Orthodontics in children

Cuando nos referimos a ortodoncia infantil debemos saber que hay distintos tratamientos para corregir diferentes maloclusiones (alteraciones de la mordida) en los niños.

When we refer to children's orthodontics, we should know that there are different treatments to correct different malocclusions (bite alterations) in children. 1. Between the ages of 6 and 11, what is known as "Interceptive Orthodontics" is performed, which is a preventive orthodontics, which can only be performed on children as it takes advantage of the fact that the growth of the maxillary and mandibular bones has not yet finished to guide their growth. The price of interceptive orthodontics in children in Madrid is between 1400 and 1600 euros, including the orthodontic study. After interceptive treatment, many children will need to wear "Standard Orthodontics" when they have all their permanent teeth in their mouths. That is, once the position of the maxillary bones has been corrected or improved, many will also require orthodontic treatment to move the teeth; however, it will be a much simpler treatment after interceptive orthodontics has been performed.

When we refer to children's orthodontics, we should know that there are different treatments to correct different malocclusions (bite alterations) in children. 1. Between the ages of 6 and 11, what is known as "Interceptive Orthodontics" is performed, which is a preventive orthodontics, which can only be performed on children as it takes advantage of the fact that the growth of the maxillary and mandibular bones has not yet finished to guide their growth. The price of interceptive orthodontics in children in Madrid is between 1400 and 1600 euros, including the orthodontic study. After interceptive treatment, many children will need to wear "Standard Orthodontics" when they have all their permanent teeth in their mouths. That is, once the position of the maxillary bones has been corrected or improved, many will also require orthodontic treatment to move the teeth; however, it will be a much simpler treatment after interceptive orthodontics has been performed.

The aesthetic brackets are transparent and therefore are much less visible than metal brackets. This means that if the child is somewhat older and wants to opt for this orthodontic option, quality is not at odds with aesthetics. The duration of treatment is usually the same as with metal braces; most cases require about 18 months, but if the case is more complex, the treatment could last around 24 months. The price in Madrid of fixed orthodontics with aesthetic or sapphire brackets usually ranges between 3000 and 3400 euros.

* Orthodontics with clear aligners (Invisalign teen)

For children and adolescents with more esthetic requirements, there is also the option of Invisalign Teen, which are clear aligners that must be worn 24 hours a day except when the child eats and brushes his or her teeth. These splints are completely custom-made and must be changed under the recommendations of our orthodontist approximately every 2 weeks.

The price of treatment with Invisalign Teen in our clinic in Madrid ranges between 4800 and 5000 euros.

It is very important to check children from 6 years of age to detect malocclusions that can be easily managed by guiding the growth of the maxillary bones with interceptive orthodontics. In addition, at this age, we can detect habits such as tongue thrusting when swallowing, thumb sucking, etc... that can deform the shape of the palate and bones. In these cases, our orthodontist will work closely with the speech therapist if necessary to correct these habits and ensure that the child's growth and development is adequate.

If we treat children early, we will be able to manage anomalies and alterations in the maxillary and mandibular bones very easily. This therapy will produce an enormous benefit, not only in the masticatory function but also in the future esthetics of our child's face. Otherwise, we can miss important alterations that, in the adult, have no solution except with orthognathic surgery (intervention to move by surgery the maxillary bones). With a very simple treatment, most of the time with removable appliances ("removable"), we will achieve an enormous benefit in the long term:

• Guide the growth of the maxilla and mandible.
• Correct habits that can generate large bite deformities and aesthetic repercussions in the face and future smile... such as thumb sucking, putting the tongue between the teeth when swallowing, among others...
• ·To achieve adequate space for permanent teeth.

1. Interceptive Orthodontics (Dentofacial Orthopedics)

This is the type of orthodontics that is performed in children between 6 and 12 years of age, a period in which the milk teeth will coexist with the permanent teeth (known as "mixed dentition"). At 11-12 years of age, the growth of the maxillary and mandibular bones usually ends, so this is the margin we have to control the growth of the bones and to be able to control their position and size. After this stage, we can only move the teeth, and there are bite alterations for which it is crucial to manage skeletal development.

