Early Orthodontics: Less Treatment Later?

While there are certain habits or issues that can lead to misaligned teeth or jaws, genetics plays a key role in whether a child will require braces. If a biological family member had braces, the likelihood that the child will require braces increases.

Besides genetics, misaligned teeth or jaw variations can also be caused by:
  • thumb sucking
  • pacifier use
  • mouth breathing
  • tongue posture
  • the loss of baby teeth too soon
  • mouth injuries

When Should a Child See an Orthodontist for the First Time?

The AAO recommends that children see an orthodontist at the age of 7 because it is at this age that issues related to overcrowding and an uneven bite become apparent. Therefore, once a child reaches the age of 7, parents should ask the dentist if he or she would recommend a visit to an orthodontist.

Reasons for braces:

  • overcrowded teeth
  • a crossbite
  • an overbite
  • crooked teeth
  • gaps between teeth
  • an underbite
  • overlapping teeth

Interceptive/Intervention Orthodontics: Recognizing Jaw Problems

By consulting with an orthodontist while the child is still very young, issues related to bite and jaw growth can be detected while the jaws and dental arches are still growing. Visiting the orthodontist early-on does not necessarily mean the child will receive braces at that time, it allows the orthodontist to evaluate the child’s teeth and determine the best time to start treatment.

Phase I: Interceptive

Phase I orthodontic treatment refers to intercepting early to address a moderate to severe orthodontic problem. Without early intervention, dental surgery or an extraction of teeth may be required. To achieve ideal results, children may require a second phase of treatment.  Not all children need a Phase I or early phase of treatment; however, some may benefit greatly by addressing problems such as crowding or crossbites at an earlier age to ensure proper development.

Phase II: Comprehensive

The average age to do comprehensive orthodontics is around 12 or 13 but depends on each child’s specific growth pattern and orthodontic needs.  Dr. Laster will give you a projected timeline at your initial evaluation.

What to Expect at the Initial Orthodontist Evaluation

The child’s teeth, jaw and mouth will be examined. During this first examination, the child may be asked to bite his or her teeth together. Dr. Laster will also want to know if the child has any issues related to chewing and swallowing as well as if the child has ever noticed a popping or clicking in the jaw. X-rays may be taken to determine the position of the teeth and which permanent teeth have yet to erupt.

Photographs will be taken of the child’s teeth and we will look at those together and discuss our observations.  Often times we will discuss various options for treatment timing and the pros and cons of various treatment modalities.  Dr. Laster can then recommend what he believes will be the most successful treatment plan based on similar cases and his many years of creating beautiful smiles and proper bites.

 Is Orthodontic Treatment Painful?

Technological advancements in the field of orthodontics have greatly improved the experiences associated with having braces. As expected, directly following placement or after an adjustment, the teeth and gums will be tender. However, over-the-counter medications can relieve this symptom.  Generally for the first 2-3 days following beginning orthodontic treatment we recommend soft foods and ibuprofen and acetaminophen as needed.

Functional Appliances Designed for Improving the Jaws and Dental Arches

It is a given that braces create beautiful smiles, but they do much more than that: Good orthodontic care contributes to an individual’s oral health. Properly aligned jaws and straight teeth can make chewing food easier and even prevent snoring.  They also will save you from premature wear of the teeth, and reduce the amount of dental work you will need during your lifetime based on the teeth contacting properly.

Functional Devices:

  • A Removable Expander – used when the amount of expansion necessary is minimal. These expanders are usually made of chrome and resemble a partial. Most of the time, a removable expander is recommended for adults; however, an orthodontic retainer may be used to maintain space following treatment until all of the child’s permanent teeth have broken through the gum line.
  • Mara – this fixed appliance consists of hook-like devices and metal caps. As an individual takes a bite, the small hooks move the lower jaw forward to correct an overbite.
  • Palatal Expander (Rapid Palatal Expander) – is an appliance designed to help the upper and lower teeth fit together better by widening the upper jaw.
  • Thumb Crib – this device addresses the issues resulting from a severe thumb- and/or finger-sucking habit. A fixed wire crib is attached to two back braces.
  • Transpalatal Bar – this fixed appliance attaches to bands on upper molars located on either side of the jaw. The bar fits into soldered clips located on each band; thus, stretching across the roof of the mouth.
  • Biteplate – a removable appliance that resembles a retainer. An orthodontist uses this device to correct a crossbite or a deep bite.
  • Twin Blocks – these appliances are used to correct misalignments in the jaw that cause the child’s top teeth to protrude farther out in front of the lower teeth than normal. Twin blocks consist of a plate on the lower and a plate on the upper, which work in conjunction with one another to bring the child’s lower jaw into the correct position. Once the lower jaw is corrected, orthodontic treatment to straighten the teeth is implemented. Twin blocks offer the best results when fitted while the child’s bones are still growing.
  • Nance Button– this appliance holds specific teeth in position, allowing other teeth to move. When the button is placed on the lower palate, force is created on the back molars.
  • Lingual Arch (Upper and Lower) – this orthodontic device is used to connect two molars together; however, the connected molars must be located on the same dental arch.


