The American Association of Orthodontists recommends that all children receive a checkup by the age of 7. This might seem early, especially since many people still imagine braces as a teenage phenomenon. However, not only has orthodontic treatment spanned across generations in recent decades, but early interventions can have a significant impact on later treatments.
Even if your child appears to be developing teeth normally, some problems could exist that only an orthodontist can detect. Early detection can be the key to avoiding aggressive orthodontic treatment later, shortening the time your child spends in braces as a teen or correcting jaw development before it’s too late. Once the jaw finishes growing, some results that could be achieved easily during childhood may require surgery.
Some dental problems commonly observed in children that your dentist or orthodontist might be looking for include tooth decay, early predictors of jaw misalignment, and abnormal tooth development.
Cavities are the results of tooth decay, which affects nearly 20% of children between the ages of 5 and 11. According to the Center for Disease Control, 13% of children between the ages of 12 and 19 have at least one untreated cavity.
Tooth decay occurs as a result of plaque and bacteria buildup in the mouth, which erodes surfaces of the teeth. Tooth decay is preventable, but maintaining proper oral hygiene can be a challenge with children. It is important to model good brushing and flossing habits from an early age. Brushing with fluoride toothpaste and using a fluoride rinse also can help prevent tooth decay.
Your child’s dentist will look for signs of tooth decay at regular checkups. However, consult your dentist sooner if you notice any of the following signs of tooth decay in between appointments:
- A dull white band on the tooth surface close to the gumline (early indicator of tooth decay)
- A yellow or brown band on the tooth surface close to the gumline (indicates moderate tooth decay)
- An overall brownish or blackish tint to the teeth (indicates advanced decay)
Your child’s diet also can contribute to risks for tooth decay. Food and drinks with high sugar contents are bad for the teeth, so you should limit your child’s consumption of these and always follow meals and snacks with brushing or rinsing the mouth.
Bottle Tooth Decay
A specific type of decay, known as baby bottle tooth decay, occurs when a baby’s teeth are in frequent contact with sugars in drinks, including breastmilk. Resulting decay can be painful and can possibly lead to infection, which may cause the infant to delay eating solid foods.
A number of simple habits can prevent bottle tooth decay, such as wiping your baby’s teeth and gums with a wet cloth or gauze after feeding, avoiding putting your baby to bed with a bottle, and encouraging the use of a cup rather than a bottle by the end of the first year.
Thumb and Lip Sucking
Sucking on the thumb, other fingers, pacifiers and toys is a normal habit for infants and very young children. However, if this habit persists once your child’s permanent teeth begin to grow in (typically around age 5), it can have implications for future dental and orthodontic health.
Persistent thumb sucking can push the top front teeth out of alignment, resulting in an overbite where the top teeth protrude over the bottom teeth instead of overlapping into a normal bite. An overbite can cause pain, difficulties with speech sounds, and difficulty chewing food. In addition, the misalignment between the upper and lower jaws can lead to malformation of the roof of the mouth. Front-bottom teeth that are tipped backward also can result from the child resting his thumb against the lower jaw.
One way to prevent excessive thumb sucking is to reward your child for enduring increasingly longer periods of time without sucking on fingers or objects. If problems persist, your orthodontist can provide an appliance that your child can wear in the mouth to prevent sucking.
A similar issue known as lip sucking is another habit to watch out for. Lip sucking occurs when the child repeatedly holds the bottom lip between the front teeth. Oftentimes this can be caused by something as simple as chapped lips, but if left uncorrected it can also create bite misalignments.
Tongue thrusting is the habit of pushing the tongue forcefully between the upper and lower teeth when swallowing or when the mouth is at rest. Because tongue thrusting exerts pressure against the back of the teeth, it can push them out of alignment.
Like thumb sucking, tongue thrusting has the potential to cause an overbite or an open bite, which is a condition that occurs when the upper and lower teeth do not meet when the mouth is fully closed. If an open bite is present, your orthodontist can create an oral appliance that realigns the jaw and prevents further tongue thrusting. The orthodontist will place the appliance in the upper arch and palate. Like thumb or lip sucking, tongue thrusting is important to correct in childhood while the jaw is still malleable and can be corrected without surgery.
Depending on the severity of your child’s thrusting habit, she may also need to work with a physical therapist to learn new movements of the tongue. If the habit already is exhibiting noticeable effects on language development, it may be necessary to work with a speech pathologist.
Premature Tooth Loss or Delayed Tooth Loss
It is rare for baby teeth to fall out prematurely on their own, but premature loss due to accidents is not all that uncommon for a child to experience. Because primary teeth are only designed to last a few years (before permanent teeth begin growing in around the age of 5 or 6), they lack the sophisticated root structures of permanent teeth and are far more easily knocked out due to injury.
It might be tempting to ignore a prematurely lost tooth. After all, new ones will grow in soon. However, losing a baby tooth too early can cause dental complications, as it can allow surrounding teeth to shift out of position if no preventative measures occur. This can create misalignments that may need to be corrected later through orthodontic treatment.
If your child’s tooth falls out early without an accident clearly causing it, there could be underlying dental issues, including decay or problems with jaw development, that a dental professional needs to address. A fixed bridge or dental implant can replace the lost tooth in order to keep appropriate spacing and ensure that surrounding permanent teeth grow into their correct positions.
Over-retained primary teeth also can pose a problem for your child’s dental health. The most common reason for lingering primary teeth is the absence of a permanent tooth to replace it. There also is a chance that the primary tooth could be fused to the jaw bone. Your child’s dentist will need to take X-rays to diagnose the cause and possibly extract the primary tooth.
You may assume that your child doesn’t need orthodontic care until the teenage years, but scheduling a routine consultation with a board-certified orthodontist by age seven means that we can catch any issues early and ensure that your child has a smile she’s proud of for a long time.