While it is recommended that children be screened for braces as early as seven years old, many people do not have braces installed until the age of 12, so-called teen braces. At this age it is no longer possible, strictly speaking, to perform interceptive orthodontics; however, significant movement in the teeth can still be made. In truth, about a decade ago orthodontic treatment was almost exclusively in patients between the ages of 11 and 18.
The look of teen braces is important
In contrast to kids braces, teen braces are placed at a time when physical appearance can be extremely important to patients. While the idea of braces has changed over the past ten to twenty years, many teens are concerned about how they will look in braces. Therefore it is important (parents, listen up) for teens to have options when it comes to braces in order to assure compliance. Teens that like their braces and think about them positively are more likely to perform the work needed to keep teen braces functional and avoid the foods and activities that could damage them. Proper care shortens orthodontic treatment time and keeps the cost of braces in check.
Teen braces have been adapted and innovated to be more comfortable than in years past. There are ways to customize the ligatures in various colors or to have ceramic (tooth-colored) brackets. Lingual braces are an option though this makes teen braces much more expensive overall. Clear braces are another option for teens under some conditions. In fact Invisalign has recently released a line of clear braces exclusively for teens.
Extractions and teen braces
Because teens do not get the benefit of interceptive orthodontics, they are often told they must have several teeth extracted to make room for the rest of their teeth. While this is indeed the case in many cases, it is never an easy decision. Tooth extraction may in fact change the profile and look of the face. While this change may be subtle, the teen patient should at least be aware of it. In some cases the changes in the face may make it more appealing and in others less so. The decision of tooth extraction needs to be weighed against the benefits of straight teeth. If aesthetics are the goal, which will look better a beautiful smile with a changed profile or crooked teeth / gapped teeth / buck teeth and the same profile?
Wisdom teeth and teen braces
Towards the end of orthodontic treatment in some patients with teen braces, a few new visitors come to the party. These uninvited guests, wisdom teeth, crash an otherwise brilliant orthodontic party. Do wisdom teeth tend to crowd teeth in the front of the mouth? Can wisdom teeth ruin years of orthodontic treatment? Not really. While it makes sense that wisdom teeth can be troublesome party crashers (after all, wisdom tooth removal is the most commonly performed oral surgery) studies on the subject indicate that wisdom teeth do not negatively impact orthodontic treatment to a significant degree.1-4 However if your dentist, orthodontist, or oral surgeon suggests that you have your wisdom teeth removed, consider this advice carefully. The wisdom teeth may need to come out for a different reason.
Retention and teen braces
Realize that even though patients in adolescence have reasonably adult mouths, their teeth are still prone to shift. Therefore it is important to use retainers when instructed by the orthodontist. Retainer use helps keep the teeth in their proper position and helps prevent them from shifting after getting braces off. Expect to wear a retainer for retention purposes almost constantly during the first year after active treatment with teen braces. After that, teen patients may need to wear a retainer up until age 25.
Reference List
(1) Harradine NW, Pearson MH, Toth B. The effect of extraction of third molars on late lower incisor crowding: a randomized controlled trial. Br J Orthod 1998;25:117-122.
(2) Robinson RJ, Vasir NS. The great eights debate: do the mandibular third molars affect incisor crowding? A review of the literature. Dent Update 1993;20:242-246.
(3) Song F, Landes DP, Glenny AM, Sheldon TA. Prophylactic removal of impacted third molars: an assessment of published reviews. Br Dent J 1997;182:339-346.
(4) Vasir NS, Robinson RJ. The mandibular third molar and late crowding of the mandibular incisors–a review. Br J Orthod 1991;18:59-66.