My grandson who is 12 just got braces about a month ago.
I am not sure how and why my son and dil chose the orthodontist they did, I never asked, but they did feel that now would be the best age for him to have braces so that when he starts high school in a couple of years the braces would come off.

The age at which a child gets braces varies depending on why they need them.

In terms of choosing a ortho, we chose ours b/c he has a good reputation, and it was one of the few in our area that gave us a discount based on our dental insurance.

My son got braces in 4th grade at age 10 to correct a cross bite. One of his front teeth was turned sort of sideways for lack of a better description. Our dentist is actually also an orthodontist, so during check ups, I always asked at what point I needed to start thinking about orthodontia. He was the one that told us ds needed to go get checked out (we didn't use our dentist as the ortho).

However, at the same time, my 13 y/o dd had had crooked teeth and an overbite for ages. The same dentist said that in her case, she should wait until all of her adult teeth came in before doing anything. She ended up getting Invisalign braces last year when she turned 14. While a little more expensive, it wasn't that much more and since she was about to enter high school, we were okay getting them for her (plus she is very responsible so we weren't worried she would lose them). My son, 10 y/o at the time got his braces off about 3 months after she got her braces. It is possible that he will need a second round (he had them about a year) when all his adult teeth come in, but at the moment, he has a retainer and his teeth look great.

My 13 y/o son's teeth look pretty good and hopefully will not need braces. We actually thought he was in the clear, but then one of his front teeth got chipped. When they did the x-ray to see if there was other damage, they noticed that the teeth on either side of his front teeth were coming in crooked b/c he hadn't lost the old teeth. They ended up pulling his baby teeth, but said if they hadn't done that (emergency) x-ray, he would have had big problems to be corrected, most likely by braces! So a blessing in disguise, at the expense of his chipped front tooth.

My youngest, 9 y/o, will most likely need braces but like her older sister, will probably wait until all her adult teeth come in.

So really, it depends on the problem that needs to be corrected. It seems like more and more kids get braces at a very early age (before age 10), whereas when I was a kid, most of us didn't get them until our teen years. When I asked my dentist about that, he said that typically kids who get them that early will have two stages of braces, unless the problem being fixed is something like what my son had and then teeth remained straight after the adult teeth came in. Fingers crossed that's what will happen for my son so he doesn't need round two.

As far as choosing an ortho, I would try to get recommendations from people who have already been through the process or ask your dentist if you value his/her opinion.

Three kids, three sets of braces. When we began I found it very alarming that NONE of my friends would recommend their orthodontist. My son was a first grader, he had a tooth coming out of the middle of his hard palate. The first guy wanted to put full bands and wires on him, fix the issue at hand, remove the wires for a few years until he was older then do the rest of the work that would be needed, leaving the bands on for 8 years!! Follow your GUT. Mine said no way could a little guy with stand all that and no way did I want bands and the issues that would cause on his teeth for 8 years. We ended up at a place near by, they fixed it with a retainer then later when he was 13 we finished the job and he had full braces. Look around you will find someone you are comfortable with.

Very good advice so far. Our family dentist was the first to suggest the kids be monitored by an orthodontist. All started at various ages, for different reasons, but all needed to have baby teeth gone. For two of the kids, that required pulling. We went with our Dentist's recommendation the first two times, but for the third we had moved and went to someone more local. I preferred the first over the second for management reasons.

We followed the recommendation of our dentist who I trust. We were really happy with the orthodontist that we used for our 2 boys.

Their treatment started with jaw expanders for a couple of years and then moved into braces when they were about13-14. He didn't believe in putting braces on too soon but I suspect it would depend on the case.

My 3 have all been different, too. My boys had an ortho who was in another town, and because they were on different schedules, I was sometimes there twice a week, so I got wise with kid #3 and picked a (highly recommended) ortho very close to home! I think both of my DS got braces in 8th grade. One had them for a long time, maybe 2.5 years, and the other was about 1.5 years. My DD has a big mess in her mouth and her baby teeth are slow to come out, so she won't have braces probably for another year (she is going into 8th grade now). We just keep going to the ortho every 6 months and she says, "hmm, not yet!" She has some space holders in her mouth now for teeth that had to be pulled.

My neighbor's kids had their braces put on before her kids' baby teeth were all out -- with a different ortho. The ortho recommended putting the braces on that early, but also told her they might need braces again later depending on what happens when all the teeth come in! That sounds crazy to me.

