Guest blog by Specialist Orthodontist, Dr. Megan Hatfield at The Raglan Suite
We all watch our little ones carefully as they grow and that includes the way their teeth are developing. Whether or not their child will need a brace is one of the most common questions that parents put to dentists.
As a Specialist Orthodontist, I am trained to detect problems with facial bones and the position of teeth and advise of the best age to treat them. In some cases, problems are best treated early, when there is a mixture of baby and adult teeth. These might include a reverse bite (lower front teeth are in front of the upper ones) or the teeth not coming through in the right order. In other cases, it’s best to wait until most or all of the adult teeth are through (from age 10-13) for a more predictable result.
Some early signs that a child may need braces are:
· Early, late, or irregular loss of baby teeth
· Difficulty in chewing or biting
· Crowding, misplaced, or blocked-out teeth
· Biting the cheek or roof of the mouth
· Teeth that meet abnormally or not at all
· Jaws and teeth that are out of proportion to the rest of the face
A large proportion of orthodontic issues are genetic. However, some problems can develop due to:
· Thumb sucking
· Dental decay
· Dental trauma
· Poor nutrition
· Childhood illness
· Early loss of milk teeth
If a child visits their dentist regularly, they will be checked for teeth development and advised if an orthodontic assessment by a specialist is required.
There are three main reasons that braces might be needed to correct the position of a child’s teeth – dental function, dental health and aesthetic:
Function refers to the ability to use their mouth for eating and speaking. For example, if the teeth don’t meet (an open bite) or are overly prominent (an increased overjet), this will affect their dental function.
Teeth would need to be corrected if they could affect dental health, for example:
· Teeth that remain buried in the gum can damage the teeth either side or contribute to decay.
· A poor bite may cause tooth wear or damage the gums.
· Prominent teeth (teeth that stick outwards) are twice as likely to be damaged in childhood.
The vast majority of orthodontic treatment we do as specialist orthodontists is to correct the appearance or ‘look’ of the teeth.
Poor dental aesthetics has been shown in many studies to affect quality of life, so it shouldn’t be dismissed as vanity or unimportant. With the rise of smartphone photography, healthy straight teeth have become a key factor in increasing the confidence of teenagers. Thankfully wearing braces is no longer considered something to be embarrassed about, especially with today’s options to have less visible or even ‘invisible’ braces.
Assessment of need
In the U.K., these factors are assessed by an orthodontist using ‘IOTN’ – or the Index of Orthodontic Treatment Need. Dental function and health is scored out of 5 and aesthetics is scored out of 10. The higher the value indicates a higher need.
Since 2006, the NHS has used this scoring system to limit orthodontic treatment to those children with the most need – that is a function/health score of 4 or 5 (or 3 if the aesthetics score is 6 or over). If a child has been declined orthodontic treatment on the NHS, it is because the IOTN score is too low. Typically these children will have slightly crooked or unevenly spaced teeth and can be treated privately as long as the orthodontist feels the teeth will be improved.
As a Specialist Orthodontist, I like to see children enjoying a happy, straight smile and can assess children of any age and advise of IOTN, with or without a referral from their dentist. If braces are recommended, I will also advise on the best timing of orthodontic treatment.
As The Raglan Suite is an independent practice, there’s no waiting list for either the assessment or treatment. We also offer a full range of options that are not available on the NHS, such as Invisalign® (invisible braces) or gradually staging treatment for nervous patients.
Dr. Megan Hatfield has won numerous UK awards for her orthodontic work and was voted the prestigious title of ‘Aesthetic Dentist of the Year’ at the 2014 UK Smile Awards. To book an orthodontic assessment with Megan call The Raglan Suite on 01423 565432 or send an enquiry through the website.