Braces (Orthodontics)

Once orthodontic treatment with braces is completed, either after Phase I or Phase II, your child will have retainers that they will wear to help prevent the permanent teeth from shifting. These are included in the cost of the braces. Please keep in mind that with or without prior braces treatment, all teeth shift with age and time. To minimize any shifting, we place retainers. Some retainers are glued to the permanent teeth and do not come out of the mouth. Other retainers are custom made clear aligners that fit over the teeth and can be removed from the mouth. These are typically done for a completed Phase II case where all the permanent teeth had braces. Sometimes, we recommend a combination of both type of retainers. Dr. Nathan will advise you on the type your child may need. We will also advise you on how and when to properly wear these retainers. As all teeth shift with age, your child will be expected to wear their retainers as long as they want their teeth to be straight, which could be their entire lifetime. Each person and each case is unique, so shifting varies tremendously from person to person.

One unique aspect of our clear aligner retainers is that they can also double as bleaching trays, should your child ever want to whiten their teeth. If you were to go to a dentist and wanted to purchase bleaching trays by themselves, you would be charged anywhere from $300-$500. Because your child would already have the clear aligner retainers, you would only have to purchase the bleach from us (around $60) to then be able to professionally whiten your child’s teeth at home for the rest of their life.

These appliances help correct “cross-bites.” Cross-bites occur when some of the lower teeth edges are outside of the upper teeth edges. This can happen in the front of the mouth or the back of the mouth. This can be result of the upper and lower jaws being misaligned or just the teeth being out position. Typically, we only correct this if it involves the permanent teeth. A cross-bite with the baby teeth may correct itself as the permanent teeth come into the mouth. Each case can be different. This condition can cause unhealthy wear patterns or fractures of the teeth, which could lead to gum disease and bone loss. We try to correct cross-bites around ages 6-10, before this leads to more complicated problems. These appliances are made of stainless steel. They are typically cemented to the back teeth, with a spring that pushes the problematic teeth into their normal position. They do not come in and out of the mouth. It usually takes 2-6 months of wearing the appliance to correct these cross-bites. Dr. Nathan will discuss the treatment in depth as needed.

Many children develop the habit of sucking their fingers or thumbs at an early age. Although not a real problem at first, if this habit continues past age 3-4, then it could cause the top front teeth to stick outward and the bottom lower teeth to lean backward. This could then result in a child having an open-bite, where their front teeth do not come together. Open-bites are one of the toughest bite problems to correct with orthodontics and are very prone to re-occurring once corrected. Therefore, it is very important to address and hopefully stop a finger or thumb sucking habit at an early age. We typically like to have this habit stopped by ages 3-5.

Some children have a very hard time stopping this habit, as they do it as a means to comfort or soothe themselves. There could be other family or social issues going on that may not make it an ideal time to stop. This could include a new sibling, a new house, a change in the family, or a new school, to name a few. Each child is different and has to be treated on an individual basis. Dr. Nathan can discuss with you the different options to try before resorting to an appliance. However, if all the other options have been tried and the child continues the habit, then an appliance to help the child stop could be indicated. This would be especially true if they are still doing the habit and have permanent teeth, as it could cause the upper and lower jaws to grow in an unfavorable direction.

These appliances can also be useful in children that have a tongue thrust or tongue swallowing concern. If a child has an open bite, then they automatically push their tongue forward into this open area to create a seal to swallow. Thumb/finger sucking appliances help stop a thumb or finger habit and/or help re-train an improper tongue position or swallowing pattern. It could be necessary to place the appliance to minimize the harm and distortion these habits or tongue position can have on the teeth and the jaws. These appliances are cemented to the back permanent or baby molars and have a wire that runs behind the front upper teeth. There are loops on the wire that prevent a child from being able to stick their tongue forward and prevent being able to stick their fingers or thumb into their mouth. They can’t close on their fingers or thumb to make the sucking sensation that they like. This appliance does not come in and out of the mouth and is generally left in position for at least one year, to ensure that the habit is totally gone. If the teeth/jaws are out of their normal position and if the habit is corrected at a young age (before all the front permanent teeth come in), then we usually see a spontaneous correction of the bite and teeth position. Of course, each case can be different, and treatment outcomes can vary. The main goal is to stop the habit. The child may or may not need additional orthodontic (braces) treatment in the future.