Our Blog

You might be surprised to see one of your second grader’s friends with a dental appliance. Isn’t orthodontic work just for teenagers? And, if not, should your seven-year-old be sporting braces right now? The answer to both of those questions is “Not necessarily.” Two-phase treatment is a process designed to correct issues that arise during different times in your child’s life.

First Phase Treatment

We recommend that every child have an orthodontic evaluation around the age of seven to determine if there is a problem that would benefit from early treatment. First phase orthodontics is not the same as orthodontics for older patients. The focus here is on the developing bone and muscle structures which form your child’s bite and provide space for the permanent teeth when they arrive.

There are some clear-cut orthodontic goals that are much easier to attain when children’s bones are still growing.

• Reducing Crowding

If your child’s mouth is small, the permanent teeth will have little room to fit in when they arrive. We may recommend gently enlarging the upper dental arch with the use of a palatal expander. This device will provide room for the adult teeth, and could potentially shorten second phase treatment time. Sometimes the extractions necessary to create more room for permanent teeth in later years can be avoided, as well as the possibility of an impacted tooth—one which doesn’t erupt because it is blocked by other teeth.

• Dealing with Jaw and Bite Concerns

Bones and muscles do not always develop properly, leading to problems with jaw and facial structure. Your younger child still has growing bones, so this is a great time to gently re-form the jaw into a healthy shape. Problems caused by crossbites, underbites, open bites, and other malocclusions can be reduced with early treatment.  

• Protecting Teeth

If your child has protruding front teeth, these teeth are more likely to be damaged in falls, at play, or while participating in sports. We can gently reposition them.

Second Phase Treatment

Second phase treatment is designed for your older child. After a resting period, when the permanent teeth finish erupting, we should see your child to evaluate any further orthodontic needs. This is the time to finish the process of straightening the teeth and making sure that each tooth fits together properly for a comfortable and healthy bite. This phase usually makes use of braces or aligners, and can take approximately 12-24 months.

Two-phase treatment is not necessary for every child. But there are some unique reasons that early orthodontics might be recommended for your child, even if it’s clear that more orthodontic work will be needed later. Make an appointment with Dr. Sal Carcara at our Westwood, NJ office, and let’s evaluate your child’s orthodontic needs, whether now or in the future, for a lifetime of beautiful smiles.

If this is your child’s first holiday season with braces, here are some tips on how to help children get the most enjoyment from these celebrations without compromising their braces or leaving them feeling left out of the festivities.

Halloween

When you think dental health, “Halloween” is not usually the first thing that comes to mind. Halloween can be tricky, but with some planning and intervention, you can make sure your child doesn’t miss out on the treats that make the holiday a favorite.

Braces present other challenges besides dealing with the scary amount of sugar in every trick-or-treat bag. Certain treats can be a challenge to clean from braces, and can even cause broken brackets and wires. How to avoid these frightful results?

• Go through your child’s treat bag when you get home after neighborhood trick-or-treating. Anything which can damage braces, such as regular gum, candy with nuts or caramel, or hard or chewy candies should be discarded. Perhaps you and your child can choose a selection of soft candy such as plain chocolate and peanut butter cups to trade for those tricky treats. Your child’s favorite soft fruits, cupcakes, and cookies could also be safe substitutes.
• Party time? Candy apples, bowls of candy corn, and popcorn balls are favorite treats at Halloween parties, but very bad for braces. Help your child recognize what should be avoided before attending, and suggest safe options like soft cupcakes.
• Finally, even safe treats will leave more sugar than normal in your child’s mouth and therefore more potential for plaque build-up. Brush and floss more often, if needed, and rinse regularly with water.

Talk candy guidelines over in advance with your child. If you’d like, Dr. Sal Carcara can recommend safe alternatives. With your help, Halloween won’t be a fearsome experience for you or your trick-or-treater.

Thanksgiving

Now, this is a holiday to be thankful for! Almost all of your traditional favorites are perfect for family members with braces.

• Appetizers: Offer soft food options such as silky cheeses and deviled eggs instead of crunchy vegetables, chips, and nuts.
• Dinner: Turkey is a required dish on many tables, and no need to miss out! Just make sure pieces are bite-size and off the bone. Creamy mashed potatoes and gravy and jellied cranberry sauce are also braces-friendly traditions. Any cooked vegetable should be fine, but do cut the corn from the cob first. Dressing is a great side dish if your child avoids any crunchy tops and edges, as are soft, nut-free rolls and muffins.
• Dessert: Pumpkin pie, cheesecake, and apple pie with ice cream are all safe (and delicious) choices. Leave the pecan pie, caramel sauce, and anything nutty or chewy off your child’s menu. And remember to brush and floss carefully after the feast!

