Answers to your questions.
How do I know if my son needs braces, and when should he get them?
Braces are used to correct “bad bites” or malocclusion (teeth that are crooked, crowded or don’t match up the way they are supposed to). There are three types of teeth alignment.
Class I type teeth are normal, and the first upper molars meet the first lower molars. The teeth are aligned, so are the jaws and the bite is balanced. When the upper and lower teeth fi t together the way they are supposed to it is easier to bite, chew, speak and smile.
A class II bite happens when the top first molar is in front of the lower first molar and the front teeth stick out over the bottom front teeth. This kind of bite can cause the teeth not to grow properly, or the upper jaw grows bigger than the bottom jaw.
A class III bite happens when the first upper molar lines up behind the first lower molar and the lower teeth are pushed out in front of the upper teeth. This can cause an overgrowth of the lower jaw and undergrowth of the upper jaw, or both. These bite problems can be inherited or the result of injury, early tooth loss, thumb sucking or using a pacifier too long.
Abnormal bites are usually noticeable between the ages of 6 and 12. Orthodontic treatment usually begins between the ages of 8 and 14. Treatment that starts while the child is still growing may have better success than waiting until the child is older. Adults can wear braces, too, but it’s best to start early. Braces help move the teeth into a good position. This movement is accomplished when the orthodontist adjusts the wires. Most children have braces for one to three years, then they have to wear a retainer for several years to hold the straight teeth in place.
Braces need a lot of help from those who wear them. Eating a balanced diet is good for the teeth. Too many sugary sweets will cause plaque (the stuff that helps make cavities), get stuck under the brackets and wires and make it impossible to keep the teeth clean. The buildup of plaque can also permanently stain and damage the teeth. Of course regular brushing and flossing is still very important to keep teeth healthy and shiny white.
The American Dental Association sent out a public warning to not try to fix teeth without the help of a professional. Some videos and websites encourage people to try and straighten their teeth with rubber bands, wire, dental floss and other objects. It is unsafe for anyone to try to move the teeth. Without the help of professional, teeth can be damaged or lost forever, and the damage can result in expensive lifelong dental problems.
When do wisdom teeth come in, and when should they be removed?
Wisdom teeth are the third set of molars to grow inside the mouth. They usually start coming in between the ages of 17 and 25 (a time in life that has been referred to as the Age of Wisdom). If wisdom teeth grow in completely, the bite is aligned and there is enough room for them. There may never be a need to take them out.
Unfortunately, since wisdom teeth are usually joining a lot of other teeth already in the mouth, there may not be room for them. If there is no room, wisdom teeth cannot grow in properly and may cause many problems. The teeth may not erupt at all or just some of the tooth comes out of the gum, and the tooth becomes impacted and trapped in the jaw. If the wisdom tooth only comes out of the gum part of the way, a piece of the gum remains on top of the tooth. When this happens the tooth can become quite irritated, and food and infection can get caught in the spaces. The area cannot be cleaned well because of the location and pain associated with the inflamed tissue. Impacted wisdom teeth can cause damage to other teeth and form cysts or infection inside the mouth. A cyst or tumor can cause damage to the bone, nerves and other structures. Once there is disease inside the mouth, the problem becomes persistent and progressive. Infections can spread from the mouth through the bloodstream and cause damage to other body organs.
The American Association of Oral and Maxillofacial Surgeons recommends that an expert evaluate third molars during young adulthood in order to assess their presence and signs of disease and to suggest a plan of action. The plan may involve removing the wisdom teeth or leaving them alone for now and continuing to monitor the teeth. If there is impaction, infection, periodontal disease, cavities, cysts, tumors or damage to other teeth, it’s time to remove the wisdom teeth.
Wisdom teeth are easier to remove when young because the roots are not completely formed, the jaw is softer and there is less chance of damaging surrounding teeth, nerves and gums. A dentist or oral surgeon removes most wisdom teeth. Sometimes local numbing medicine is all it takes to remove the teeth, while other situations require intravenous sedation or even general anesthesia. Who does it and how it’s done are decided based on the young adult’s age and the condition of the wisdom teeth. Removing the teeth when there are no indications to do so is generally not done. However, if the wisdom teeth are causing any trouble whatsoever, see your dentist or oral surgeon and make a plan to get them out.
Ann Petersen-Smith, PhD, APRN, CPNPPC, CPNP-AC, is an Assistant Professor at the University of Colorado Anschutz Medical Campus College of Nursing.