Orthodontics: is it for your child?

The dentist examines the mouth of Caroline, 12. A baby tooth refuses to drop the adult dog found its way into the gum. "Can you uproot his baby tooth?" Asks Réjeanne Mathieu, East Angus, pointing the mouth of her daughter. 20 years ago, we would not have hesitated. But there is categorical refusal today, dentists know that the gums and mouth in general are better when we con-serve all its teeth.

"Orthodontist-you must evaluate the case of Caroline before I proceeded to extract," says the dentist.

The idea n'enchante little Réjeanne Mathieu. The specialist she consulted the previous year for you Sylvie, his daughter 19 years, has announced that it would undergo surgery and dental devices worn for two years. Invoice amount: $ 5000, including a first payment of $ 1,000. The mother and daughter have abandoned the idea.

Incorporating no dentist will accept to extract the tooth Carolina, Réjeanne Mathieu took him home to Sherbrooke orthodontist, Dr. Denis Bernard. The proposed solution: first pin to make space, removing the baby tooth, and then pin on all teeth for 18 months. Then Carolina will wear a device that will keep his teeth in their new po-sition for 2 years. The cost: $ 5000. Fortunately, Dr. Bernard accept smaller payments.

As Réjeanne Mathieu, many parents hesitate before embarking on orthodontic treatment. The same questions concern: is it really necessary? What treatment is most effective? What is the best time to intervene?


Fewer teeth?
The Mallocclusions
The Mallocclusions can take many forms. Sometimes, for example, that some children are embarrassed by a space between the incisors top and bottom, even when their upper and lower molars touch (open occlusion). For others, the lower and upper jaws are not the same width (cross occlusion). But all Mallocclusions generally fall into three broad categories:


Class I jaws are aligned, but the teeth are crooked, tours or too tight.


Class II The upper jaw is too advanced and the bottom, small and erased.


Class III The lower jaw is prominent.

According to the American Association of Orthodontists, the number of Americans receiving orthodontic treatment has almost doubled from 1984 to 1996, from 2.5 million to 4.4 million people. In Canada, about 300 000 children are currently monitored by an orthodontist. In Quebec, ortho-dontistes increased from 76 to 129 in-between 1981 and 2001.

Our teeth are they worse-than people? Rather be no sense of aesthetics that has evolved. We give it more and more important. A phenomenon which dental insurance, which generally reimburse 50 per 100 of treatment, have contributed significantly. Result: care more affordable ...


A correct
In a normal mouth, teeth are straight. When the jaws are closed, those of high overlap slightly the bottom, and molars touch. Orthodontics corrects Mallocclusions, ie the misalignment of teeth.

A malocclusion is either héré-ing State, or the result of bad habits - sucking its thumb, pushing his teeth with his tongue, and so on. It can also occur after an accident or the premature loss of a tooth. A malocclusion is sometimes unnoticed in the eyes of parents.

"If the incisors and canines are straight, the child will have a beautiful smile and his parents will not think to consult an orthodontist. But that does not have a child of malocclusion making its chewing less effective, "said Dr. Alain Chaumont, orthodontist in Laval.


Health First
A number of parents lead their child to the orthodontist for a health issue rather than offer them a sparkling smile. Aline Michaud-Levesque, a nurse from La Prairie, did when she saw that her son Simon would have the same teeth as his father, whose molars are very worn because of poor occlusion. With age, problems with chewing, gum, and even digestive may appear.

The eldest, Nataly, did not want to undergo treatment in early adolescence, despite persistent pain in the jaw. Now aged 21, she decided to use orthodontics for cosmetic purposes. The case of their sister Josée is different when it closed the mouth too strong, its lower incisors injured his palace.

The repetition of beatings by teeth falling in the wrong place can eventually cause serious trouble at the turn of the quarantine. "The lower incisors one of my patients 45 years are completely Discalced," says Dr. Daniel Boivin, practicing orthodontist in Brossard.

In some people, occlusion is bad to the extent that it prevents a good chewing and leads the same problems of digestion.


The share of nature
A space between the incisors often characterized the smiles of toddlers. "It closes often alone at the age of 11 or 12 years, when the canines erupt and they exert pressure on the lateral incisors," says Dr. Sylvain Chamberland, orthodontist of Quebec. The chances then it disappears, however, are much thinner. You can fill it with a composite material or place pin - if we look really great!


Better pin
Over the past two decades, stainless steel rings around the teeth have given way to small boxes glued on which orthodon teeth tiste fixed-thin son alloy.

"A thermal alloy as the cui-ing-nickel-titanium is flexible in cold weather, but resumed its rigidity once in the mouth," says Dr. Denis Bernard. Installation is easier than stainless steel and adjustments less frequent. The pressure applied on the teeth moves slowly and steadily. This correction may last from 12 to 36 months. Thereafter, it will suffice to preserve the outcome.

"Usually, the child bears a removable 24 hours over 24 during the first six months, says Dr. Danielle Boivin. Then we gradually reduced the number of hours. It also installs a wire-keeping behind the lower teeth for several years. "


Treat sooner or later?
The pins have long been the preserve of teenagers. But many children now wear braces too. The three girls Manon Deblois, de Varennes, focused devices several months to 9 years old. Justine, the eldest, is 13 years old and completing a second treatment session.

The interventions on the framework, which is to expand a palace close or alter the development of a jaw, are much easier before adolescence, orthodontists observe the child being in the midst of growth.

"We can avoid having to undergo the latest treatments more complex," says Dr. Michel Di Battista, an orthodontist from San Bruno. To make the result, pins are still often needed on the adult teeth. "It is still possible to extend the palace to 14 years, but this is not as easy," said Dr. Sylvain Chamberland.

The merits of these treatments in two phases is controversial. A professor at the University of North Carolina, Dr. Camilla Tulloch, followed 166 children for 10 years as part of a study funded by the American Institute of Health. Some had received treatment in two phases, one other in adolescence. "We do not really notice any difference in results between the two groups, she said. In fact, if treatment begins early, treating only the child longer. "She admits, however, that a type III malocclusion is better treated at a young age.

Dr. Randy Lang, an ortho-dontiste Toronto, shares her opinion. The most Mallocclusions treated, those teeth prominent or too tight in the upper jaw may well be corrected in a single session in adolescence:

"For a similar result is faster and cheaper."


Does it hurt?
In Canada, orthodontic treatment, including pins, visits and periodic adjustments, costs on average $ 5,000. The price of the initial consultation is generally between $ 30 and $ 50 and includes a panoramic radiography. If you accept treatment, the orthodontist will be a record (photographs, fingerprints and teeth measurements) for an additional fee of $ 175 to $ 400, which will then be deducted from the total. After the initial payment, you can usually stagger the payments.

So much for the pain portfolio. For others, orthodontists warn their patients of possible discomfort the day following treatment and recommend taking painkillers if needed. For some, the pain is real. "After a visit, it really hurts!" Launches Kristel Vultaggio, 16. "The instrument used to broaden the palate Jean-Christophe caused him tension and pain into the nose," says his mother, Julie Borduas.

The cooperation of the child is essential to the success of treatment. To prevent cavities or tooth decalcification, the child should brush with the application and continue to see their dentist regularly. Dr. Alain Chaumont is categorical:

"I have already stopped or delayed treatment because the child lacked goodwill."