What you need to know before your kid gets braces

Marlene Bruckner wasn’t surprised when she found out her 10-year-old son needed braces. By age seven, Nicholas already had a massive overbite, and his baby teeth were visibly crooked. But, worried about his age and the costs associated with the procedure, Bruckner wanted to wait until Nicholas was older to get him into an orthodontist’s chair. “His orthodontist said if I didn’t do this procedure by the time he was 16 years old, they would have to break his jaw to fix it,” says Bruckner.

The Canadian Association of Orthodontists reports that in 2012, approximately 450,000 Canadian kids saw an orthodontist. That’s up by 50,000 in 2004. But that doesn’t mean our teeth are worse off than they were a decade ago—we’re just more (self) conscious of them.“It used to be you only got braces if the teeth looked crazy,” explains Helene Grubisa, the past president of the Canadian Association of Orthodontists, in Oakville, Ont. “Now parents are more concerned about correcting their kids’ bite so they won’t need braces as adults.”

So what exactly do you need to know before going ahead with this lengthy procedure?

When to start Dentists sometimes refer kids to orthodontists. Although it may seem early, the Canadian Association of Orthodontists recommends all kids have an assessment appointment by age seven, since this is the age when problems can be identified and intercepted. The state of your kid’s teeth will determine their next visit.“The visit doesn’t mean there will be anything to do yet, but sometimes you want to start treatment a bit earlier,” Grubisa says.

However, orthodontists don’t always agree on whether early treatment is necessary. “It all comes down to different philosophies,” Grubisa explains. Get clarity by asking lots of questions. “If your orthodontist indicates treatment is needed as soon as possible, have them  explain why,” Grubisa suggests. “If, after that, you’re still unsure about whether the procedure is necessary, seek a second opinion.”

Who needs them “Fixing the way in which the teeth fit together is the main functional reason for braces,” says Grubisa. They can help correct overbites, underbites or crossbites, which can lead to wear and tear on teeth and gums or cause uneven jaw development. Braces can also address cosmetic problems, including teeth that are crowded or spaced too far apart, extra or missing teeth, and issues caused by bad habits such as thumb-sucking, tongue thrusting and the early loss of permanent teeth. Some of these issues, such as  tongue thrusting and thumb-sucking, push the upper teeth forward, creating an overbite.

“Very few cases are ones we have to treat for functional conditions such as an anterior crossbite,” says Sergio Weinberger, a London, Ont., paediatric dentist and orthodontic specialist. Teeth should generally meet when you bite—an anterior and posterior crossbite refers to some teeth remaining behind the upper or lower row when the mouth is closed.

At what cost? On average, braces are worn for 18 to 24 months. The cost depends mainly on the treatment’s complexity (the length and difficulty), the type of equipment required and where you live, but a safe estimate is between $5,000 and $8,000. Insurance plans often offer partial coverage, and some orthodontists work out payment plans with patients.

Remember, if you’re not clear about the treatment your orthodontist is proposing, ask, or get a second opinion. “Braces area big commitment,” says Grubisa. “You need to be comfortable with who’s treating your child.”

Expert tip
Did you know?: These days, tooth-coloured ceramic braces, coloured elastics and even clear braces are an option. Lighter, flexible and less cumbersome selections are also available. Ask your practitioner about the Invisalign clear plastic trays as another option. Say goodbye to the old days of heavy metal.

A version of this article appeared in our January 2016 issue with the headline, "Brace yourself," p. 49.

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