Orthodontics and Space Maintenance

How will I know if my child’s teeth and jaws are growing normally?

During your child’s cleaning and examination visits in our Winston-Salem and Kernersville offices, we will always evaluate your child’s growth and development.  We will continually monitor baby tooth exfoliation, permanent tooth eruption, and jaw/bite growth.  If your child is having any issues with his or her development, such as a crossbite or dental crowding, we will inform you and recommend an orthodontic consultation.

Will my child need orthodontics or braces?

Your child’s pediatric dentist will let you know if and when it is appropriate to visit an orthodontist.  For most children, orthodontics or braces are optional, meaning braces are only needed if your child wants straighter teeth.  For some children, orthodontics are strongly recommended to allow your child to bite normally.  If your child is having issues with his/her bite, we will let you know and make a referral to a local orthodontist when your child is developmentally ready. 

Braces vs. Invisalign

If you and your child choose to have orthodontic treatment, you will probably have to decide between traditional metal braces and Invisalign.  Each option has its own advantages.  Your child’s orthodontist can help you choose the best option for your family

Traditional Metal Braces

Traditional metal braces have been used by orthodontics for decades and are proven to have beautiful, long-lasting results.  Because traditional metal braces are permanently cemented to your child’s teeth, they have the advantage of moving the teeth efficiently, which can make treatment more predictable.  The main disadvantage of metal braces is they are more difficult to clean around, putting your child at an increased risk of cavities or white spot lesions.

Invisalign or Clear Aligners

Invisalign has become increasingly more popular and can now correct almost any jaw or bite issue.  Invisalign has the advantage of being clear and being able to be removed, so your child can easily brush and floss like normal.  The main disadvantage of Invisalign is that it must be worn 22 hours per day in order to correct tooth alignment efficiently, so your child must wear the aligners at all times, with the exception of when he/she is eating.

Is there anything I can do to help my child’s teeth and jaw development?

Some children will require a little “extra help” to ensure their jaws and teeth will develop optimally.  These interventions can include space maintainers, removal of over-retained baby teeth, crossbite correction, early orthodontics, and habit cessation (such as thumb sucking and pacifier use).

Space Maintainers

Space maintainers are permanently cemented orthodontic appliances that help keep space in your child’s mouth for the permanent teeth.  They are removed once the necessary permanent teeth have come into the mouth. If your child has lost a baby tooth early, a space maintainer may be recommended to keep the space for the permanent tooth replacement.  Additionally, space maintainers can be used to prevent back teeth from shifting forward, which can help alleviate crowding and potentially avoid braces. 


Removal of Over-Retained Baby Teeth

Occasionally, baby teeth will not fall out on its own.  This can be caused by multiple reasons including tooth crowding or the permanent tooth not erupting in the correct location.  If a baby tooth is over-retained and is not going to fall out on its own, the pediatric dentist will recommend gentle in-office removal.  This procedure will help protect the permanent tooth and enable it to erupt into the appropriate location.

Tooth Crossbites

In an ideal bite, the top teeth will come outside the bottom teeth when biting.  In a crossbite, the bottom teeth will come outside of the top teeth when biting.    If the crossbite involves the front teeth, it is called an anterior crossbite.  If the crossbite involves the back teeth, it is called a posterior crossbite.

Anterior Crossbite Correction

If your child has an anterior crossbite, the pediatric dentist will point it out at the cleaning and examination visit and discuss treatment options.  Anterior crossbites are important to correct as they can cause gum recession, tooth chipping, and restrict jaw growth.  If your child’s anterior crossbite involves only baby teeth, we will monitor it until the permanent teeth erupt.  Some primary tooth anterior crossbites can self-correct with the permanent teeth erupting into the appropriate biting relationship.  If your child’s anterior crossbite involves permanent teeth, we will discuss different orthodontic treatment options.

Posterior Crossbite Correction

If your child has a posterior crossbite, the pediatric dentist will point it out at the cleaning and examination visit and discuss treatment options.  Posterior crossbites are important to correct as they indicate that the top jaw is undersized and affect jaw growth.  If your child has a posterior crossbite, we will wait until enough permanent teeth are in and then discuss different orthodontic treatment options. 

Early Orthodontics

Many of our parents want to know if and when their child will need braces.  For most, the answer is we will decide when all of the permanent teeth are in, which is typically around age 13 years old.  Some children with bite issues or severe crowding could benefit from early orthodontics.  If your child could benefit from early orthodontics while some of their baby teeth are still present, we will outline the possible treatment options. 

Habit Cessation

Does your child use a pacifier or suck his or her fingers? 

Did you know that these habits over a prolonged period of time can negatively affect your child’s bite?

If your child has an oral habit, such as a pacifier use, thumb sucking, or finger sucking, our office will discuss the importance of early cessation.  We recommend encouraging your child to quit by 36 months, though it is often easier to cease the habit if it is addressed sooner.  Our team is happy to discuss different cessation strategies such as a 30-day reward calendar, thumb guards, and mavala stop nail polish.  When your child fully gives up their oral habit, we will have a special prize ready for him/her to celebrate!