What is orthodontics in children?
Orthodontics is a specialty of dentistry which is based on diagnosing, treating and preventing dental malpositions and malocclusions of the jaws.
In addition, orthodontics in children allows diagnosing a whole series of problems that can occur during growth, both at the bone level and with dental replacement.
During the child’s development there are a series of changes which can favor or prevent some malocclusions in advanced ages and can also be treated quickly and easily.
There is an anteroposterior growth of the arches. The arches grow anteroposteriorly, more molars erupt distally. There is a presence of interdental spaces. These are space reserves and may be due to transverse growth of the jaws. In primary dentition, the interincisor angle is greater (the incisor teeth are very straight, the permanent teeth are more inclined towards the vestibule. Therefore, the greater the inclination, the greater the space. that change, and this happens in the anterior sector (in the incisors) but in the lateral sector we find the so-called drift space.Definitive teeth are not larger than the temporary ones, for example the premolars are smaller than the temporary molars.
There are many more orthodontic therapeutic possibilities in than in other ages because during childhood there are all circumstances which are very favorable.
When is orthodontics necessary in children?
Orthodontic specialists advise that the first check-up with the orthodontist is recommended between 5 and 7 years of age. It is between this age when dental replacement has begun and the jaws are in full growth.
During the check-ups with the orthodontist, both the extraoral and intraoral areas of the child are explored. It focuses on observing the eruption of the teeth, being able to see whether or not it corresponds to the child’s age, as well as exploring the child’s bite or observing the position of the maxillary bones among themselves and as a whole.
Even if the child’s tooth eruption and bite are correct, it is important to perform annual check-ups to follow the entire process of tooth replacement in the oral cavity.
Children must go to the dentist or specialist, the pediatric dentist, for the first time every year after the first teeth erupt (at 6 months). These appointments are important to be able to diagnose in time any series of changes in the oral cavity that may go unnoticed by the child’s parents.
Why is it important to perform orthodontics in children?
In childhood, the maxillary bones and all the bones of the face are developing, so forces can be applied to them and modify their growth to correct any pathology and also achieve more harmonious facial proportions.
It is important to know that once the growth is complete, the treatment of bone malocclusions that affect the bones of the face can only be performed by orthognathic surgery.
Also in children, some temporary teeth are replaced by permanent teeth which are mesio-distal in size, smaller than those of milk. Therefore, there is an excess space that may be necessary to perform some type of dental movement and correct the established malocclusion.
On the other hand, the habits that children carry out can cause the appearance of dental malocclusions since they prevent the correct growth of the facial bones and cause an imbalance of the facial proportions. Some of the habits are: thumb sucking, oral breathing, atypical swallowing, among many others.
All this series of habits means that malocclusions such as the anterior open bite can be established, due to thumb sucking or atypical swallowing, a crossbite, due to the presence of oral breathing and atypical swallowing since there is no stimulation of the palate by the language.
What are the orthodontic treatments in children?
Orthodontics in children can be interceptive, functional or corrective.
Interceptive orthodontics is the one that prevents more serious posterior pathologies. It is only based on making movements to a few teeth, controlling space, habits and dysfunctions in children, such as finger sucking, oral breathing or the presence of a pacifier or bottle in ages over 2 years.
Functional orthodontics is intended to focus craniofacial growth towards a correct position and achieve stability in it, even when the bones are growing.
Finally, corrective orthodontics is based on treating the malocclusion that is already established by applying different forces with orthodontic appliances. This type of orthodontics is usually performed when there is a permanent dentition or in the final part of the replacement of the mixed dentition.
Thus, the orthodontic treatment to be performed varies depending on the age of the child and the type of alteration or habit that is present and that must be corrected. It is important that before starting orthodontic treatment a complete extraoral and intraoral study of the child is carried out to analyze all kinds of alterations, as well as an exhaustive exploration of the children’s functions and habits.
What types of braces for children are there?
Orthodontic appliances for children can be classified mainly into two types of appliances: removable and fixed appliances.
The orthodontic appliances in children that are removable are usually made of acrylic or metal which have hooks that rest on the molars. This type of removable appliance is usually used to correct skeletal alterations in the bones, such as the posterior crossbite, when the upper jaw is narrower than normal and what you want is to widen it and gain transversal space. They can only be used when the child is of growing age. For the placement of this type of appliance, the child must be very collaborative, putting it on the hours that the orthodontist recommends in order to obtain good results.
The other type of orthodontic appliances are fixed ones. Fixed appliances are those that are cemented in the teeth to make some kind of movement in them. Fixed appliances in children can also be used to widen the palate and treat the posterior crossbite, but without the child having to take them off and put them on each time. Another fixed appliance can be the brackets that are usually used for the treatment of malocclusions once the teeth are final or in the final phases of the mixed dentition.
There are multiple types of children’s braces. The choice of a removable or a fixed appliance will depend on multiple factors, such as the type of malocclusion, the age of the child, the habits they perform, their collaboration, among many others.
