Poor oral hygiene and pre-braces dental treatment required. Braces treatment involves moving teeth in bone, a healthy oral environment is important for successful treatment. If there is existing dental decay that needs treatment or active gum disease that needs to be addressed, your dentist may advise to address those issues first. When there is an improvement in the overall health of the oral environment, it would mean that the patient is better able to look after his braces.
Fixed braces that are stuck on to your teeth tend to trap food and plaque more easily, hence
requires more effort and diligence to ensure that the teeth and gums are kept clean and healthy. Your dentist may need to assess if there is an overall improvement in the patient's oral hygiene before advising starting braces treatment to avoid risks such as white spot lesions or discolouration of teeth during the course of braces treatment.
Hope I managed to address your particular situation.
Best wishes,
Dr Priscilla Lu, Orthodontist
