EARLY WARNING SIGNS

Orthodontic treatment can be quite often be prevented by observant parents looking for tell tale signs of a developing malocclusion (wrong bite) and taking evading action. Certain minor interruptive actions can have major positive results in some cases, but there are certain definite reservations about treatment being done too early which will be discussed later. Posture and general appearance: Children with poor body posture as a rule also have something wrong with the way their teeth fit. Watch out for slumped shoulders and neck bent forward accompanied by an open mouth and possible slight drooling. When this goes hand in hand with dry lips it is a sure sign of chronic mouth breathing which in itself has an adverse affect on the shape and position of the jaws and teeth.

The child that is “addicted to” lip ice should not be neglected! In addition watch out for allergies which cause blocked noses leading to mouth breathing – and also for the so called “allergic salute” (rubbing of the nose and eyes) as well as burning, watery and red eyes. Retruded (weak) or prominent (strong) lower jaws should also be observed and expert advice should be sought – but, not necessarily treatment at this early age. It does however make sense to start some long term planning. Protrusive upper front teeth (“buck teeth”) are very obvious and sometimes require early intervention, but so does a deep bite and retrusive teeth (leaning towards the tongue) which are not as easily observable. Extensive spacing between the front teeth as well as overlapping of teeth is usually a sign that something may be wrong. Problems with shedding of baby teeth should be closely monitored between 6 – 14 years of age. This is one of the reasons why early screening of children at the age of 7 should be routinely done. Although intervention with appliances may only be indicated in a small percentage at an early age, this is particularly relevant in the case of upper eye teeth that may become impacted. When correctly handled, a difficult and costly procedure can in most cases be prevented or, at least, simplified.

SIGNS INSIDE THE MOUTH (INTRA-ORAL)

Common sense goes a long way and caring mothers who look into their children’s mouth with a cheap mouth mirror bough at a chemist or dentist, may easily detect abnormalities even though they are not trained and thus be of great service to their offspring! Look for asymmetry, in the left and the right; front and back teeth. What is the distance between the top and the bottom front teeth? Check on the shedding pattern and do new teeth appear within days or weeks after loss of baby teeth – or does it seem to take months? Do the jaws look balanced?

HABITS AND FUNCTIONS

Does your child hide his face when he smiles or does he always smile with a closed mouth? Is he the “unfriendly” one that doesn’t look grandpa in the eye when he shakes his hand? … The shy one perhaps, who hides his mouth behind an open hand or a fist?

Open bites are caused by habits like thumb sucking or rubber dummies. This can cause abnormal swallowing which in turn leads to changes in tooth position and speech problems. Don’t ignore that “cute” lisp – it may not go away by itself. Watch out for clenching and grinding of teeth which is often a sign of problems associated with shedding of the teeth.

Early loss of baby teeth: These teeth are important as they act as space maintainers for their permanent successors. They deserve to be treated with respect as their loss creates the danger of space loss with subsequent unwanted crowding of teeth..

Dentists will normally inform patients about the consequences of early removal of baby teeth and prescribe space maintainers when necessary. If in doubt, consult a specialist orthodontist.

SUBTLE SIGNS FOR THE MORE OBSERVANT!

Any asymmetry of the face should be observed and questioned, as well as complaints of cheek-, lip – and tongue biting. Don’t ignore frequent mouth ulcers -there may be a simple solution to this uncomfortable problem. There may also be subtle symptoms of the joints and sometimes this is misjudged as earache. Watch out for clicks in the joint – at an early age, it is a sure tell tale sign of a problem. Never give your child a painkiller without knowing what is causing the discomfort!

IN THE GENES

If there is a family history of previous orthodontic treatment, work with your dentist and orthodontist as a team. Always remember that your dentist will evaluate the orthodontist’s findings and can arrange for a second opinion if deemed necessary. The most basic human right is to utter an opinion and vice versa have an opinion on the utterances of others – which may lead to further opinions being expressed! Thus, one eventually arrives at the truth.

It is no different in orthodontics – to treat or not to treat, when to treat and when not to treat – it is a matter of common reality that is established through effective communication and arriving at a realistic agreement. You as a parent can and should play a major role in this by careful observation and evaluation of the findings and then you should take responsibility for your decisions after you have been properly informed by the professionals. (This may involve more than one discipline and should be coordinated by the orthodontist or your family dentist.)

It is in your hands (and eyes) to make a difference!