Pediatric Orthodontics

Pediatric Orthodontics

Most of the orthodontic problems occur due to early loss of teeth caused by caries formation in milk teeth. Early extraction of milk teeth will cause the space which is necessary for permanent teeth to be lost and therefore erupting permanent teeth will not find space in mouth. In some cases, even when there is no crowding in milk teeth, hereditary skeletal and dental problems may occur during eruption of the permanent teeth. Bad habits such as thumb sucking and pacifies use play a role in formation of skeletal disorders. Quitting these habits early will prevent these disorders from progressing, and sometimes it may correct the issue. In some cases in which nasal breathing is obstructed (conditions such as presence of tonsilla etc) skeletal problems will occur. Every child should go through and orthodontic examination for early diagnosis and treatment of these problems. Time for the first orthodontic examination of children is around the ages 6-7, which is the time for permanent teething. As a result of orthodontic examination, factors which have a role in formation of dental problems may be found and solutions may be created, and the treatment of skeletal disorders which is very difficult to treat after growth and development period may be administered. During orthodontic treatment, parents are informed about issues to be careful about during teething of children. Therefore, parents may help in early diagnosis.

What I should know about dental structure of my child?

First permanent teeth begin to erupt when your child is 6-8 months old and it continues until the age of 3. Dental series stay stabile in between 3-6 and begin to change in the ages 6-7 when the incisor teeth in the front and premolar teeth in the back erupt. Although problems do not usually occur in milk teething period, parents should be careful about milk teeth which erupt in the wrong direction or do not erupt at all. Things to consider during the period of permanent teething are: Early loss of milk teeth, upper incisor teeth erupting in too front or back, color and shape disorders of newly erupted permanent teeth, prolonged permanent teeth eruption due to milk teeth not falling off in time, tooth decay in the first molar teeth which erupt in the age of 6, Upper jaw being too tight to cover the lower jaw, Upper and lower teeth not covering each other, presence of bad habits such as thumb sucking or pacifiers.

Is there an age for ideal treatment?  Problems that occur only due to position of teeth which do not involve skeletal disorders can be solved in any age. These disorders are solved by repositioning the teeth via brackets. In cases of skeletal disorder presence such as upper or lower jaw being too up front or lower and upper teeth not covering each other, it is important to begin the treatment in childhood for efficiency and permanency of the treatment. If skeletal problems are not treated in time, it may cause problems that can only be corrected with surgery later.

Which devices are used during treatment?  The basic principle of orthodontic treatment is to remove the cause first and correct the disorder later. If dental and skeletal disorders occurred due to reasons such as thumb sucking or breathing from the mouth, mobile or fixed devices which will prevent these habits are used. Stopping this behavior during developmental age will make the problems to stop and even get better.

Generally, there are tow types of devices: Mobile devices are used for disorders involving a couple of teeth. These devices may have strings which push the teeth or screws which enlarge the jaw. They are usually used for a couple of months.

Fixed devices, meaning brackets, are inserted onto the teeth and used for more difficult treatments. Brackets may be in color of metal as well as that there are types for adult use in color of a natural tooth.

Porcelain brackets are usually used for adult patients. These brackets make the slightest coloring visible and therefore oral care should be made in attention.

In correction of skeletal disorders of children in developmental age, areas apart from the mouth may be used for support. In cases in which lower jaw is in the front chin protectors may be used as well in cases upper jaw is in the front neck apparatus may be used in order to pull it back. These devices are usually used for 14-16 hours a day but your doctor will define special durations of use for your child.

Patient’s compliance is very important for the orthodontic treatment to be made efficiently and quickly. Orthodontics is a team game played between patient, doctor and parents. It is very important for patients to use the removable devices and intra oral elastics as told and in wanted durations and to keep oral hygiene in high levels.

Will there be any changes in daily life of my child during treatment? 

Orthodontic treatment is administered widely in childhood ages. Your child can do anything during orthodontic treatment, apart from slight limitations. Your child may join sportive functions, sing and play musical instruments. Orthodontic treatment will not affect your child’s grades and it will improve both outer look and oral health during developmental phase of body and personality and it will create a more balanced physical and spiritual health.

What should be considered the most during treatment is that the teeth should be brushed properly after each meal. Your doctor will help you about how to maintain oral hygiene of your child. Gaining the habit of tooth brushing during orthodontic treatment is the guarantee for oral and dental health for a lifetime.

Not harming the fixed devices is very important for the efficiency of the treatment. Biting hard foods may damage our strings. In order to prevent this, being more careful when consuming seedy fruits and chips, cracker etc. and avoiding the foods that may stick to the brackets would be useful. There may be discomfort in teeth, gingival, cheeks during the initial phase of the treatment for a while. These discomforts are a natural result of the process of getting used to orthodontic devices. This slight discomfort will last a few days and will not occur in the rest of the treatment.

How long does orthodontic treatment take? Simple crowding which only involves the teeth require treatment duration that may take 6 months-1 year. This duration is different for each patient and it depends on the type of treatment, type of devices and personal factors such as age and gender. In order to correct dental crowding, dental extraction may be required in some cases. In this case, treatment duration may be between 18-24 months. In some skeletal problems which are diagnosed early and should be treated early, treatment may be longer, although the intensity of the treatment is reduced. During your treatment, you will have to visit your orthodontist once every 4-6 weeks. This duration also depends on your treatment process.

Dr. Ahmet KİĞILI

Dişhekimi / Prostodonti ve Estetik Diş Hekimliği

1986 yılında başladığı Gazi Üniversitesi Diş hekimliği Fakültesinden 1992 yılında mezun oldu.

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