If you are concerned that following the usual food guidelines might be a little more difficult during this time of year, talk to us. Dr. Sal Carcara and our team are happy to suggest ways to make your child’s first holidays with braces memorable for all the right reasons. The last thing you’ll want is an emergency visit to our Westwood, NJ office!

Perhaps you are already planning for the years when your teenager will need orthodontic work. But hearing that your seven-year-old would benefit from orthodontic treatment? That might come as a complete surprise! It’s a recommendation with real benefits, though—early intervention can save children from tooth and bite problems now, and even simplify their future orthodontic care.

Treating young children for orthodontic problems is called “interceptive orthodontics.” When the permanent teeth start arriving, there might be problems with spacing, bite or protruding teeth. Often, treatment while the bones are still growing is the best way to prevent more serious problems later.

We recommend that your child have an orthodontic consultation with Dr. Sal Carcara around the age of seven. This exam is especially important for children who may have been thumb suckers or used a pacifier after the age of three, or if you notice obvious teeth, speech or bite issues.

• Crowding and Spacing Issues

Teeth are arranged in two crescent shapes called arches. When the arch of your child’s mouth is small, the permanent teeth can become very crowded as they erupt. Formerly, teeth were removed to make more room. Now, early use of a palatal expander can enlarge the upper dental arch in order to help the permanent teeth come in without crowding. The need for future tooth extraction is reduced, and there is a better chance for correct spacing and alignment with early treatment.

On the other hand, when a child loses a tooth too soon, too much space left between baby teeth can also be a problem. The remaining teeth can shift, leaving the wrong place open for the adult tooth to come in. We might recommend a space maintainer so that there is no shifting of the teeth and there is room for the proper adult tooth to erupt in its proper spot.

• Malocclusions (Bite Problems)

Some malocclusions, like a crossbite, can be caused by problems with jaw and facial structure. Again, we might recommend a palatal expander to help the upper arch of the teeth to fit properly with the lower jaw. Problems with overbite, open bite and other bite issues can also be addressed at this age if necessary. Early care can discourage TMJ (temporomandibular joint) disorders, reduce speech problems, and improve facial symmetry. 

• Protruding Front Teeth

Teeth that protrude are much more likely to be damaged when playing or after a fall. Methods such as braces or appliances can reposition them and protect them from breaking or fracturing.

Many children will not need early intervention, and many can wait until they are older for orthodontic work. But if your young child has orthodontic problems that should be addressed, early intervention can do more than set the stage for successful orthodontics in the teen years. Talk to our Westwood, NJ team about what we can do for your child. Interceptive orthodontics can protect teeth, guide jaw and speech development, modify harmful oral habits and help to adjust bite problems before they become serious—when it comes to your child’s dental health, the best solutions are early ones!

According to the American Association of Orthodontists, orthodontic treatment for children should start at around age seven. Dr. Sal Carcara can evaluate your child’s orthodontic needs early on to see if orthodontic treatment is recommended for your son or daughter.

Below, we answer common questions parents may have about the benefits of early childhood orthodontics.

What does early orthodontic treatment mean?

Early orthodontic treatment usually begins when a child is eight or nine years old. Typically known as Phase One, the goal here is to correct bite problems such as an underbite, as well as guide the jaw’s growth pattern. This phase also helps make room in the mouth for teeth to grow properly, with the aim of preventing teeth crowding and extractions later on.

Does your child need early orthodontic treatment?

The characteristics and behavior below can help determine whether your little one needs early treatment.

• Early loss of baby teeth (before age five)
• Late loss of baby teeth (after age five or six)
• The child’s teeth do not meet properly or at all
• The child is a mouth breather
• Front teeth are crowded (you won’t see this until the child is about seven or eight)
• Protruding teeth, typically in the front
• Biting or chewing difficulties
• A speech impediment
• The jaw shifts when the child opens or closes the mouth
• The child is older than five years and still sucks a thumb

What are the benefits of seeking orthodontic treatment early?

Jaw bones do not harden until children reach their late teens. Because children’s bones are still pliable, corrective procedures such as braces are easier and often faster than they would be for adults.

Early treatment at our Westwood, NJ office can enable your child to avoid lengthy procedures, extraction, and surgery in adulthood. Talk with Dr. Sal Carcara today to see if your child should receive early orthodontic treatment.