The Right Time For Braces, Part 1

The average age to wear braces is about 12 years old, but that’s not necessarily the best time to start braces. Why? Orthodontic problems vary a huge amount. From slightly crooked or spaced teeth, to severely protruding teeth (buck teeth), to major bite problems (lower jaw too far forward or too far back), to a bite that causes the jaw to grow to the side, to delayed eruption of teeth, just to name a few! Each of the many variety of problems effects the best time to start braces, some as early as age 7 or 8, and others as late as 18 or 19! Orthodontic problems can be divided into two types: those needing treatment in two steps (an early step and a later step) or those best treated in one step. Each of these steps has an optimum time to start depending on the details of the particular patient’s bite problem. It is important to know how to tell the difference between a problem needing two steps vs. one needing only one step.
Quality Braces Care: 
Proper timing of braces greatly effects the quality of the care. If you start too early, the patient can wear braces longer than necessary. If you start too late, the patient might not receive the best result. Both lower the quality of orthodontic care. There are 7 principles that guide selecting the best time for braces:
1) Make treatment as simple as possible and still get the best result obtainable.
2) Treat to minimize irreversible problems.
3) If a current problem can cause other problems, keep that from happening, when reasonable.
4) Provide treatment that maximizes stability.
5) Consider the benefits to the patient of achieving a beautiful smile as soon as reasonable.
6) Avoid treatment that suffers from delays.
7) Minimize treatment costs in money and time.
Principle 1: Simplicity with the best result.
Sometimes there is more than one way to achieve the best result. The orthodontist has to know a wide variety of ways to make braces work so he or she can pick the simplest way for that patient to receive the best result. Broad, expert knowledge is important here!
Principle 2: Don’t allow irreversible problems if at all possible. 
Sometimes there is a bite problem that if allowed to persist will become partly or fully irreversible. It’s very important to know how to recognize these, also requiring expert knowledge, experience, and to know how to treat these early enough to avoid an irreversible condition. Bites that cause the jaw to grow to one side are an example and have to be caught very early to avoid irreversible growth problems.
Principle 3: Don’t let one problem cause other significant problems. 
Some bite problems can over time cause other problems, making the bite problem harder to get an excellent result. The best age for braces seeks that we have the highest degree of predictability and that we will obtain an excellent result. Not allowing a problem to compound many times makes a difference. With a severe overbite, for example, the upper front teeth go way down over the lower front teeth and can interfere with proper development and alignment of the lower teeth or impede growth of the lower jaw. Selecting these cases properly, with expert knowledge and experience, improves the quality of the result.
In “What is the Best Age for Braces? Part 2” we will look at the remaining principles and end wrapping it all up in how proper timing for braces, derived from expert knowledge and experience, supports providing braces for a lifetime of beautiful smiles. Stay tuned!