Ask the Expert: My daughter's teeth stick out – will she need braces?

'Compared with even five years ago, treatment can be far quicker, and less painful'

Q: MY 12-year-old daughter’s teeth stick out and she’s started to get upset about them. Will she have to wear braces to straighten them, and if so, how long will it take and is it likely to be uncomfortable for her?

Children’s orthodontist Dr Chaw-Su Kyi says: “Barring serious jaw misalignment, nobody needs braces. However, if your daughter is unhappy with her smile, she might want to see an orthodontist who specialises in teenagers. Compared with even five years ago, treatment can be far quicker, and less painful.

“Before I treat anyone with an overbite, it’s important to find out why their teeth are sticking out. Is it due to the upper front teeth being too far forwards, or the lower teeth being set back? I can tell this without even looking inside the mouth, by assessing my patient’s profile.

“If your daughter’s lower jaw is too far back, a clear removable brace on the bottom teeth will encourage them to move forwards. Be careful of any dentists telling you to remove any teeth, or move the upper teeth back, as this can risk worsening the profile (sometimes called ‘caving in’).

“This part of the treatment will take about 10 months, with patients wearing their aligners full-time. They can be removed for eating and playing an instrument, but they have to be worn 22 hours a day.

“Following these 10 months, I’d suggest your daughter wears a brace on her upper and lower teeth to fully straighten them for a further few months. She will then need to wear a fixed or removable retainer to make sure her teeth don’t move back.

“If your daughter has an overbite, so her upper teeth are too far forward and she finds it difficult to close her lips together without stretching them, she may need some teeth taking out to correct the bite. She would then have fixed braces for around 18-24 months.

“Tooth misalignment can be caused by thumb or finger sucking. The thumb acts like a brace, pushing the upper front teeth forwards, or the lower front teeth back. The powerful cheek muscles will narrow the upper teeth, creating a crossbite. Often the upper and lower front teeth won’t meet together, which is call an anterior open bite. An anterior open bite is one of the most difficult things to correct.

“I’d recommend any parents try and stop this habit before the ages of seven or eight, as at this age the teeth will naturally relapse and often self-correct. Breaking the habit is of utmost importance, and easy measures often work – placing a plaster on the thumb, using anti-nail biting varnishes or wearing gloves or a sock on the hand when sleeping. If this doesn’t work, a simple brace, called a habit breaker, which doesn’t allow them to suck their thumb, can be fitted.

“Fixed braces can be uncomfortable for the first four or five days after fitting, but with some pain relief (paracetamol or ibuprofen), it should be manageable. Within the first week, the mouth becomes very accustomed to the brace, and it’s relatively comfortable.”

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