Ah, the braces years. For many parents, it conjures flashbacks to their own childhood experiences with a mouth-full of metal (for me, it lasted 30 months!) – not to mention the toll it takes on their wallets. Thankfully, orthodontia has come a long way over the years. And with better techniques, your kids’ time in braces and trips to the orthodontist will likely be much easier and shorter than they’ve been in the past.
But before your son or daughter gets fitted with a new silver smile, here are some common questions and answers to all things braces and kids orthodontics.
When to start looking
When do kids need braces? Seven years old – at the latest. Don’t worry: Just because your child is going to see the orthodontist doesn’t mean he’s going to have braces put on that day – or even that year. According to the American Association of Orthodontists, or AAO, these initial visits are to evaluate any potential problems with your child’s teeth.
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But these first visits are generally to track his teeth’s progress – not to automatically recommend braces. In fact, the AAO points out that this “initial check-up may reveal that your child’s bite is fine.” And most orthodontists don’t charge for these evaluation exams.
You may want to approach your child’s dentist about orthodontic care if she hasn’t already brought it up and your child is nearing or past the age of 7. But don’t be surprised if your child is the one to broach the topic with questions about friends who he’s noticed getting braces – or even with concerns about his teeth sticking out or having gaps.
Do younger kids need braces?
“Most of the time when the teeth are coming in, it’s a good time to evaluate for cross bites, overbites, crowded teeth and other conditions,” explains Michael B. Rogers, DDS, an orthodontist and 2011-12 president of the AAO. These conditions (called malocclusions, or a misalignment of the teeth) may be easier to fix with a few adjustments when the child is still in her early years.
Dr. Rogers gives overcrowding as an example: Baby teeth that are too close together can make it harder for your child to keep the teeth clean and may even give her a crooked bite. Through a careful evaluation and X-rays, your child’s orthodontist can make recommendations for her treatment. Maybe she needs to have some baby teeth pulled to make room for adult teeth. Maybe some teeth need to be pulled and she needs braces sooner to guide developing teeth to come in straight to make more room for other teeth.
Dr. Rogers points out another reason younger children may even request a visit – their appearance. “There may be psychological reasons children want to have braces, they might be teased about their teeth for various reasons.”
Finding an orthodontist
Keep in mind that your child will be making frequent visits to the orthodontist while she’s in braces. Most of these visits will be relatively painless, but they can become tedious. Plus, your child will need to follow the orthodontist’s directions. In other words, you’re not just choosing an orthodontist based on her credentials, but also how well her personality meshes with your child’s.
Do more than just a Google search for “orthodontists near me.” Your child’s dentist is the first person to ask for recommendations. Dr. Rogers says that most of his patients come from dentist referrals. Your child’s pediatrician may have suggestions, too. You might also ask friends in the neighborhood if they have someone they’ve worked with and liked.
Once you’ve narrowed your list of potential orthodontists, you should plan on visiting a few with your child. These visits, which will take about an hour and include a thorough evaluation, will give you and your child a sense of the different orthodontists, their approach to care – and also their charges.
The first visit
When you call to schedule your initial orthodontist visit, the receptionist may ask you to either bring your child’s recent dental X-rays with you or may ask to call your child’s dentist directly for those records. Your orthodontist and your child’s dentist will be working together to ensure your child’s healthy smile, so it’s important to figure out if they get along, too.
At the first visit, the orthodontist may take additional X-ray images of your child’s teeth. He may also take pictures of your child smiling straight on and a profile to keep on file. Looking at the teeth one by one, he may record information about your child’s teeth, so that he can follow their development closely.
After this evaluation, the orthodontist will make a recommendation for your child’s treatment. Who knows? Maybe he’ll say your child doesn’t even need braces.
Once you’ve talked about your child’s treatment, the final discussion during this first visit is likely to be about costs. The office manager may be the one to guide you through this conversation. How much do braces cost? Dr. Rogers explains that these costs will vary from orthodontist to orthodontist for a variety of reasons, including the complexity of your child’s treatment, so he didn’t want to give exact figures. In general, however, $3,000 would be a low figure for a simple case, says Dr. Rogers, while braces can run up to $10,000 for complex cases (this would be the high end) and/or for specialized ‘clear liner’ braces (one familiar company is Invisalign).
While some health insurance providers do cover part of the cost of braces, others don’t. For parents in that situation, Dr. Rogers says there are a variety of payment plans offered by orthodontists. Sometimes the costs can be divided up over the course of your child’s care, or even beyond. In other words, you don’t have to pay for treatment all at once.
Whether your child has just had his first dentist visit or she’s starting to doubt the Tooth Fairy, planning for braces doesn’t have to be a headache. And if it helps, the time kids spend in braces appears to be shrinking. A recent AAO report showed the average length of orthodontic treatment as 22 months. That’s two years and one month less than the average length of treatment in 2008.
Maybe by the time your son or daughter is fitted for braces the treatment length will have gone down even more.
This article was originally reported in October 2012 and has been updated.