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I have a 20 month old son with an underbite. When should I start seeking treatment for him?
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You have proposed a good question which may be answer differently depending on the severity of the underbite and which orthodontist you ask. There are some good reasons to correct an anterior crossbite (underbite) as soon as it is appropriate. An anterior crossbite can cause excessive wear or damage to the anterior (front) teeth. Anterior crossbites can also cause the lower incisors to be forced anteriorly (pushed forward excessively), which can result in a loss of bone support in front of these teeth as well as gingival recession. Research has also indicated that forward posturing of the lower jaw can cause a limited amount of additional forward growth of the lower jaw. Therefore, if the anterior crossbite is causing the lower jaw to be positioned forward much of the time, this could result in unfavorable jaw growth, making the crossbite more difficult to correct later on. These, in addition to esthetics, are reasons to correct the anterior crossbite at a fairly early age. On the other hand, it is my opinion that some anterior crossbites which are obviously the result of excessive forward growth of the lower jaw and/or a deficiency in of forward growth in the upper jaw simply cannot be corrected with orthodontic treatment alone and should not be treated until they can be addressed adequately with surgical correction.
Your original question focused on the timing of treatment for an underbite (anterior crossbite). In general, my preference is to delay treatment of an anterior crossbite until the permanent incisors are erupting or sometimes even until they have completely erupted, which is usually about age 7 or 8. Since I will usually begin treatment for the crossbite at 7 or 8, it would not be too early to have your child evaluated at age 5 or 6. There are two reasons that I prefer to wait until the permanent incisors are erupting before correcting the crossbite. The first is that since the permanent lower incisors tend to erupt linugally (on the tongue side), and the upper incisors tend to erupt labially (on the lip side), it is possible that the crossbite will correct itself with eruption of the permanent incisors. Another reason I like to wait is so that the child is ready to be treated from an emotional standpoint. I prefer that the patient be old enough to understand the problem and be able to comprehend and follow our instructions so that the treatment can proceed quickly and efficiently.
Sometimes an anterior crossbite can be treated with the use of a simple removable appliance (like a retainer) and other times it is more appropriate to use some fixed appliances (like braces) to correct the crossbite. There are also additional appliances which can be used effectively to correct anterior corssbites, and sometimes an orthodontist will coordinate treatment with an oral surgeon, depending upon the type and severity of the issue. The specific situation and severity of the crossbite will determine which methods are utilized.
Since the age to treat an anterior crossbite varies depending upon the situation and the orthodontist who will be treating the case, I would recommend the evaluation of your child at a fairly early age to determine what timeline would work best in his/her situation. If you are concerned about any issue with your child, it is best to find out as much information as possible; most orthodontists offer no-cost evaluations.
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How much do braces cost?
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Because orthodontic issues and treatment options vary so widely, a specific figure is very difficult to give. Your specific issue may only require a special type of retainer or removable appliance, which would range from about $85 to $235. A First Phase or Partial treatment may range from approximately $115 to $2400, depending upon what the treatment goals are, and what further treatment is/is not needed. Perhaps you are a candidate for removable aligners like Invisalign, or Lingual braces that go behind your teeth. Those prices depend upon the length of treatment/number of aligners prescribed and if you are treating one or both arches. Comprehensive treatment with fixed appliances (braces) also ranges in cost depending upon if you are an adult or child, if you need extractions or not, if palatal expansion is recommended, or if you have a case that requires surgical coordination with an oral surgeon. Many of those orthodontic treatments mentioned may range from approximately $800 to $5200. Also keep in mind that these costs are specific to our office; treatment costs can also range depending upon the orthodontist and where that orthodontist practices.
Consultations are free and there is no obligation, so we encourage you to come in with your questions. You will learn about orthodontic treatment options specific to your case and you will receive a cost estimate if treatment is recommended for you or your child. We work with your insurance and flexible spending plan, and have payment plans available. Come see us - we look forward to answering your questions!
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How long do I have to wear braces?
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You might wear braces anywhere from a few months to a couple of years, depending upon your prescribed treatment. Some factors that determine the length of time include the severity of your specific orthodontic needs, how quickly your teeth naturally move, and your cooperation with good oral hygiene, attending your appointments, not breaking your appliances, and wearing elastics (if prescribed).
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What are my options as an Adult who wants braces?
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More and more adults are finding that they want the same great results that children and teens are getting from orthodontic treatment. We offer several esthetic options for people who would like their orthodontic appliances to be less noticeable or invisible, including clear brackets, Invisalign, and lingual braces (behind the teeth). Call for a free consultation and find out how easy it is to start your new smile!
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What kinds of braces do you have?
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A very popular question! In addition to our traditional metal braces, we offer gold and clear brackets. We also have "self-ligating" brackets, which produce less friction and may reduce treatment time. We also offer aligner systems such as Invisalign and lingual braces (behind the teeth) if appropriate for the type of treatment you need. Schedule a free consultation today to see what options are best suited for you!
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Do I need a referral?
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No. Although we work closely with area dentists, a referral is not necessary.
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At what age should you begin orthodontic treatment?
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The American Association of Orthodontists recommends that children should visit an orthodontist by age 7, or earlier if a problem is detected by parents, the family dentist or the child's physician. When children are examined at a young age, it is easier to intercept any developing issues. Sometimes an early phase of orthodontic treatment is warranted to correct certain "bite problems." The extraction of primary teeth early is also sometimes indicated to allow a permanent tooth enough space to erupt. The detection of potential problems at an earlier age may prevent more complicated or lengthy treatment down the road.
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expert: Dr. Eric R. Overby, DDS, MS
