(© Bonnie Schiedel. Originally published in Homemakers, November 2009)

How to determine if your preteen needs braces

You survived the sleepless, fussy nights when your little one was teething. You made it through the drama of losing baby teeth. And by now you might be wondering if your preteen might need braces.

The Canadian Association of Orthodontists (CAO) recommends that every child see an orthodontist at age 7, in order to get a jump on any potential problems. "At that stage, we can help to intercept habits like thumb-sucking or tongue-thrusting that can cause issues down the line," says Dr Bob Cram, an orthodontist in Red Deer, Alta and CAO president. Some dental problems may be clearly visible to parents and your regular dentist—crowding, spacing, crooked teeth—but it’s best to see an orthodontist at least once, even if your child’s teeth look fine, in order to plan for the future or just get the all-clear. Most kids who get braces get them between ages 9 and 13, when all the permanent teeth have erupted. "By that point, we’re trying to catch a growth spurt and to tinker with the growth pattern of the teeth and mouth," he says.

How braces work

Braces straighten crooked, crowded and protruding teeth—defined as malocclusion—by putting steady pressure on the teeth for a certain amount of time (generally about two years). The common cause of malocclusion are teeth that have too much or too little room in the jaw, resulting in ones that crowd or grow out of place. Other causes are thumb sucking, pacifier use and premature tooth loss. Malocclusion also refers to overbites (upper teeth overlapping lower teeth), underbites (lower teeth overlapping upper teeth) and upper protrusion (buck teeth). For some preteens it can be a cosmetic problem, for others it can result in problems eating or speaking.

What’s available?

Metal Those familiar metal braces are most likely what your orthodontist will recommend for tweens, since they are least expensive and most durable. Formerly made with stainless steel wire, metal braces are often now made from nickel titanium, which does the job faster and requires fewer office visits compared to stainless steel. Does your tween have her heart set on star-shaped brackets and purple wires? "Those options are only available with the old stainless steel braces, so kids change their minds pretty quickly when they learn it means they’ll have to wear the braces longer," says Dr Cram.

Ceramic The brackets are made from clear or tooth-coloured material, meaning the braces are less visible. They are a bit more breakable and expensive than metal braces, and because the brackets are larger, they require more attention to oral hygiene.

Lingual Marketed under the brand name iBraces, these metal braces are worn behind the teeth. They’re more difficult to install and the brackets aren’t usually used on preteens because they may not have all their permanent teeth yet.

Aligners These aren’t braces, but rather clear plastic removable trays, sold under the brand name Invisalign, that are worn nearly 24/7 during treatment, and only removed to eat, drink, floss and brush. They need to be replaced every two weeks.

Retainers These removable appliances keep newly straightened teeth in line and are often included in the overall cost of braces. They may also been worn to correct problems that don’t require braces, such as closing a space or moving just one tooth.

Tin grins

Many kids find that braces are no big deal because so many of their friends have them. "At first I thought that braces were kind of dorky, but after a couple weeks I just got used to them," says Megan Foster, 13, of Thunder Bay, who’s had braces since she was 10 (her baby teeth were reluctant to depart, meaning that she has to wear braces for longer than the usual two years). "She does get a sore mouth for a day or two after an adjustment, but Tylenol takes care of it," adds her mom, Lana Bresele. "I also think knowing that her dad and I both had braces helps because we understand."

Chew on this

Tender mouth on adjustment day? Check out The Braces Cookbook 2 by Pamela Waterman and Amee Hodge. Includes recipes, tips for sore mouths and a glossary of orthodontic terms.