Braces are something of a rite of passage for most children. An estimated 4.5 million Americans – most of them children and teenagers – wear braces on their teeth, according to the American Association of Orthodontics.
For parents, the thought of braces brings to mind a mouthful of uncomfortable metal, pokey wires, and complaints of discomfort. But kids have an entirely different perspective.
“Braces used to have a negative social impact,” says Garrett A. Weston, DDS, of Larchmont Orthodontics. “My patients are actually excited to get their braces because all their friends have them. They get to choose wild colors for their elastic bands that celebrate their favorite teams, camp, birthdays, holidays, and the colors change every month. Braces are thought of as almost a fashion and social accessory rather than a medical device.”
Orthodontists generally see patients for a first look at 7 to 8 years old, or second to third grade, if the primary pediatric dentist sees early signs of disharmony in the alignment of the child’s bite or issues regarding incoming adult teeth. From there, the orthodontist makes a determination as to whether early intervention is needed or if treatment can wait until 5th or 6th grade. This is when most children get braces and they will wear their appliances for 24 to 30 months. At the end of active treatment (when teeth and jaws have been guided into ideal position by braces), most patients wear retainers to support the new position of the teeth and continue to see the orthodontist for another year or so.
“Orthodontists have become more scientific in their approach as opposed to anecdotal,” says Weston. “We have the benefit of more than 30 years of scientific data, statistics, observations, and experience than the previous generation of dentists and orthodontists who had to work more by intuition.”
Design of orthodontic appliances has evolved to the point that braces are no longer the clunky metal construction that parents might remember from their youth. Nano-technologies and engineering advancements have improved the ability to mill braces and retainers that are much smaller and more comfortable. But among the most noticeable changes in orthodontics, is that the gloopy, vinyl impression molds that made kids gag are a thing of the past.
“New digital technology called the intraoral scanner is the biggest game changer in the last 10 years for patient comfort as well as diagnostic accuracy and treatment advancement,” says Weston.
Previously, orthodontists took an impression, poured plaster models, sent it to a lab and then created the dental appliance. Now, the orthodontist simply passes a small rounded wand over the teeth and gums creating 3-D computer images. The computer files can simply be transferred with a click to the lab for fabrication of accurate appliances like braces and palate expanders, as well as retainers and aligners.
In choosing an orthodontist, parents must be certain that the practitioner has not only graduated from a four-year dental school, but has gone on for advanced study for an additional two to three years at an accredited orthodontic and dentofacial residency program. General dentists do not have the same level of education and experience in orthodontic treatment that orthodontists do, so parents should be certain of their general dentist’s experience if they suggest providing orthodontic treatment.
Most of the time, parents choose orthodontists based on word of mouth or referrals from their primary care pediatric dentist. Parents can also find an orthodontist referral through the American Association of Orthodontists’ website, aaoin
In choosing the orthodontist that is right for your family, it is important to find someone that you not only like but that is not far from home as your child will likely be visiting the office at least once a month for up to two years in some cases. The orthodontist should also be easily available for appointments and accessible for questions and emergencies.
“This is your child’s face and smile. You want to do this right and you don’t want to do this more than once,” says Weston. “It’s critical that parents and the child are able to collaborate and ask questions of the orthodontist. Don’t be afraid to ask questions if something doesn’t feel right about the treatment, and if you are not satisfied, get another opinion.”
Corinne Zola is one of the founders of the Westchester Children’s Museum and a current Board member. She is a proud mom of two and lives in Mamaroneck.