We went local as well and were pleased. Oldest child needed no extractions or additional hardware other than the actual braces. But he lost his retainer twice afterward and at the age of 21, is now wearing invisalign. Thank goodness for an insurance company switch as well as multi-family discount. Be SURE to wear retainers after they are removed!
Child number two was told he would need surgery to go up and get incisors that were not coming down on their own, but he did not. He was also told he would need the herpes appliance to bring his jaw forward and he did not. He DID have to have 12 baby teeth removed at age 14 that had permanent roots attached to them. The surgeon said they would have never fallen out on their own, despite having permanent teeth under them. He had it done in the hospital under local anesthesia thankfully, since some came out in pieces. He is getting ready to get his braces off at age 16, but has some overlapping gum tissue that he will need removed first by a periodontist.
Child number 3 saw our orthodontist at a 5 due to an underbite as recommended by our dentist. Nothing was needed and her permanent teeth came in with no underbite. She is 12 with straight teeth so far, so we are really hoping to avoid orthodontia with her.
I would suggest that you meet your local orthodontist and form your own opinion. Know that sometimes they predict a treatment plan that is not needed or may change as your kiddo grows. That's what happened with us. And use your gut instinct. If they recommend that something be done that you're not comfortable with, you can always say no and gather other opinions. My dentist suggested removing my sons teeth in multiple visits in his office. I said "no way". I couldn't put him through that. Also, it's his body. With each of my kids, we proceeded with what they were comfortable with. They gathered their own info from friends too.
Good luck.

My two sons needed orthodontia starting at different ages for different reasons...DS#1 started with a palate expander in 2nd grade, then regular braces at age 12. DS#2 got braces at 12.

We chose our orthodontists on the recommendations of our dentist. We changed with DS#2 to be more convenient, so I could take him for appointments during his free period at school. Both boys came out looking fine, but I liked our first orthodontist because at every appointment he walked out to tell me how things were progressing, or called me in to show me what he was doing, and made and showed me casts he made of DS' mouth. The second orthodontist didn't do any of those, and had assistants doing more of the work. The second one was, though, more personable.

Choose an orthodontist who takes the time to look at your child, to talk with him, and to discuss with you the phases he plans in detail.

We interviewed some orthodontists who spent more time talking about their "incentive programs" for the kids than on treatment. The ones we chose had no such programs.

Speaking of retainers - I used to charge my kids a dollar for every time I discovered it wasn't in their mouths when it should be. Yelling didn't help but charging them did. Braces cost a lot of money and time and if they were not going to respect that then they could start paying me back.

I am a mean mom.

This conversation reminded me that our orthos office was set up so that when you walked into the front door it was set up so that all the examination beds were all in one big room. There were probably 5-6 of them for two orthos. There were chairs for the parents just off to the side but you could go over and talk to the ortho as he was examining your child but he would always come over to talk after.

I don't know why he did that but it didn't bother me or my children.

There were a couple of private rooms as well and a couple of offices for treatment plans.discussion.

Thank you for sharing all of your experiences. It's comforting to know they can vary so widely, and even within a family--that's what I'm finding.

My dentist recommended an orthodontist within walking distance of my home, but his treatment plan was far more aggressive (I'd call it radical, even) than what other orthodontists recommended. Another orthodontist was recommended by a friend, and then "un-recommended" by another friend for very good reasons.

There has also been a surge in 2nd and 3rd graders with braces in our town, and while I don't doubt that this is warranted in some cases, most of these younger kids seem to go to the same orthodontist whose brand new office complex resembles a trendy coffee bar, as one friend described it, and apparently has a shuttle to take kids to/from school for appts. That whole scene just doesn't sit well with me.

We're going to meet with one more orthodontist who was recommended by a few families. He's a bit further away, but is the only one who seems consistently recommended.

Blfenton, your strategy for getting your kids to wear their retainers is genius! I'm keeping that in my backpocket. I've heard from more than 1 parent that wearing retainers are essential to maintaining what all that $$$ bought.

I appreciate everyone's input.

I like your idea about the retainer. Wish I had thought of it. I just told my son that I buy the first one, if he loses it, breaks it, or it doesn't fit due to him not wearing it, he buys the next one. I took him to the bank and watched him withdraw $350 of his own hard earned money for a new retainer, and give the money to me. That was hard. Unfortunately, he lost that one and when he found it, it no longer fit, hence the invisalign. This is my ADD kid and despite reminders, nagging, helping him to develop a system to remember, ect. it still happened to us. He is my kid that has to learn everything the hard way. I feel for him, and love him so, but he's gotta learn.

I am a big believer in "preventive and interceptive" orthodontics. If you start before the child has all their adult teeth you can affect the growth and development of the jaw in such a way that when the time comes for full bracket and band orthodontics, the child may need less tooth movement, may not need premolar extraction, and may end up with a better facial profile.

