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How can I tell whether my child needs braces?
Your family dentist will most likely be the first to point out any problem — such as a severe overbite, crowded or crooked teeth, or a cross-bite — that calls for a consultation with an orthodontist. It makes sense to start thinking about this early, since most kids who need braces get them at age eight or nine, when they don't yet have all their permanent teeth and the jaw is still growing. If your child has a cross-bite (half overbite, half underbite) you'll want to correct it before the first baby tooth has been plucked by the tooth fairy. Otherwise, it may cause the jaw to grow asymmetrically.
Are thumb suckers more likely to need braces?
Only if they're still sucking when their permanent teeth start coming in, after age five. If your child hasn't kicked the habit by then, she may be sucking intently enough to pull her adult teeth inward, causing them to crowd together or creating an overbite. But this isn't common; most bite problems are inherited.
How do braces work?
An orthodontist glues tiny brackets to the front of the teeth and connects them with a wire. Then he adjusts or changes the wire every four to six weeks, as the teeth are slowly pulled into position. Your child might also have to wear rubber bands (connecting top teeth to lower teeth to add pinpoint pressure) or headgear, a metal brace that fits into slots in the brackets and wraps around the head, pulling the front teeth back. Once the braces come off, most kids will need to wear a retainer, a removable custom-made brace, to keep the teeth in place until the wisdom teeth have come in and the jaw has stopped growing, around age 18 or 19. Some may continue to wear it one day a week even as adults.
Do braces hurt?
Much less than when you were a kid. Gluing the brackets to the front of the teeth eliminates the need to force metal bands around each tooth, as was necessary with the braces of decades past. And the wires used today are more flexible, particularly those made of alloys, such as nickel titanium, so they apply pressure more gently. That's not to say the process is painless. Most kids complain of soreness for a day or two after their braces are tightened, but an over-the-counter painkiller such as ibuprofen can usually ease the discomfort. If the gums or cheeks become raw or irritated from rubbing against the brackets, your orthodontist can provide wax to smooth things over until the tissue heals.
How long will my child have to wear braces, and how much will it cost?
These are the two most common questions orthodontists hear from the parents of prospective patients. The bottom line varies from patient to patient, of course, but most kids wear braces for one to three years. The cost ranges from $1,800 to $5,500, depending on the treatment's length and complexity. At an initial consultation, the orthodontist will perform a thorough exam of your child's teeth and jaw, taking X-rays and impressions. Based on that, he will give you his opinion on the best course of treatment and an estimate of the cost. In the end, how long it goes on may depend on the youngster's willingness to wear headgear or rubber bands as necessary.
How can I find a good orthodontist?
Start by asking your child's dentist for a referral or by calling your local dental society. Also get recommendations from friends and family members whose children have had braces. Then set up a consultation with one whose office location and hours are convenient for you. Don't hesitate to shop around. Pay attention to how the orthodontist interacts with your child. Kids are more likely to follow instructions if they like their doctor.