When your preteen needs braces

Your child may be referred to an orthodontist even before she's lost her baby teeth. Here's what to expect.

Photo: Cat Gwynn/Corbis

The news that Simone DeSilva, at age 10, needed braces to fix a fairly significant overbite came as a shock to the Stouffville, Ont., youngster. “She cried in the dentist’s chair and asked if she had done something wrong,” recalls her mother, Amy DeSilva. “We assured her it wasn’t her fault; it’s just the way she’s built.”

If grade four sounds earlier than you remember kids having braces when you were growing up, you’re right. Children with an improper bite (called a malocclusion) are now being identified at younger ages and, in some cases, are treated before all their adult teeth come in. According to the Canadian Dental Association, this technique of “interceptive” orthodontics works with growing teeth to stop and correct problems as they develop.

A bad bite, often caused by crooked or crowded teeth (and, yes, thumb or finger sucking can also play a role), is not just a cosmetic concern; it can wear teeth down and create jaw tension and headaches. We all want our kids to have brilliant smiles and, of course, avoid pain, but braces are an expensive proposition: typically $5,000 to $8,000, depending on the clinic you choose and the work required. Other possible treatments include headgear, palate expanders, retainers, lip bumpers, elastic bands and oral surgery. Unfortunately, none of these services are covered by provincial health plans, and private insurance usually only pays for about half the cost. So, before you decide to grin and bear it (your poor pocketbook!), here are a few things to consider:

Be realistic about upkeep It’s not easy to clean teeth with braces — kids need to brush and floss in a special way or the tooth enamel may become permanently discoloured. If your child isn’t mature enough to take responsibility for the cleaning, it may be best to wait. That’s what DeSilva did, preferring to delay a year until Simone was 11.

Mira Pilch, a Toronto mother of two kids with braces — Jonah, 13, and Olivia, 11 — agrees. “At this age, you can’t brush their teeth for them. So you’ve got to decide how much of a drill sergeant you want to be.” Also, keep in mind that someone (probably you) will have to take time out to attend monthly appointments.

Beware of bells and whistles On the referral from her dentist, DeSilva took Simone to what she describes as the “Cadillac” of orthodontic clinics, complete with neon lighting, video games and fun events such as movie days. This type of high-end service comes with a matching price tag, in this case $7,000, compared to the $5,500 at the clinic DeSilva eventually chose instead.

Maximize your insurance Always consult your health-benefit provider before committing to any treatment. Without a predetermination of the cost and your eligibility, your claim could be denied. Also, you might have separate coverage for X-rays or tooth extractions if they are performed outside of the orthodontic clinic. If so, get your family dentist to perform these services.

Don’t feel pressured In some circles, your child may stand out if he or she doesn’t have some kind of orthodontia. “At my kids’ school, having braces is completely normal,” says Pilch. “Their friends were all doing it and they weren’t made fun of or anything.” While this can be a blessing, it may also make some parents feel neglectful if they don’t shell out for braces. If you can’t afford treatment right away, remember that teeth can be moved at any age, even in adulthood. Discuss a time frame and payment options with the orthodontist, then plan how much you need to save.

A version of this article appeared in our March 2013 issue with the headline “Metal mouth,” p. 86.

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