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Kids and Health Care: With Teeth, Patience is Key

Another important thing to remember, when it comes to dental care: Picking a good orthodontist can be as hard -- if not harder -- than picking a good pediatrician. There are many opposing treatment theories among orthodontists, and you'll want to have the doctor who can best handle the oral problems your child has...if he or she has them at all.

Some parents get caught up in the fact that, during the 1990s and 2000s, orthodontists have encouraged serious dental work on younger and younger children. Through the 1980s, most children weren't even considered for braces and other corrective measures until they were in their teens. Twenty years later, kids as young as 7 or 8 had them.

Driving the trend are orthodontists who say that starting treatment earlier can prevent more complicated problems. Others, however, recommend delaying or withholding care until most, if not all, of the permanent teeth are in place.

Some experts suspect the trend of earlier orthodontia is driven, in part, by financial gain. Starting early is a good way to lock patients in -- and doctors who elect to postpone treatment may lose patients to more aggressive colleagues who suggest doing something dramatic sooner.

But sometimes it's the parents who push for the early braces. Around age 7 or 8, children go through what dentists often call the "ugly-duckling" stage of dental development. Not all of the permanent teeth have come in yet -- and those that have come in are often crooked. Driven by the child's awkward appearance, and fearful of future problems, some parents become impatient.

Orthodontists who advocate early intervention believe that treatment can influence development of the dental arch and prevent more serious problems when the permanent teeth come in. For example: In a child whose teeth are misaligned because they're too crowded, an "expander" can create space and prevent more severe crowding; or, for a child with an overbite, a headgear can slow the outward growth of the upper jaw.

These types of early interventions can sometimes eliminate the need for later orthodontic treatment but, in most cases, a second, brief phase of treatment is required.

Opponents of early intervention argue that it's being over-utilized -- suggesting that some children are receiving unnecessary treatment. Some problems will correct themselves if left alone. For example: A space between the two front teeth may close after the surrounding teeth fall out and larger permanent ones grow in; or crooked teeth might straighten as the mouth grows, increasing in width.

The choice to have your child treated early or later is a personal one. The challenge is to find an orthodontist you can trust to give you good and truthful advice. You will have to rely on that person to tell you what's necessary and what's not.

Don't take a passive attitude when it comes to your kids' orthodontist. Make sure you understand exactly what's going on and why, and that your kids' orthodontist explains everything in simple terms to both you and your kids. In other words, educate yourself as to the treatment plan and goals...every step of the way. When in doubt, get second opinions.

There are plenty of unscrupulous orthodontists who will treat children for years and years...and by the time they reach early adulthood their teeth don't look any better, and they have to start back at square one with a new orthodontist. Don't let this happen to your kid.

To this end, choose an orthodontist as carefully as you would a pediatrician.

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