Not all orthodontists are trained this way. I know that lots of orthodontists will say "make an appointment for your child when they lose their last baby tooth". For some kids, this is too late.

In my family, everyone has needed braces. My mother had braces in the late 1930s, which were removed when they moved to Virginia and there was no orthodontist for hours around. She had them again as a young adult. My father should have had braces. My older siblings had braces, and when the orthodontist looked at me, he said that I should not wait until I had all my adult teeth. I think I had my first two bands and a wire at nine, and I knew other patients my age that had removable appliances (usually girls, maybe more responsible). I also had functional "exercises" to do. (Mostly swallowing modification).

So I had preventive and interceptive orthodontics, full brackets and bands from 13-15 (a typical age then, but kids are routinely getting their adult teeth earlier, probably due to all the hormones in chicken and milk) --and I had adult orthodontics in my late 20s. (and a surgery). My facial profile is better than my oldest sister's because my treatment involved more than removing four premolars and straightening the teeth. Her teeth are in perfect position, but technically her lower facial profile is a bit flat and she lacks full lip support. This can happen with conventional two year ortho done when the patient has all adult teeth --even more commonly 40 years ago when she had her braces.

If I had Not had the preventive and interceptive orthodontics I almost surely would have needed much more extensive orthognathic surgery than I had, and that's much harder on adults than it is on kids.

The reason for preventive and interceptive is that you can alter bone growth. If you need to expand the palate (for example) of a kid, the suture isn't closed and you can simply push it apart with an appliance. In an older kid or an adult the suture may be closed and they may need to break the suture to push it apart.

All of this is not just cosmetics. As we evolve, our jaws are getting smaller, we will eventually lose our wisdom teeth and some premolars altogether (that's why some people aren't getting them now.)

If this is awfully technical, it's because I am a periodontist and went to a predoctoral program that emphasized teaching theory in orthodontics, and growth and development. (and I have a design degree if that confuses anybody).

Thanks for sharing this thoughtful explanation, Palimpsest. Unfortunately, the lack of consensus among orthodontists in my area breeds skepticism about those who may be attempting preventive and interceptive orthodontics. Many parents start making the "boat payment" comments when they see young children in braces. There seems to be a disparity in orthodontic training, as well as education among parents all around. I find this curious, because braces are becoming almost a requirement of childhood development anymore (for those who can afford them). Shouldn't we all be more educated about this process?

I took it upon myself to research one type of surgery strongly recommended--initially--for one of my kids. My findings (and I researched academic journals like AJO-DO) indicated my child was not, after all, a good candidate. When I shared this with the orthodontist and the oral surgeon who would be performing the surgery, they agreed with me. We discussed it further, and I was baffled by their responses. Yet had I walked in and said, "OK! Let's do it!" they would have agreed with that, too. This surgery wasn't recommended by any of the other orthodontists with whom we consulted.

So, was it a preventive and interceptive approach, or a needless one? Did I turn down a beneficial progressive treatment, or did my kid dodge a useless surgery? There is no consensus at all. Not even by those who recommended it. I know you don't have an answer to this, but I thought I'd share my perspective as a parent trying to maneuver these waters.

I think there is not a consensus on some forms of treatment because there isn't one best way to achieve good results.

As for the "boat payment" sort of comment, I think this sort of thing is interesting because we get that sort of comment even from patients who are much wealthier than we are and yet have some sort of business related job that I still have no idea what it is even when they explain it. They just seem to make money by doing something extremely abstract or having meetings all day long, but it's not task oriented. I can quantify what I do, and I get my hands dirty, so maybe I don't fully understand jobs that are all processes of the mind. Allied health professionals, in my mind do a form of relatively expensive menial labor.

This is another topic completely, and don't get me wrong. A lot of dentists are extremely well compensated. But the overhead is Immense. I work in a small practice and the owner has to generate almost $300 an hour before he breaks even, just to keep the office open. I work in a larger practice with a lot more staff (but only one owner-practitioner) and the amount she has to generate just to keep the door open is even higher. I think there is this notion that if you have a procedure that takes an hour and the dentist charges $800, that about $795 of it goes directly into his pocket, and that's not really the case.

Some of the braces in grade-schoolers are actually palate expanders. I had one in grade school, but it was more like a retainer that the ortho adjusted every couple of months. The new expanders look like braces and the parent adjusts it daily.

My older son takes after my side of the family in looks, with the narrow palate to go with it. My younger son looks like DH's side, wider mouth and jaw. So their needs were different.

