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Straight Talk

by Daniel Sean Kaye

Today’s orthodontic work is better, faster and more accepted than ever before

Braces and orthodontic work are a sort of benchmark for most teens. But gone are the days of heavy metal braces that pinch, stab and ache for years. With today’s technology—and some early homework on the parents’ end—orthodontic work is becoming quicker and easier than ever.

When to begin
“It is generally recommended by most orthodontists as well as the American Association of Orthodontists that children should have their initial consult at the age of 7,” says Dr. Ross Segal, of Segal and Iyer Orthodontics. “In most situations, it is preferable to wait until all the adult teeth are in before starting orthodontic treatment [typically between 10 and 13 years of age], but in many circumstances, starting treatment early is indicated and necessary in order to avoid major complications in the future. [It’s] not unusual to see children that are 7 or 8 years of age with retainers or even braces.”

Dr. James TenBrook, president and CEO of TenBrook Orthodontics, echoes that sentiment. “This allows the orthodontic specialist to evaluate the growth and development of the jaws and face, as well as the erupting permanent dentition. It’s important for the orthodontist to guide you and your family from about age 7 on up, to prevent problems with your teeth and growing jaws.”

And while ages 7 or 8 are great guides on where to begin, a parent’s intuition is never wrong either. “I advise parents to talk to their dentist for a recommendation or when they first see an issue,” explains Dr. Thomas Kadar of Kadar Orthodontics. “That’s usually around middle school age and can include teeth sticking out, crooked or crowded teeth, huge spaces, or when something has gone wrong. Maybe the parents just don’t like how the teeth look. But that’s why I tell people to talk to their dentist—dentists are more particular.”

In addition to helping with crowding, evaluating jaw growth problems can help avoid future jaw surgery, and issues such as teeth grinding, excessive mouth breathing and salivation, even speech issues. “Thumb- and finger-sucking habits and tongue thrusting can lead to low tongue posture and speech problems, which can affect a child’s self-esteem and progress in school,” says TenBrook. “All of these things can be corrected and prevented at an early age, leading to much less time in braces, with full, beautiful smiles and no tooth extractions.”

Debunking myths
Getting a start early is important for parents and children, because those old school orthodontic procedures we all grew up with have come a long way. Visits are as much about education as they are about prevention.

Kadar does lament that kids aren’t typically getting much information about orthodonture at school, so he often visits schools to teach it. “People get a lot of information from the internet and friends,” he says, and this can add to misinformation. “One of my main goals is to try to alleviate fear and anxiety. I tell them it’s different than what their parents experienced. Extractions are not usually needed. You won’t just be eating mashed potatoes, and taking tons of Tylenol. It’s just a few days of discomfort.”

“I often hear a parent say to me, ‘I needed to have multiple teeth extracted when I was a child because my mouth was too small.’ They are very surprised when I tell them we will be able to treat their child without extractions even though their mouth is even more crowded,” says Segal. “Although in some cases extractions cannot be avoided, orthodontists today make many of their decisions based on the patient’s face and individual needs as opposed to simply the degree of crowding or size of the jaw. As a result, the number of cases that warrant extractions are far less in comparison to a few decades ago.”

“When I got my braces, I had to go through the gooey impressions. Today, we have digital scanners,” says Kadar. “It used to take hours to place the braces, but now it can be done in under one hour. We don’t use needles, it’s not invasive, there’s no drilling into teeth, and you don’t wrap around teeth. It’s no longer a mouth full of metal. You can get colors around them and some are invisible and some are placed on the inside of the teeth. Now braces are custom-made and more precise and efficient than ever before.”

Segal also mentions that the Invisalign treatment used to be an option exclusively for adults, but now the Invisalign Teen product has become very popular among middle school and high school students. “Kids are expressing interest in this mode of treatment, only to be told by their parents that it’s not an option,” he says. “Invisalign and Invisalign Teen has evolved significantly and today it can be used to treat the majority of cases.”

The best thing to do is to get second opinions if you feel you aren’t getting the best information, Kadar says. And even though getting word of mouth is good, he does agree that parents need to talk to their dentist. “They know who does the best orthodonture. Do yourself a favor; go to the office,” he says.

And don’t be afraid to listen to the younger members of the family. After all, they’re the patients. “Kids are actually very good watchers of their teeth, and often notify Mom and Dad of any problems,” says TenBrook.

“Kids and young adults are far more prepared and savvy about dental health, and the importance of a nice smile, than we ever were growing up.”

The Importance of Early Visits to the Dentist
Orthodontics are important, of course, but what about even littler teeth? Pediatric dental visits have come a long way, and starting early might make all the difference in your child’s dental future.

“Early visits are essential for establishing a good pattern of regular dental care. We are able to assess whether all the teeth are there and if there are any issues,” says Dr. Mary Farren, owner and dentist at Mary Farren, DMD, LLC Family & Cosmetic Dentistry.

So important, in fact, that Farren advises parents begin dental treatments as young as 3 years of age. “At that point, all their baby teeth are usually in and they are at an age where they can usually sit in the chair,” she says. And the sooner the child gets used to seeing the dentist, the better it is for them long-term. “I am able to establish a relationship with the patient from a very young age. The goal is to maintain that relationship over the course of their lives.”

Farren says that an important thing they do at her office is to first educate the parents about proper oral care.

“The most important thing you can do at home for dental health is to teach your child the importance of brushing their teeth and the proper method of brushing,” she says. “A large number of kids are not brushing twice a day and are not brushing long enough. These are two big mistakes that can lead to a lifetime of cavities and other dental issues. Parents need to teach their children the importance of good oral hygiene. If parents do not stress this at home, it is nearly impossible for us to get through to their children.”

One fallacy parents hold onto is that harder toothbrushes clean teeth better. “Brushing with medium or hard bristle toothbrushes can lead to gum recession and loss of tooth structure,” she says. Many parents also learned that baby teeth don’t matter because they fall out. “This is wrong and especially detrimental. Baby teeth are necessary for many things including speech development, nutrition, and maintaining space for the adult teeth to come. Baby teeth can get all the same issues as adult teeth. You do not want to wait until your child is in pain to seek dental care for them.”

A good thing is that kids today are often taught the importance of good nutrition. “They are taught that fruit juices are not good for you and especially not for your teeth,” she says. “Thankfully they are also taught about the importance of preventive care. Too many adults only seek treatment when they are in pain. Hence, they associate dental visits with pain. However, dentists are here to prevent pain and to relieve pain. We are not here to cause pain.”


Kadar Orthodontics
485 Hurffville-Crosskeys Road
(856) 582-1400

Mary Farren, DMD, LLC Family & Cosmetic Dentistry
1908 Springdale Road
Cherry Hill
(856) 751-6606

Segal and Iyer Orthodontics
501 Route 73
(856) 810-1006

TenBrook Orthodontics
Serving South Jersey
(877) 764-5310

Published (and copyrighted) in the Art of Living Well pull-out section of Suburban Family Magazine, Volume 6, Issue 6 (August, 2015).
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