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MESSAGES TO
Early Braces Treatment In Children

Early Braces Treatment In Children

A DxD Session with National Dental Centre


Ended on Thu Nov 15 2018
Ended

Top Answers


You are quite right about the fact that most of the time orthodontists will only start full braces treatment when a child has all their adult teeth present.

However, every child is different and there exists certain conditions where early management may help to prevent worsening of the bite condition or may prevent future problems from developing. We refer to such treatment as interceptive orthodontic treatment.

Interceptive orthodontic treatment is usually for a shorter duration to treat the urgent problem before the complex braces treatment will be carried at a later stage when adult teeth have all erupted. If you are in doubt, you can bring your child to an orthodontist for a consultation.

You can also refer to the article I contributed here for more information: The Orthodontist's Complete Picture Guide To Braces For Children (2018).

Dr Elaine Tan

Consultant, Department of Orthodontics

National Dental Centre Singapore

14 Sep 2018

At age 5, your child would just be beginning to transit to adult teeth and may have a mixture of small baby teeth and larger adult teeth. The adult teeth may also grow from the tongue side on the lower jaw and slowly drift forwards to its final destination.

Having two rows of teeth, one being the baby teeth and the other adult teeth, can look quite messy. Rest assured that this process of transition is normal. However, whether the adult teeth will straighten out on its own will depend on some of these factors:

1. Available space for the adult teeth

Teeth need space in order to sit straight, baby teeth are smaller in width than the adult teeth, so although the baby teeth may be straight and neat, the space it leaves behind for the adult teeth may not be sufficient. The adult teeth may have trouble finding the right amount of space to sit straight. Ideally there should be some spacing between the baby teeth, so that the adult teeth will have ample room to grow into the mouth.

2. Timely exit of baby teeth

The baby teeth hold the space for the adult teeth and sometimes the baby teeth may not drop out in time for the adult teeth to occupy its space. This creates an obstruction for the adult teeth and may cause the adult teeth to grow out crooked to avoid this obstruction. If you notice the baby teeth has been loose for quite some time, it may be helpful for the child to see a dentist to assess if the baby teeth need help to exit.

 3. Position of the adult tooth

Sometimes the adult tooth bud may not grow out in its correct location. The adult tooth bud refers to the adult tooth in its early development stage, each tooth bud should sit above and slightly behind its baby tooth predecessor however sometimes they don’t line up properly and may get “lost” as it grows out.

At 5 years old, the adult teeth are still finding its way into the mouth, so it would be good to monitor and observe the changes.Visit the dentist at least once a year and your dentist should be able to ascertain if everything is on track!

Dr Elaine Tan

Consultant, Department of Orthodontics

National Dental Centre Singapore

14 Sep 2018

Hi Yen Wan,

Braces treatment is used for the correction of teeth and jaw malalignment. Not all teeth and jaw malalignment requires treatment. Braces treatment is usually an elective procedure, whereby the choice of undergoing treatment is dependent on the child and parents.

At the first consultation, I would usually ask the child why they want braces treatment, and if there is anything he/she doesn’t like about his/her teeth or face, and whether it is affecting his/her daily function and psychological well-being.

To be objective, I often use the Index of Orthodontic Treatment to assess the severity of the condition. The index uses a grading system to determine the severity of the malalignment; with grades 1 and 2 suggesting mild need for braces treatment, grade 3 for moderate need, and grades 4 and 5 suggesting great need. The index uses a few criteria to achieve the grade.

Most of the time, the child will undergo a physical examination of the face and teeth. However, if there are any delayed or abnormal eruption of permanent teeth, your child may need to go for an x-ray of the teeth to observe the dental development.  

The American Association of Orthodontists recommends that all children be screened by an orthodontist at age 7. So do bring your child in for an assessment by an orthodontist!

Dr Elaine Tan

Consultant, Department of Orthodontics

National Dental Centre Singapore

14 Sep 2018

The price ranges from $3,500 to $4,800 at National Dental Centre Singapore for routine braces treatment for patients in permanent dentition This does not include the extractions of teeth. The price range varies at different clinics in Singapore.

It does sound like your son will benefit from braces treatment for his overcrowded teeth. However, your dentist will need to first assess if he is ready for braces treatment.

It’ll be advisable for you to bring your son for a consultation with an orthodontist and they’ll be able to advise you better on the treatment plan as well as the estimated cost.

Dr Elaine Tan

Consultant, Department of Orthodontics

National Dental Centre Singapore

14 Sep 2018

As braces treatment is an elective procedure, Medisave cannot be used to pay for it.