I wore braces 40 years ago when I was 20 and that was, as Pal mentioned, of the days where they would just yank out teeth and then move others around to fit into the new spaces. That was because of a very narrow jaw ( just like my kids) and I would have completely benefited from palate expanders which my kids had.

It's interesting how many of my friends who had braces in their teens/late teens and who are now having to wear them again. It appears that their teeth are collapsing out of their jaws, although I don't know why. At 60 they are going the invisilign route.

Physiologically, as you get older, your teeth move forward and toward the midline which is why your lower front teeth in particular get crowded. Since those teeth are thin front to back, they can slide over each other as the roots move together.

There is a technical evolutionary and anthropological explanation as to why this happens to humans.

I had noticed that our first orthodontist had braces on one day, and he said the same thing! He's probably in his 40s. I've notice my own shifting, too, and because of that I notice it in other people middle aged and up, too. I have known other adults get braces to correct that, but with kids' college tuition for the next 8 years, I think I can hold off till I can't eat corn from the cob anymore lol!

If you need braces because you teeth are shifting and not lining up, don't wait. I didn't understand what was happening and my bite was changing and I started cracking teeth. Went to a new dentist who immediately understood the issue and now I am wearing insisalign (clear removable braces).

Getting braces is not just for looks!

Both of my older girls had braces..the oldest was a two stage process starting very young if I remember correctly. 3600. each for them.

My twin boys both have braces and they are 12 today. They will both be done in less than a year. One of them had a tooth (I think a canine) that was hideously misplaced and a device was used to try to make room for it and it worked. It came down nicely. If we hadn't done this, we would have had to pull a molar. The other twin had some kind of spacer in the back after losing baby teeth. Anyway, I found a new orthodontist in my town that was progressive and open to starting early. Very pleased that I didn't wait.

He is really good at getting them to brush their teeth. Lots of pictures of decay under braces., white spots, etc Now if I could only get him to talk the into wearing deodorant , lol.

And my boys love him. 5k for each. Prices have gone way up.

My friends' in town all go to the same orthodontist. And, I am telling you every one of their kids had braces starting in 2nd grade. Friends told me in doing it that early, they probably wouldn't have to have braces later on. But, now a couple-three years later, they are back into braces.

I don't know enough about it to really decide. I did do some research on the internet, and came across a report from some dentists (have no idea where I found it, it's been about a year ago), stating that 95 percent of kids getting braces that early really do not need them, and it's best to wait until all their baby teeth are gone. They claimed it was sort of a scam by orthodontia now. I have two friend's in my circle who are dentists and of course their kids started early in braces. They, of course, are very good friends with a couple of orthodontists in town who puts braces on all my friends kids. My son's dentist (I don't go to my friend's husband who is a dentist) is very conservative and sending me to an orthodontist who doesn't live in my town to evaluate my son.

For us, it's not really the money issue, in getting my son braces too early, it's the fact he would have to go through wearing braces twice that bother me.

Like I said, I really don't know everything about it, I just personally feel that it's what everyone does now, in certain circles (yes, my circle of friends) and I need to find out more about it in order for me to become more comfortable with our decision.

This post was edited by olliesmom on Fri, Jun 27, 14 at 13:11

Our orthodontists started one boy sooner than the other because he had already lost all his baby teeth. The other one started after losing his. He is the one that had the spacer to make room for the adult teeth to come in.

I didn't think they could start until all of the baby teeth were gone. But, that is just my orthodontist. YMMV.

It is common to wait for baby teeth to be gone. Mine refused to pull any baby teeth..but when kidlet #3 showed no sign of losing the last one he did sort of encourage us to pull it. He absolutely had her wiggling it!! I am happy with all three of mine's results. The only comment I would add is the odd thing happening among my nieces. All used the same ortho, two different families ALL their mouths look the SAME! IMO it seems this guy has a look he went for as opposed to finding each persons unique look. I would never mention it to my siblings but I do wonder if anyone else notices. And no it is not because they all look like our side of the family--they are far from that!!

We live in a small town and have an excellent orthodontist (only one). I am a dental hygienist by profession so I know more than the average parent about this subject. Three daughters, three different treatment plans, based on growth and development. All had excellent treatment outcomes.

Pal gave an excellent explanation, and as a periodontist he is in a position where he sees all the various treatment trends.

"Records" must be taken, including a cephalometric radiograph/tracing to determine the growth pattern of your child. Once you have this done, you can request a second opinion elsewhere. However, it will be tricky because the orthodontist will be speaking a language you do not understand!

If you trust your general dentist, then go with his/her recommendation.