the Dr. has said our daughter needs partial braces on her upper front teeth to correct an underbite. The problem is that the teeth he wants to attach the braces to are baby teeth, and one is becoming loose. She will be turning 9 in two weeks. How can you have braces when there will be a hole where her adult tooth will be coming in? Won't the braces pull in and try to fill the space that is empty? He also didn't bring up a retainer or expander until we asked about them. She also has an extra baby tooth behind her front teeth that we have scheduled to have pulled out in about a week. The reasons he gave for not using the expander or retainer was that the roof of her mouth will be sensitive after her surgery & he wouldn't want "his" daughter to have this pain, and she may take it out and lose it. For the amount of money he wants to charge us we could probably afford to have her lose 6 of them! And the baby teeth part really bothers me. thanks!
HiCustomerIs your general dentist recommending these orthodontic procedures and plans to perform them himself? Or is this being recommended by a licensed/accredited Orthodontist?If it is your general dentist, then thank him for the information and ask him for an Orthodontic referral.Depending on the severity of the malocclusion and underbite, your daughter may or may not need brackets to be placed on some of her primary teeth to help expand the maxillary arch. Just because brackets and wire are placed, it doesn't mean the arch will be pulled in together, especially when there will be gaps due to the loss of the baby teeth. Depending on the wire used, we can actually expand the jaw and shift teeth in the direction we want.Palatal expanders are bonded to the back molars and although uncomfortable to wear because it does take up a bit of space, are surprisingly not that painful when we expand the palate. And at 9 y.o., I believe the palate can still be expanded with an expanded if need be.Again, if there is orthodontics that needs to be done, please make sure your daughter is seen by an orthodontist. I don't mind general dentists attempting slight orthodontic corrections. However, if your daughter does have an underbite, then it's better to leave that to someone who has received additional training in all facets of orthodontics.Regards,JulXXXXX XXXXX, DDS
Yes, this is an orthodontist that was recommended by our regular dentist. I also believe that all of her molars are baby teeth as well. her front 2 adult teeth are the ones that need to be pulled forward at the moment, all others on the side are baby. He also said once we get those teeth forward they would come down over her bottom teeth and help keep the lower ones in check. This won't do a thing for her jaw though will it?
At 9 years of age, your daughter should already have 4 adult molars in place. They are known as the adult 1st molars, or teeth #'s 3, 14, 19, & 30, or sometimes refer to as the "6-year molars".It is true that once we're able to position the upper front teeth in front of the lower teeth, they can help keep the lower ones in check. And this is best done with brackets and wires. In this particular situation, a palatal expander will not help your daughter much because the palate expander widens the upper jaw. So if she has posterior crossbite, then the expander would be a better method to fix that.It is possible that your daughter may also need to wear a head-gear later on in her ortho treatment, if her mandible (lower jaw) continues to outgrow her upper jaw. However, head-gears aren't as popular as before because we find patient's not very compliant. Head-gears are fantastic and work very well. But if patients are embarassed to wear them, or do not cooperate, then they become useless.It sounds to me that the orthodontist is trying to "stage" your daughter's orthodontics. In recent years, the multi-staging technique has become more and more popular among the orthodontic community. This is advantageous because we can better intervene and adjust along the way, instead of resorting to extractions and drastic shifting/movements. However, the disadvantage to staging orthodontics is that oftentimes, this results in a much higher price tag for parents. And this can be very tough especially as we're going through some very tough economic times.My recommendation for you is that at your daughter's next appointment, be candid and honest with the orthodontist. Tell him that although you want your daughter to undergo an ideal treatment, you need to be realistic with finances. That we all need to make sacrifices along the way and your daughter most likely won't hold a grudge against you if her teeth aren't aligned "perfectly" to some "ideal" orientation. But you just want to do your best to help her correct the underbite and get the rest of her teeth aligned properly without breaking the bank.And hopefully, your orthodontist can take a step back and formulate a different treatment approach that may involve some compromises here and there, but as long as we're able to get your daughter's smile to a good configuration, you're happy, she's happy, everyone's happy.Regards,JulXXXXX XXXXX, DDS
Practicing General Dentist since 2002