What type of Orthodontic service can you expect from us?
Firstly, consider the actual treatment:
Orthodontics is NOT just about straightening teeth but just as importantly ensuring the maximum harmony between all the dental and facialstructures. In practice, this means not only aligning teeth, but also focussing on issues such as ‘lip support’, ‘facial length and symmetry’, ‘smile width’ and most importantly, ‘profile’.
For example, not many people (including many ‘specialist’ orthodontists) realise that when finishing a teenager’s treatment, it is better to leave slightly too much tooth showing than too little! This is because within as little as ten years, as the face matures, the upper lip will quite naturally start to drop, thereby hiding more of the teeth. If you want to look great in your 40s, you may have to accept being slightly ‘toothy’ in your 20s!
Orthodontics has TWO main problems to contend with: Firstly, there may appear to be ‘too many teeth’ for the jaw, resulting in either crooked teeth, or teeth that stick out a lot. Secondly, the upper jaw size may not correspond with the lower jaw size, resulting in one of the two sticking out over the other.
Consequently, when a young child complains of ‘Goofy’ front teeth, it could actually be caused by one of three possible options:
- The upper front teeth actually do stick out too far, or
- The upper jaw is too big, or more accurately, too far forwards, or
- Most commonly of all, that the lower jaw is too small, or too far back.
(It can also be a combination of all three, in varying degrees.)
As you can imagine, it is VITAL that the actual causes are correctly identified and diagnosed before any treatment is proposed. In the case where this is NOT done, one of the commonest mistakes made is to treat a child who has correct upper teeth and jaw size, but has a very small lower jaw (and hence, apparently, teeth that stick out) by extracting teeth in the upper jaw. The damage caused to the profile can be horrendous, leaving the patient with not one small (lower) jaw, but with two!
The resultant ‘bird-like’ profile flattens the face, and accentuates the nose, and is one of the least acceptable but all too common orthodontic outcomes.
Any experienced practitioner should be more than capable of diagnosing such cases from the outset, and offering growing youngsters an alternative. Unfortunately, such orthopaedic treatments are often more difficult and more expensive to carry out, and consequently may not always be even offered.
In other cases, there may often be a difficult choice to make between treating with or without taking out teeth. There is no right or wrong here. Every child is different, and we believe these decisions should be made jointly between dentist, patient and parent. In recent years there was a huge swing towards avoiding extractions at all costs (i.e. the ‘American route’). However, whilst quite naturally this sounds very attractive (especially to the patient) there are great risks in taking this approach too far.
My feelings are that patients will fall into one of three groups:
- Those who definitely MUST have teeth out
- those who definitely SHOULDN’T have teeth out
- and finally the most important group, those who may actually have a choice (depending on facial profile and width of smile desired, and willingness to commit more resources – in both time and money – towards achieving their desired goal.
It is perhaps in this area where choosing the private route, as opposed to simply accepting the NHS, might potentially do the most good!
AND ON TO THE SERVICE ITSELF:
Apart from the issues regarding waiting times already mentioned, more and more parents simply find the added benefits of their child being attended to on a private basis both more convenient and agreeable.
Virtually no NHS clinic now permits children to visit after 3.30 pm and consequently all appointments involve missing school. Private appointments are tailored to suit individual needs, and many people agree that they feel less rushed. Also, all treatments are either directly supervised by, or more usually carried out by the prescribing dentist. Many NHS practices rely heavily on the use of orthodontic therapists to carry out the majority of the treatment itself, frequently (and this is currently an issue of serious debate) totally unsupervised by the dentist.
Furthermore, all patients are offered a range of treatment options, from such minor things as simply choosing from invisible or brightly coloured braces, to making choices regarding jaw growth options instead of extractions.
REMEMBER: If you aren’t satisfied with a crown or a filling, it can at least be replaced at some date in the future. But –
YOU ONLY GET ONE REAL CHANCE TO DIAGNOSE AND TREAT A GROWING CHILD ORTHODONTICALLY
Extracted teeth cannot be ‘put back’ later. You can only ‘grow a jaw’ when that child is growing. The profile and smile your child is given now will be with them for the rest of their life.
LET US GUIDE YOU THROUGH THE COMPLEXITIES
OF MODERN ORTHODONTICS AND HELP YOU
MAKE THE RIGHT CHOICES FOR YOUR CHILDREN.
Author: Dr John Davey
Brixworth Village Dental Practice