A boy with smile

A Blog to clear up misconceptions about orthodontic treatment

Clear aligners (Invisalign) don’t work.

When used properly, clear aligners work very well. Not only can you expect teeth to be “straighter than they are,” but in the right hands, you can expect an EXCELLENT result after being treated with clear aligners. The difference lies in the level of skill and experience of the doctor using the tool. As goes for anything, a great tool can produce good, medium, or bad results, depending on who’s using it. This is definitely true for moving teeth with clear aligners.

Creating amazing results requires the doctor to have specific knowledge and experience, as well as a compliant patient! Aligners must be worn 22+ hours/day, and only removed when eating and brushing. The treatment planning process is completed on the computer, where digitized teeth are positioned, attachments (tooth-colored bumps that act like handles on teeth) are placed and bite corrections are planned. It’s a complex process that is extremely effective when it’s done right!

I should wait until after my wisdom teeth come in to get braces.

Although I understand the desire to keep your teeth straight once they’re there, please don’t listen to this advice! Wisdom teeth come in around the age of 17, and the ideal time to get comprehensive orthodontic treatment is age 12! 12 is the number here because jaw growth finishes around this time, so if we wait until later, an improper jaw relationship cannot be corrected! In addition, age 12 is when the last permanent teeth come in (the last ones other than wisdom teeth), and an age where the bone is still very adaptable.

If you’re worried that your wisdom teeth will push your beautiful pearly whites into crookedness, fear not! That’s what retainers are for! If worn properly, even wisdom teeth coming in won’t stand a chance at moving your teeth out of their perfect spots. They’ll stay safe right where they are, and your smile will remain beautiful.

Kids who are less than 10 years old don’t need braces.

I strongly recommend that every kid see an orthodontist when they’re 7 years old, here’s why: jaw bones are still growing in all directions (width, length, height) at age 7. If either jaw is deficient in any dimension, an orthodontist can modify the size of the jaw to be correct. Some dimensions of jaw growth stop by age 10, which means that they’re now set in place and cannot be corrected.

I’d like to explain a little more about the thought process when we’re evaluating a 7-year-old vs. a 12-year-old, to determine if they’re ready for orthodontic treatment. When we’re looking at a 12-year-old, it’s actually similar to looking at a 20, 30, or 40-year-old patient: all permanent teeth are in, all baby teeth are out, we’re looking to align all teeth to make an amazing smile, and place each tooth in its healthiest long-term position. Quite often, people assume that this is the only goal when people get braces. For a 7-year-old, the thought process is completely different.

It is almost irrelevant at this point if every tooth is straight because first of all, we’ll correct these issues when the patient is 12, and second of all, half the teeth are baby teeth anyway! The questions I ask when I’m evaluating a 7-year-old are: are the jaws aligned properly? Is either of them too narrow? Is it either too far forward or too far back? Do all the permanent teeth down in the gums have room to come into the mouth?

If all these aspects look good, often the child does not need early orthodontic treatment at all! If they do have a mismatch, discrepancy, or lack of space in a critical area, however, the issue must be addressed before jaw growth stops, which is why early orthodontic evaluation is so important. One important note is that a child will need comprehensive orthodontics around age 12 regardless of whether or not they needed early treatment at age 7