Looking for advice on treatments for 8 y.o

[JamesMR]

Hi Everyone,

Thank you for accepting me into the forum! I am hoping to get some advice from people who have experience or have experienced treating young children with dental crowding. My 8 year old daughter has severe crowding and whilst young it is clear she is going to have issues fitting all the adult teeth in her mouth as she gets older. Having had a very bad experience with an orthodontist as a child I am very hesitant to go down the route of traditional orthodontics. The orthodontist who treated me (Australia, in the early 90s) took out 8 adult teeth (including both lateral insisors) in order to straighten my teeth. I ended up with a severe underbite and suffered from snoring and sleep apnoeia. I had double jaw surgery last year to try and improve my breathing however it is still not ideal.

I really want to do everything I can to ensure this doesn't happen to my daughter. She is predominantly a mouth breather and I can already see her jaw is set backward. I have been to see two different orthotropists (essentially just "holistic" dentists) who are recommending an expander to assist in widening her palate to help make room for adult teeth and promote forward jaw development. This really makes sense to me. However, yesterday we went to see a very highly decorated Orthodontist and he said things are fine and that the size and shape of her jaw are genetically determined (not environmentally determined) and will develop over the next few years as her adult teeth come through. He assured us that he tries not to extract teeth in his treatments but I am unsure how she is going to fit all the teeth in her mouth if her jaw doesn't widen or grow properly due to her mouth breathing. I mentioned to the orthodontist that I had seen two orthotropists and he said that orthotropics is very "20th century" thinking which was theorised before there was much understanding about genetics. He even smugly pointed to his orthodontic degrees on the wall and said that "whilst it is nice that they take an interest they don't have the qualifications for straightening teeth"

My wife very much liked him and is hesitant to put her confidence in a dentist/orthotropist who has not had the extensive training in orthodontics. I am really unsure what to do as I can see why my wife is a little skeptical but am just concerned that down the track the orthodontist is going to say he needs to start pulling out her teeth in order to get them straight.

Has anyone had experience with orthotropics and can confidently say it is a good route to take for kids or is it generally considered backward thinking "hokum pokum"

Any advice you can give me I would be very appreciative!

Thanks!
James
Brisbane, Australia

[bbsadmin]

Orthotropics is not really based in solid science, and you are wise to be skeptical of it. Holistic thinking is good for some things, but jaw problems is not one of them. IMO, you should be getting opinions from qualified orthodontists. Get several opinions. There is no harm in seeing 3 or 4 orthodontists to see what they say.

That said..... years ago it was very common for orthodontists in Australia to extract teeth in children -- sometimes when it wasn't the best choice. I would advise you not to let that happen unless it is 110% necessary. I don't know if orthodontists in Australia are still as keen on doing extractions as they were in the past. (The problem is that if you extract the adult teeth before a person's face is finished growing (around age 18), their face could grow longer and flatter (and less attractive).

Expansion to make room is common for children, and easier for them than you might think. After about age 18 the upper palate fuses, so expansion at older ages requires SARPE (surgical expansion).

Get several opinions and take your time. Go with the orthodontist that you like, who listens to you and takes the time to explain their treatment plan.

[djspeece]

Orthotropics is not really based in solid science, and you are wise to be skeptical of it. Holistic thinking is good for some things, but jaw problems is not one of them. IMO, you should be getting opinions from qualified orthodontists. Get several opinions. There is no harm in seeing 3 or 4 orthodontists to see what they say.

That said..... years ago it was very common for orthodontists in Australia to extract teeth in children -- sometimes when it wasn't the best choice. I would advise you not to let that happen unless it is 110% necessary. I don't know if orthodontists in Australia are still as keen on doing extractions as they were in the past. (The problem is that if you extract the adult teeth before a person's face is finished growing (around age 18), their face could grow longer and flatter (and less attractive).

Expansion to make room is common for children, and easier for them than you might think. After about age 18 the upper palate fuses, so expansion at older ages requires SARPE (surgical expansion).

Get several opinions and take your time. Go with the orthodontist that you like, who listens to you and takes the time to explain their treatment plan.

Great response! Best of luck to you.

[Carno]

When I was 17 I visited an orthodontist and started treatment and the first thing he did was put me in a removable palate expander. I only tell you that to say that it can be done as late as that age, and then the crowding fixed via braces. Your daughter is EIGHT, her skull/face is not done growing yet; I'd relax a little bit and not go crazy about orthodontics just yet. There is still over a DECADE before your daughter would even be close to needing SARPE.

By the same token, definitely do not let any orthodontist pull adult teeth at this stage SPAM SPAM SPAMMING. That would be insane to do. I have several friends who had adult teeth extracted as kids, and all of them complain of it now (in their 30s/40s). I would also ditch any sort of "holistic" dentist. That's quackery and should be avoided.

Shop around to find an orthodontist that you like and who is upfront and open and takes time to answer all of your questions. Do not settle for a supposedly "good" orthodontist who dismisses your concerns out of hand and doesn't take time to listen and respond. Orthodontia has come a LONG way since the 90s, so don't be overly anxious that your daughter's experience will be like yours. And relax a little bit, she's EIGHT.