Brace Face

May 2008

By: Dr. Scott R. Harden

There is no aspect of dentistry that has experienced a more drastic change than orthodontics – or as it commonly called, “braces”. Just one generation ago children had absolutely no desire to get braces put on their teeth whatsoever. They were fraught with the notion of being a social reject. Such names as “tinsel teeth, brace face, and railroad tracks” all signified the poor attitude children had about this aspect of dental care. Children would cry hysterically when it was time to enter the orthodontist’s office and plead with their parents not to take them. This may seem like a distant memory out of an old black and white movie, but it really was not that long ago.

So the question arises, what changes have taken place in the dental profession or more importantly in the mind of the public that has thwarted the evil “metal smile” connotation and transformed the process into the desirable status symbol it has become today? Even young children at age 7 want braces when they get older. What has significantly altered the perception of children living in today’s society that creates a literal yearning to get braces, especially atypical for the teenage population that will display unyielding resistance to any request from their parents?

An adult could reason that children and teenagers are simply intuitive enough to embrace the value of oral health and appreciate the benefits of straight teeth that function properly. This sounds like a stretch of the imagination. The true answer is probably multifold. Braces most likely act as a status symbol and give children a unique identity, no different than a trendy outfit or fashionable hairstyle. Children simply want to achieve an identity among their peers. Further, despite what adults often interpret as unflattering choices in our children’s appearance, children do want to look good in today’s society. Flashing a beautiful smile for teenagers is a major factor that adds confidence to a dynamic stage in their lives that is filled with peer pressure.

Today’s philosophy regarding orthodontics is more encompassing of children’s dental needs than ever before. Children that have significant developmental problems other than just crooked teeth, such as jaw discrepancies or seriously misaligned teeth (termed “crossbites”), can be treated with phase I interceptive orthodontics at an earlier age. When orthodontic treatment is required early, an orthodontist can utilize a child’s orthopedic growth, a time when their bones are still growing, and reroute incoming permanent teeth to assist with proper growth of the child’s jaw. Ideally, a child should be seen as early as age 7 for phase I orthodontic care, with the goal of getting in and out of treatment as quickly as possible utilizing appliances such as expanders to influence jaw growth in whatever direction needed.

Performing phase I therapy, in principle, may avoid the need for later orthodontics, cut down on the time of phase II orthodontics (typically age 11-12), or permit a more stable result following phase II orthodontics. Early treatment can regulate the width of the upper and lower dental arches, gain space for permanent teeth, avoid the need for permanent tooth extractions, reduce likelihood of impacted permanent teeth, correct thumb-sucking, and eliminate abnormal swallowing or speech problems. In other words, early orthodontic intervention can simplify later treatment during the teenage years.

Delaying orthodontic treatment should be an educated decision. Therefore, it is always best to have an orthodontic consultation and understand treatment issues. In some cases, delaying treatment may not make any significant difference. In other cases, however, timing is very important and postponing orthodontic treatment could very well create compromised results that may result in less stable tooth alignment, more involved treatment lasting years instead of months, or requirement for teeth extractions that could be avoided.

At the forefront of modern trends, orthodontics is performing a much more important role directly with restorative care such as crowns and implants. Communication is always at the backbone of success for combined care. At Fountain View Dentistry, we have combined the service of family dental care with an orthodontist integrated into our office to achieve this level of optimal care for patients. This is a trend in dentistry that you will see more of in the future. The benefits are obvious — optimal oral hygiene, especially with teenagers, restorative treatment following orthodontic alignment the teeth into ideal positions, and creating comprehensive planning for esthetic treatment such as a smile makeover. When a busy restorative dentist and orthodontist are in different offices, timing and communication on any of these issues is exponentially compounded and details are often never discussed.

Orthodontics is a great field of dentistry that permits children growing up today to enjoy straight teeth, a radiant smile, teeth that are easier to clean, all which improve function helping to prevent TMJ problems and severe wear on their teeth. In today’s society, braces are actually enjoyed by children and adults alike as a non-invasive, easy procedure which is relatively affordable and greatly improves the quality of your life.

Dr. Harden is a dentist at Fountain View Family Dentistry, Cosmetic Center & Spa. He is the Restorative Director for the Cherokee Study Club, and a national advisor for two dental research companies. He can be reached at (770) 926-0000.