Braces

What Are Braces?

Braces are devices that put steady pressure on the teeth, slowly moving them into a straighter position.

Why Do Kids Need Braces?

Kids can need braces different reasons, including:

• crooked, overlapping, or overcrowded teeth
• "bad bite" (known as malocclusion). Malocclusion is when there's a difference in the sizes of the top and bottom jaws. When the upper jaw is bigger than the lower jaw, it's called an overbite. When the lower jaw is bigger, it's called an underbite.

Often, your child's dentist will be the first to notice problems during a regular visit and recommend that you see an orthodontist (a dentist who specializes in correcting jaw and/or teeth alignment problems). The orthodontist can decide whether your child does indeed need braces and which devices would be best.

What Happens at the First Orthodontist Visit?

At the first visit, the orthodontist will examine your child's teeth, mouth, and jaw. They may ask your child to bite the teeth together and may also ask questions about whether your child has problems chewing or swallowing, or has ever had clicking or popping of the jaw.

The orthodontist may take X-rays of the mouth and teeth to see how the teeth are positioned and whether any permanent teeth still need to come in. They also might make a mold (or impression) of your child's teeth by pressing a tray of gooey material into the top and bottom teeth. When the mold is removed and the material hardens, the result is a replica of your child's teeth that will help the orthodontist decide which treatment options are best.

What Types of Braces Are There?

Most kids just need braces with brackets, wires, and rubber bands. The brackets attach to the teeth and are connected by a wire and rubber bands. The wire is tightened bit by bit over time to slowly help line the teeth up properly. The rubber bands come in fun colors that kids can pick. Some braces are metal, some are clear, and some are white ceramic. Some even go behind the teeth (lingual braces).

Clear removable braces that move teeth with plastic trays called aligners (rather than wires and rubber bands) are also available, but these are only right for some people.

Some kids may need other devices too, such as headgear (usually worn only at night). Headgear uses a horseshoe-shaped wire that attaches to the back teeth, providing stronger force to move the teeth. The orthodontist also might recommend that your child have one or more teeth removed to create more space in the mouth.

While wearing braces, your child will need to visit the orthodontist every few weeks for monitoring and adjustments.

How Long Will My Child Need to Wear Braces?

How long kids need to wear braces depends on the problems the orthodontist is trying to fix. The average time is about 2 years. After that, a child might wear a specially molded retainer — a small, hard piece of plastic with metal wires or a thin piece of plastic shaped like a mouthguard. Retainers keep the teeth from wandering back to their original places.

How Do We Care for Braces?

Because it's easy for food to get stuck in wired braces, kids who have them need to work extra hard to keep their teeth clean. Brushing after meals is a must, as is daily flossing (the orthodontist can give your child a special flosser to use in and around braces). Regular dental cleanings and checkups to look for cavities are also important.

Your child should avoid certain foods (such as popcorn, hard and sticky candy, and gum) because they can damage braces. Sugary sodas and juices also can be a problem because they can contribute to tooth decay. Kids with retainers or clear plastic aligners should always remove them when it's time to eat.

Because braces put pressure on the teeth, they can feel uncomfortable once in a while, especially after the orthodontist makes adjustments. Taking over-the-counter pain relievers and eating soft foods can help if this happens.

See the orthodontist right away if your child has a loose wire or bracket, or a wire that is poking their mouth. If the orthodontist can't find a problem, your child might use some soft orthodontic wax to cover any sharp spots on the braces that are bothersome or rubbing against the inside of the mouth or gums.

How Can We Afford Braces?

Braces can be expensive. But there are ways to get them at a reduced cost:

• If your family has dental insurance, it may cover some of the bill. In some states, Medicaid will cover braces.
• Programs like Smiles Change Lives cover a large amount of the cost for children whose families meet the income requirements.
• Some orthodontists offer payment plans and discounts.
• Dental schools often have programs where kids can get braces for less by seeing orthodontists in training.