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Seeking Orthodontic Advice

And back to our regular programming.  An urbanMama recently emailed: I know this topic has been posted before, but I would love another round of advice. My 5-year-old daughter and her already-crowded little jaw are destined for braces, and we'd like to get a preliminary evaluation for orthodontia. I have two questions:

  1. Can anyone share their experiences with making a decision about doing an early round of braces/spacers/extractions/whatever? My impression is that the current practice is to do two rounds (one at age 8ish, one at 13ish), but there's controversy about whether the first round just adds expense and trauma without much payoff. I'd love to know what others have learned in researching, making the decision, and looking back on the decision.
  2. Can anyone recommend an orthodontist (not necessarily pediatric), especially in SE?


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Was just talking about this topic today. My son's dentist said that the early round is mostly for cosmetic reasons and a later round will be needed regardless. His advice was to wait if we could handle a few years of pictures with slightly crooked teeth. His opinion was that a only a small percentage of early intervention cases were actually necessary.

My nephew's dentist said that the early round is successful because the jaw/teeth are more malleable and will make the subsequent round easier or maybe not even necessary.

I'm interested to read other posts on this topic.

I was told by a hygenist who works in a pediatric office that orthodontia before age 12 increases the likelihood of them moving after the work is completed.

We are happy with our orthodontist, Marie Lathrop, who has an office on SE Milwaukie in West Moreland. We have decided to hold off for now with my 8 year-old. Dr. Lathrop checks back in with her every 6 mos. to see how things are progressing.

We have a great orthodontist close to SE in SW, Garfinkle Orthodonist (father and son). We were told the early round is just cosmetic, but would probably shorten the second round just a little bit. There was no pressure to do an early round, but we decided to (at age 10).

My 24 year-old friend from PCC just had a gum surgery to try and graft tissue into her gums that are badly receeded around some of her teeth. The reason she gave was that she had braces too early and the teeth moved, but the gums didn't. She said her periodontist said it's a common problem for her age group. Of course I would check with my dentist/orthodontist before I made any decisions, but it's food for thought.

I would love to hear more on this topic. My almost 7 year old Daughter has been to the orthodontist for evaluations. She has a lot of crowding and a few teeth coming in at odd angles. He is recommending the first early round of braces and spacers. His concern is how her jaw will grow with the crowding but I feel she is too young and plan to seek another opinon. Has anyone been to Jeffrey Sessions and what age was your kid/kids if they got the first round?

Parkside Orthodontics has my vote in SE Portland just a block away from Laurelhurst Park (great place to spend time with a younger sibling while appointments take place). We didn't do the early treatment with either child as everything is going well so far.

I don't have advice on the early evaluation and treatment aspect - but I am in the middle of braces as an adult! I'm very happy with my orthodontist, Jerry Rensch in the Hollywood District (http://portlandbraces.com/).

Yep, in the same boat. We were told our now 6 year old daughter would definitely need braces for her crowded teeth and that we may want to do the preemptive early round in second grade. After reading these posts, I'm now not so sure she needs to go through the agony that is braces twice. I got mine at ten, only a couple of years later than what they are recommending for our daughter, and had them for about three years. I don't see how this will shorten her time in braces or lesson the discomfort of them. I suppose this is a bridge we will cross when we get there....

I had a retainer to open up my palate & fix my overbite when I was young. We didn't have money for braces so the retainer was a great start. When I was 27 my dentist commented my enamel was wearing unevenly and braces would be needed soon or partial dentures would be in my future. Braces for two years and a permanent wire on the top front 6 teeth, darn those stubborn front teeth! Love my smile and would try to keep the braces on a bit longer to see if the top front would have held still. Good Luck.

We got opinions from both the KP orthodontist and a the folks at the OHSU School of Dentistry. They both agreed that with my daughter's very crowded teeth, with lower primary canines locking in the upper adult lateral incisors, that the most conservative approach was to pull the canines, to allow the permanent middle teeth (4 up, 4 down) to hopefully migrate to their proper position on their own. So we had the canines pulled, and the permanent teeth are lining up, somewhat. No braces yet, but we go in every few months to check on how things are moving.

I'm typically a proponent of minimal intervention, but I was convinced that doing a 2 part intervention made sense for my child. We started evaluations around 8 and a half.

I don't have any experience with this regarding my own child (he's too young), but I do remember my own orthodontic experiences and watching my younger brother go through his. I first had spacers and a palette expander put into my mouth around age 10-11 with braces put on shortly after. I had braces for 18 months and then had to wear a retainer for another 2 years afterward. My experience wasn't too bad and my teeth have only now begun to shift a bit (18 years later).