Braces are able to correct problems with alignment by placing a steady pressure on the teeth. This continuous pressure eventually moves the teeth into the desired position. On average, kids just need the traditional braces that have brackets, wires and rubber bands. Today, the rubber bands are available in fun colors, allowing each child to customize his or her look.

Although traditional metal braces are still commonly used, there are a variety of other options available:

  • White Ceramic Braces – these braces are much less noticeable.
  • Clear Braces – these braces are nearly invisible.
  • Clear Aligners – this method for straightening teeth uses removable, clear plastic trays, as opposed to rubber bands and wires, to move the teeth.  Invisalign is a brand of clear aligners
  • Lingual Braces – braces are placed behind the teeth.

Parts of Traditional Braces:

  • Arch Wire – these wires consist of metal and are specifically designed to fit explicitly into the brackets used for braces. It is the adjustments to the arch wire that exerts the pressure on the teeth. The wire is changed frequently during treatment to a heavier wire that is designed to exert greater movement of the teeth.
  • Brackets – these are small, square-shaped pieces that are available in a variety of compositions, including ceramic and metal. Some brackets have hooks for which to attach rubber bands.
  • Power Chain – these are rings that consist of wire or elastic. They are linked together, forming a continuous band between the teeth. Power chains are usually used to prevent spaces from developing or to address narrow spaces that already exist between the teeth. Power chains are replaced during each adjustment.
  • Orthodontic Bands – these rings fit around the molars and are custom-designed on-site by the orthodontist. Bands usually have metal attachments for the arch wires to pass through. While traditional bands consist of stainless steel, less conspicuous materials are being used to create bands; thus, offering patients who are interested in ceramic and clear braces a variety of transparency levels from which to choose. Bands are affixed to the teeth using dental cement.
  • Elastics (Rubber Bands) – these are removable and they are attached via the hooks on the upper and lower brackets. The interarch rubber bands apply continuous pressure on the upper and lower jaw, gradually influencing their movement toward the proper bite.
  • Coil Springs – these may be positioned between the brackets of two teeth when the teeth are too close together. The spring is placed over the arch wire, exerting pressure that opens up the space and separates the teeth.
  • Ligatures – these are the extremely small elastic bands (or wires) that attach the brackets and arch wire together. Ligatures may be silver, clear or a variety of fun colors. These are replaced whenever an adjustment is made.

Additional Orthodontic Appliances

Some children require additional devices. Furthermore, there are cases when overcrowding of teeth requires removal of a tooth (or several teeth) to create the space necessary for permanent teeth to erupt.

Additional Devices:

  • Headgear – this horseshoe-shaped wire provides stronger force to move the teeth. This device is typically only worn at night.
  • Forsus – this appliance is affixed to the teeth. It is designed to move the lower jaw forward when the mouth is closed; thus, retraining the jaw to correct the bite.
  • Lip Bumper – used to create the space needed to accommodate a child’s adult teeth and avoid extraction. This removable appliance uses the natural forces of the child’s muscles that surround the lower teeth to lengthen and widen the dental arch. Keeping lip pressure from the front teeth on the lower jaw allows the tongue to slowly move them forward; thus, aligning the crooked teeth. The consistent pressure of the lip bumper against the lower lip gently moves the molars backward, which gradually stretches the dental arch and makes room for the erupting permanent teeth.
  • Removable Retainer – this appliance is designed to keep the corrected teeth in the proper position once the braces have been removed. This appliance attaches to the upper and/or lower teeth. Initially, the patient wears the retainer continuously; however, eventually, the removable retainer will only be worn at night.Fixed Retainer – this type of retainer is frequently used following orthodontic care. A fixed retainer consists of a metal wire that is affixed to the backside of the teeth. These retainers are permanent.

Length of Treatment

After orthodontic care has begun and the braces are placed, the child will visit the orthodontist on a regular basis for monitoring and adjustments. These visits usually take place every 6 or 8 weeks. The length of time a child needs to wear braces depends on the issues being addressed; however, on average, most children wear braces for approximately 2 years.  Because of Dr. Laster’s commitment to using the newest technologies, many of our patients achieve their perfect smile and bite in less than two years.

Insurance Coverage for Orthodontic Care

Most dental insurance plans will cover a portion of the costs associated with orthodontic care, including braces. Please contact your insurance company to inquire about your coverage.

At Laster Orthodontics, we help families develop healthy, life-changing smiles using customized treatments, cutting-edge technologies, and caring relationships. Our individualized treatment plans help our patients achieve their perfect smile in the quickest, most painless way possible by utilizing a wide range of options from traditional braces to Propel accelerated treatment to Dr. Laster’s in-house aligner program, Laster Perfect Smile. With three locations throughout the Triangle Area, we create life-changing smiles every day.