Dr Elaine Tan

Consultant, Department of Orthodontics

National Dental Centre Singapore

14 Sep 2018

Your child can still continue to play sports, including soccer. Wearing braces shouldn’t stop him from playing soccer especially if that’s his passion!

Patients can still continue to play sports even with braces treatment. The only risk is that when the ball accidentally hits the mouth, the impact from the ball against the braces may cause the brackets to detach from the teeth.

You can purchase a set of sports guard from any sports shop. I recommend those which are malleable when soaked in warm water, so that when the teeth move and change shape, the sports guard can be adapted to fit the latest arrangement of teeth.

Dr Elaine Tan

Consultant, Department of Orthodontics

National Dental Centre Singapore

14 Sep 2018

Any recognised orthodontist would have gone through rigorous training in the field of orthodontics and would be adequate to treat your child. You can look up the Association of Orthodontists website (www.aos.org.sg) to look for recognised orthodontists.

There’re no paediatric orthodontist as all orthodontists are trained to treat child patients for any type of orthodontic problems.

There are, however, paediatric dentists, who are dentists that have undergone further training in the specialty of pediatric dentistry. They are trained to see patients up to 12 years old for simple orthodontic problems.

Dr Elaine Tan

Consultant, Department of Orthodontics

National Dental Centre Singapore

14 Sep 2018

National Dental Centre Singapore

There are many problems early braces treatment can help resolve. These problems may vary depending on the individual.

Early braces treatment can help correct:

  1. the eruption of permanent teeth that may be stuck in the alveolar bone
  2. the growth direction of upper or lower jaws for patients with jaw growth disharmony
  3. bite and prevent future/further damage to permanent teeth
  4. bad habits like digit sucking
4 Oct 2018

With straighter teeth, your child will find it easier to brush and maintain his/her oral hygiene. Straight teeth also make your child look better when he/she smiles and boost confidence!

4 Oct 2018

Hello Jean,

The benefits of early braces treatment for children are listed below:

  1. Help in an eruption of permanent teeth that may be stuck in the alveolar bone
  2. Improve growth direction of upper or lower jaws for patients with jaw growth disharmony
  3. Improve bite and prevent future/further damage to permanent teeth
  4. Reduce risk of damage to prominent front teeth
  5. Eradicate bad habits like digit sucking
4 Oct 2018

Thanks for the D2D.

The different types of braces may include:

  1. Fixed appliances E.g.: regular braces that are “glued on” your teeth
  2. Growth modification appliances E.g.: facemask or twin block
  3. Removable appliances E.g.: bite plate

The treatment modality chosen will depend on the individual patient diagnosis. This will be discussed with your dentist/orthodontist.

4 Oct 2018

Hello Meixin,

I am happy that you are on this journey with your daughter! There is nothing much that you need to do. Most of the responsibility will be on your daughter to clean her teeth and braces well. Her dentist probably would have taught her how to clean her teeth with braces on.

Other than cleaning, she also needs to avoid chewing on hard food e.g. nuts, crab, ice cubes, to prevent the braces from coming off the teeth. Apples also need to be cut into bite-sized pieces instead of eating off a whole apple.

When she sees her dentist for her monthly braces adjustments, the dentist will be better able to advise if she’s taking care of her braces well.

4 Oct 2018

Hello Min, thanks for the D2D.

National Dental Centre Singapore

I am so sorry to hear about your bad experience. The level of discomfort varies for different children, depending on their pain threshold.

However, children are generally more adaptable compared to adults and they do not usually complain of much pain.

If the discomfort is unbearable, mild painkillers e.g. Panadol, may be prescribed.  In addition, the braces technology today is more advanced and discomfort is minimal.

4 Oct 2018

I am so sorry to hear about his discomfort from braces. I would advise you to bring him back to see the dentist. You could also try giving him some Panadol syrup to help relieve the pain.

4 Oct 2018

Congratulations on your daughter’s first step to achieving a beautiful and healthy smile! I usually tell my patients they can continue with their normal diet.

However, they should avoid chewing hard food like nuts, crabs or ice cubes as these may cause the braces to come off from the teeth. She also should not bite off a whole apple, but instead cut the apples into bite-sized pieces.

After initial placement of braces, teeth tend to be more sore for the first few days. She can consider taking a soft diet like porridge, soup, tofu, yoghurt, eggs, etc. during these few days.

4 Oct 2018