Orthodontic treatments vary from dental treatment, in that they primarily address malocclusions, jaw spacing and tooth alignment, rather than the actual health of the teeth. That is why it is often more difficult for parents to determine when a child needs orthodontic treatment rather than dental treatment. So how can you know it is time to take your child to the orthodontist?
• Bad Bite - As the adult teeth begin to replace primary teeth, bite occlusions can develop. These often become visible to parents between middle childhood and the pre-teen years, although an orthodontist can identify a bad bite with early evaluation.
• Visible Tooth Crowding - If your child's newly emerging teeth are already crowded, you should make an appointment with our office to discuss braces.
• Tooth Grinding (Bruxism) - Children who grind their teeth at night may do so unconsciously, but the condition requires treatment to prevent the development of headaches, TMJ, and tooth damage. Oral appliances are available to correct nighttime tooth grinding.
• Difficulty Chewing, Biting, or Speaking - If your child is displaying difficulty speaking or eating, or if he or she often experiences cheek biting, schedule an orthodontic consultation.
• Asymmetry - If your child's face is asymmetrical, or if his or her teeth do not meet together in a natural way, orthodontic treatment may be necessary.
Evaluation and Preventive Care
Even if your child has no visible tooth or jaw alignment problems, the American Association of Orthodontists recommends that every child visit the orthodontist for an initial examination no later than age seven. The reason for early evaluation is because orthodontists are capable of finding subtle problems with the jaw and teeth growth and spacing before they become more pronounced and also more difficult to treat.

By bringing your child in for an evaluation, you may be able to treat orthodontic conditions with shorter and more simplified treatments that are also more affordable than treatment during the teenage and adult years.

Orthodontic treatments are used to correct malocclusion, a condition more commonly known as a bad bite. The length of treatment time varies depending on the severity of the bite problem.

What is a "bad bite"?
A bad bite occurs when spacing or alignment problems are present. This often includes teeth that are protruding, crowded, or crooked. Sometimes teeth appear straight, but have an uneven bite because the upper and lower jaws do not align properly. Teeth that are irregularly spaced - either too far apart or too close together - can also cause bite problems.

Frequent causes of bite problems:

• Heredity
• Thumb-sucking
• Premature tooth loss
• Accidents

Benefits of orthodontic treatment:

Appearance -
Correcting a bad bite often creates a more attractive smile, which frequently raises the patient's self esteem.

Preventing Decay -
It also results in a healthier mouth. It is much more difficult to thoroughly clean teeth that are crooked, protruding, overlapped, or crowed. This may allow plaque to build up, which can lead to gum disease, tooth decay and even tooth loss. Orthodontic treatment corrects these conditions, so cleaning can be more efficient.

Avoiding Alignment Issues -
An uneven bite can interfere with the motions of chewing and speaking. This can cause abnormal wear to tooth enamel, which may require pricey cosmetic restorative treatments, such as crowns or veneers, to correct. It can also lead to problems with the jaws. Orthodontic treatment lessens the likelihood of those issues, as well.

Types of orthodontic treatment:

- Braces: Metal or ceramic brackets are bonded to the front of teeth. Wires and elastics are attached to the brackets to straighten teeth.

- Invisalign®: Advanced 3D computer images of the patients' mouth are used to create clear, custom aligners that slowly move teeth. They are nearly invisible and are more comfortable than traditional braces. They are also removable, which makes it possible to continue with normal brushing and flossing.

- Retainers: A retainer is a removable piece worn inside the mouth that uses pressure to force teeth to move into proper alignment. They are used after braces are removed.

Length of orthodontic treatment:
Treatment typically ranges from 12 to 36 months. Factors include the age, cooperation level, and growth occurrence of the patient. The complexity of the case also impacts the treatment time.

Visibly crooked teeth are not the only reason to take your child into the orthodontist. There are some subtle things to look for as well, which may indicate the onset of more serious orthodontic issues. Many orthodontic issues are much easier to address if treated and corrected during a child's development.

Waiting until facial development is complete or until the permanent teeth have come in can make correction of many orthodontic issues more challenging. Both children and adults can benefit from orthodontic care at any age, but addressing issues early is almost always the ideal choice.

If you're wondering if you or your child might have need for orthodontic care, there are some things you can be on the lookout for. Here are some of the most common warning signs of orthodontic issues:

• Difficulty when chewing or biting
• Chronic mouth-breathing
• Sucking the thumb, the fingers, or any other oral sucking habits that continue after the age of six
• Overbite - when the upper teeth overlap the lower teeth by more than 5mm
• Top front teeth that cover more than 25% of the bottom teeth while biting
• Underbite - when the top front teeth go behind the bottom row of teeth when biting
• Crowded, crooked, overlapped, misshapen, misplaced teeth or extra teeth of any size
• Crossbite - when one or more teeth tilt toward the cheek or toward the tongue causing excessive stress on the jawbone
• The center of the top and bottom teeth don't line up
• Uneven teeth-wearing
• Baby teeth coming out too early for the child's age
• Pain in jaws
• Clicking in the jaw joints
• The jaw shifts off-center while chewing or biting
• A jaw that protrudes, or recedes, too much
• Difficulty speaking or enunciating clearly
• Chronic biting of the inner cheek or roof of the mouth
• Asymmetrical facial structure
• Grinding or clenching of the teeth

If you notice that either you or your child has one or more of these conditions, they could be signs that there is a risk of orthodontic or health problems. The sooner these problems are addressed, the wider and brighter you will be able to smile going forward!

Adults who need orthodontic care often share the misconception that they are too old for braces and would rather not deal with the embarrassment. You are probably familiar with horror stories about rubber bands snapping, mishaps with kissing, and unsightly food sticking in metal braces. Many adults believe that braces are just for children, but they are neglecting all the benefits of correcting misaligned teeth. Braces may cause you to feel self-conscious, but they are temporary. Along with straightening your teeth, braces also provide the following benefits:

• Better oral hygiene
• Easier to clean aligned teeth
• Less complicated dental procedures
• Eliminate the embarrassment of crooked teeth

One common reason for not correcting misaligned teeth is the appearance of metal braces. Adults do not want to face co-workers and friends with colored rubber bands and metal laced throughout their mouths. The expert healthcare professionals at SingHealth suggest several alternatives that are just as effective as metal braces. You have three options for correcting your misaligned teeth without the embarrassment, and they include:

• Ceramic braces
• Lingual braces
• Invisalign®

Ceramic braces are like metal ones except that they match the natural color of your teeth. This option is less noticeable and will usually not show up in photographs. Lingual braces are attached to your back teeth only, so no one will know that you have a corrective device. Invisalign consists of clear plastic coverings that you can remove for eating and teeth brushing. All of these options lead to a more attractive smile that you do not have to feel embarrassed about.

If you do choose metal braces to correct your teeth, you should consider the following suggestions for limiting embarrassing moments. The rubber bands holding the brackets in place come in silver, which will draw less attention to your mouth. Changing the removable rubber bands on a regular basis will help prevent the material from wearing down and snapping. If you chew with your back molars and cut your food into manageable bites, you are less likely to get particles stuck in your braces. Following our treatment advice and instructions will limit the time you have to wear corrective devices. Focus on the end result of straighter teeth whenever you feel particularly self-conscious about your braces.