My brother had the early intervention and had spacers and braces at age 8, then they came off and he had to get them again at age 11-13. Then his teeth continued to move and he needed braces again at 15-17. All I remember was my mom having to lean over him and tighten or widen his spacers while he screamed his head off from the pain. Looking back, I think my parents agree that he was too young for the first set (or two) of braces and they should have waited.

My son was told at his very first dentist visit (age 3) that he'd need braces because his mouth was so crowded. I had braces starting early and figured that's where we were headed. But no, we had an orthodontic consult with Dr. Dugoni (same office as Dr. Rensch) and he said to pull certain baby teeth to allow permanent teeth room to come in. We did that at age 8. A year later, his mouth was super crowded again and we went in for another consult--me figuring that this time it was braces for sure. Nope, another round of xrays and another set of baby teeth pulled. And . . . a year later same deal. Only this time, Dr. Dugoni looked at the xrays and said that we would have to pull four permanent teeth. I was shocked and upset and he walked me through the reasons why braces would not work--this wasn't an issue of cosmetics where the teeth were crooked. There's just no room in his jaw for all of his teeth, and using braces to make room would not work because you can force the jaw to grow bigger. We went for second opinions with Dr. Saferstein and at Parkside Orthodontics. They all said exactly the same thing. So we went ahead and had the teeth removed. He'll still need braces to straighten everything, but not until he's 12 or 13.

So, I guess what I'd say is that you should get lots of second opinions and not depend too much on anecdotes from folks like me. The issue with your child's teeth may not be the same as Johnny down the street even though it sounds the same to a lay person. When you go for the second opinions, have a copy of your child's xrays and have your questions written down and take notes about the orthodontist's answers. Ask for references to studies about the effect of early orthodontia on later gum health, etc. The consultation appointments are free, so take advantage of them to get educated.

Oh, and don't write off straightening as "cosmetic." Teeth that overlap often trap food and get more cavities.

My almost 10 year old son has just finished his first round of orthodontia that started at 8. I would echo earlier commenters' responses that it depends very much on the individual situation. My son had a palate expander because his upper jaw was narrower than his lower jaw- it seemed like an obvious thing to do at a younger age when everything is more malleable. The other issue was that one of his permanent teeth in the front was hitting a permanent bottom tooth and causing wear. We were hoping the retainer he got after the palate expander would move things enough to avoid braces but in the end he got 4 braces on the top to move the teeth out so they wouldn't hit. Now he has a retainer to hold everything in place for while. For the most part, it was a very painless experience- not like I remember with my own braces. We used Dr. Marie Lathrop on Milwaukie in Sellwood and highly recommend her. She was good at explaining things and giving us various options to choose from.

Anyway, we're just wrapping up "phase two" (of two) of orthodontia for my daugther; she's just a few weeks shy of 13. As many of the other commenters said, get multiple opinions (and not from the hygenist, please) before proceeding. As far as cost goes, both phases of orthodontia for my girl cost within about $100 of what one set of braces applied right now would have cost. Essentially, a wash.

Love Dr Rebecca Kuperstein at Parkside Orthodontics - she is great!

We adore our dentist, Dr.Martha Rich (in the Medical Dental Bldg. behind the Central Library), who we have been seeing for over a decade. She is very professional and well regarded in the community being up at OHSU teaching as well. I am a bodyworker and, at my first appointment, told her that I was concerned about the 'night guard' that I needed to be fitted for (for grinding). I didn't want it on my upper jaw as that would impede the craniosacral action of my cranium and spine. She was all over that and said, for that reason, they fit them for the lower jaw. She is not an orthodontist but if you are looking for someone who is aware of the body beyond the typical western model and who is also well aware of child development and the implications of orthodonture on a developing body- she can help you out and recommend someone like-minded. We really respect and trust her!

Actually, Dr. Martha Rich does do orthodontics! As in all her other work, Dr. Rich approaches orthodontics with a preventive approach. Evaluating bite and airway development in children, Dr. Rich sometimes recommends retainers for children as their bite is developing to guide the teeth into place and in some cases avoid further orthodontic treatment during adolescence. I work for Dr. Rich and would be happy to answer any questions that I can!

You can ask different orthodontists about your concern. List down what they recommend to you, then pick out what's best for you. Well, that's what some would do. At least you can see which the best is because you've consulted a lot of people.

I've been thinking about having braces since my dentist suggested that I have one. Thanks for sharing your experiences here! :D I'm more confident and excited about it now. :p

This was a great article. I was searching for a orthodontist in Kitchener for months when we first moved there. It's not easy finding a good fit for your family, especially with kids who didn't like going to the dentist. Hope you find a great one too!

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