At Orange County Pediatric Dental Group, Dr. Renzi and Dr. House believe that braces and other types of early orthodontic treatment are an important part of Pediatric Dentistry. 

Many children are excited about getting braces, but worried that they will hurt. With advances in brackets (braces) and orthodontic wires, most patients are surprised at how easy and comfortable orthodontics can be. Although patients of any age can benefit from orthodontics, it tends to work much quicker on children and teenagers as they are growing and the bone is less dense, compared to adults.

At Orange County Pediatric Dental Group, Dr. Renzi and Dr. House perform and orthodontic evaluation as a routine part of our initial and periodic (check-up) examinations. We often see potential orthodontic problems in young children and make a point to mention them to families. We will also typically take a panoramic radiograph (x-ray) around age 6. This also is an extremely helpful tool to help anticipate the presence of crowding, missing/extra teeth, or incorrectly positioned teeth. After reviewing the panoramic radiograph, Dr. Renzi and Dr. House will discuss what they saw with families. We have found that families appreciate this because it helps them to plan for the future financially. 

Why are so many young kids getting braces? I didn't get mine until I was a teenager.

Orthodontic treatment philosophy has changed since many parents and grandparents of our patients went through their orthodontic treatment. In the past, children had to wait until all of the adult teeth were in and quite often, four bicuspids (premolars) were removed. Unfortunately, while this can relieve the crowding, it can also negatively impact the patient's profile as he or she ages and the face flattens as part of the ageing process.

Many orthodontic providers believe in interceptive orthodontics (Phase I orthodontics or early orthodontic treatment). The goal of this is to intervene when problems are detected and to help make more room for the eruption of the permanent teeth. We want permanent teeth to erupt into the correct position, centered in bone and healthy gum tissue. We also want to make sufficient room to avoid the need for the removal of permanent teeth, if possible. An analogy would be when your GPS reroutes you because it sees that there is a bridge out, so it takes you down a different route to reach your destination. You can think of Phase I treatment as a "rerouting" of the teeth when it sees a problem ahead. 

Phase I treatment sounds great. Why doesn't everyone do Phase I treatment?

At Orange County Pediatric Dental Group, Dr. Renzi and Dr. House are firm believers in the benefits of Phase I treatment. However, not all patients are candidates for phase I treatment. Some of the reasons for waiting are:

• Patient is not cooperative enough to tolerate orthodontic treatment
• Oral hygiene is too poor for orthodontic treatment
• Orthodontic condition is mild and is better treated when child has all permanent teeth (single phase treatment)
• Patient does not want braces--compliance is critical for success
• Parents do not want braces for their child at that time

Why do children need a second phase of treatment if they do Phase I treatment? 

There are times when patients need a second phase of treatment, known as Phase II treatment, when all of the permanent teeth have erupted. At Orange County Pediatric Dental Group, Dr. Renzi and Dr. House do most of the "heavy lifting" up front in Phase I treatment. This sets the stage for the permanent teeth to have enough room to erupt. However, we can't control a tooth bud that is rotated or a second permanent molar (12 year molar) that is tipped in an unfavorable position. We wish that we could! For us, Phase II treatment is typically a short treatment that involves minor corrections, like adjusting rotated teeth, uprighting 12 year molars, and helping bring the upper and lower jaws closer together.

Benefits of Phase I treatment (there are many more):

• Helps make room for permanent teeth to erupt

• Helps close spaces if they are present
• Helps decrease "overbite" (what we call an overjet)--decreasing the risk of dental trauma to these teeth
• Can open the bite in the case of a deep bite (where top and bottom teeth overlap extensively, sometimes damaging gum tissue on the roof of the mouth)
• Can increase self-esteem
• Can make oral hygiene easier in cases of crowded teeth
• Can make Phase II treatment time shorter
• Can prevent permanent teeth from becoming impacted or erupting out of position (think of adults with canines that look like "vampire fangs" due to crowding)

Does every child get the same Phase I treatment plan?

Absolutely not! After an examination and review of orthodontic records, Dr. Renzi or Dr. House will develop an orthodontic treatment plan tailored to your child's unique needs. Some children need treatment of one of two teeth, while others require treatment of both top and bottom jaws, needing intervention to straighten teeth and to bring the jaws into alignment properly. Other children fall in between these categories. After analysis of the orthodontic records, Dr. Renzi or Dr. House will see you (your child is always welcome, too) for a consultation to review the records and to discuss the treatment plan, as well as any alternative plans, if they are appropriate. We always welcome questions, as it is important for parents to feel comfortable with their child's orthodontic treatment. 

At some offices, I hear that the kids see different doctors often. The kids don't even know the doctor's names. Is it like that here?

No. We believe in continuity of care. This is difficult when the doctor keeps changing. Our staff will schedule your child with his or her primary doctor unless you need to bring your child in on a day that doctor is unavailable. You would be aware of this and you would have the choice to schedule or to schedule on a different day when your child's doctor is available. Both Dr. Renzi and Dr. House received orthodontic training in dental school and in their residency programs. They now have over 60 years of experience providing orthodontic care for patients!

What about Invisalign for children?

While Dr. Renzi and Dr. House provide orthodontic treatment with aligners using based on the same principle as Invisalign, we do not use aligners on children with mixed dentition (a combination of baby teeth and adult teeth). Compliance is the most critical key to success with orthodontics. It is difficult to obtain compliance with our teenaged patients who undergo treatment with aligners. We have found that our younger patients often will discontinue regular retainer wear following braces when they start losing teeth as they do not like the feeling of an appliance that pushes against their loose teeth. In addition, with years of experience, we have found that compliance has been poor with removable appliances of other types. For these reasons, we have opted to provide care for children undergoing orthodontics using fixed orthodontics.

If you have questions about braces for children, please contact our office.