This type of orthodontics consists of removable appliances for children, the so-called "functional appliances" usually made of acrylic resin, which are anchored to the teeth by means of retainers. Sometimes these devices can be fixed.

These appliances are used to treat the following bite and/or growth disorders:

• Crossbite. Under normal conditions, the teeth of the upper arch are placed in front of the lower arch when biting. In children with crossbite, this would be the other way around, which means that the mandibular teeth would be placed in front of the maxillary teeth, both in the anterior area and in the posterior teeth. The treatment of crossbite in children is usually oriented to the expansion of the palate for which the "palate expander" (removable appliance) or the "disjunctor" (fixed appliance) are indicated, which will gradually make the palate widen, taking advantage of the fact that the growth of the bones is still in force.
• Anterior open bite. If our child bites with the molars and back teeth but the front teeth (usually incisors and canines) do not contact, we are talking about an anterior open bite. These children are characterized because they cannot cut food with their front teeth. If this problem is not treated, the same will occur in adulthood.
• Skeletal Class II or retrognathism: this type of malocclusion is one of the most frequent and is characterized because the maxillary bone (the bone where the upper teeth are located) is very advanced with respect to the jaw. This will not only condition the position of the teeth but will also affect the aesthetics of our child's face. This is usually due to a lack of growth of the mandibular bone and/or an excess of growth of the maxilla, which causes a difference of several millimeters between the teeth of one arch and the other. For the treatment of this alteration, devices are used to stimulate the growth of the mandible and bring it closer to the dimensions of the maxillary bone. Devices such as the Bionator are an example of those used in this malocclusion.
• Skeletal Class III or Prognathism: this type of alteration is based on an advanced position of the mandible with respect to the upper jaw, which will affect not only the bite but also the facial aesthetics of our child in a striking way. This is usually due to a lack of growth of the maxillary bone and/or an excess of growth of the mandible, which causes the child to "bite backwards", that is to say, the lower incisors will be placed in front of the upper incisors when biting. In children, taking advantage of the fact that the bones are still growing, it is possible to slow down the growth of the jaw by means of an appliance called a chin guard or to stimulate the growth of the maxilla by means of a facial mask.

2. Corrective orthodontics:

This type of orthodontics is usually placed after about 12 years of age, when bone growth is complete and the permanent teeth have erupted. Its function is to align the teeth, correct crowding (crowded teeth) and achieve a good relationship between the teeth of the upper and lower arches. It also solves an increased overjet or overbite (when the upper front teeth are too far outside the lower teeth or when they cover them excessively vertically).

With this treatment, in addition to improving the bite and therefore the function, the esthetics of the smile will be greatly improved and oral hygiene will be facilitated by aligning the teeth.

Types of corrective orthodontics:

Although we speak here of orthodontics in children, corrective orthodontic treatments are the same as those performed in adults, so these lines can be generalized for both children and adults.

* Fixed orthodontics: this is based on the use of so-called "brackets" that are attached to the front face of the teeth. These can be of two types depending on the material:

• Metal brackets. These devices that are cemented on the teeth are metallic in color and are widely used in people without aesthetic requirements, since their quality-price ratio is very good. Joining the brackets are placed several types of arches that are changed frequently, which are the devices that will modify the shape of the dental arches.

• Aesthetic brackets are translucent and therefore are much less noticeable than metal brackets. Different metal archwires are placed on them, so although the brackets are much less noticeable, at short distances you can see the devices in place. It is true that for people who prefer to conceal their orthodontic appliances to a greater extent, this may be their treatment of choice.

  With both metal and esthetic brackets, the duration of treatment is usually around 18 months for most cases, but those with more complex braces require somewhat more treatment time, around 24 months.

  Sometimes an extra anchorage is necessary in orthodontics to facilitate the movement of teeth, especially in adults. For this purpose, micro-screws or mini-screws are used, which are special small screws that are placed in the gum next to the tooth to be moved; by means of elastics and other devices that anchor these micro-screws to the teeth, the latter are pulled to perform the desired movements. The same function can be performed with dental implants in people who have lost teeth.

  

• Orthodontics with clear aligners (invisalign®)

  For people with more aesthetic requirements there is the option of Invisalign, which are transparent removable splints that must be worn 22 hours a day (we should only remove them when we eat and perform oral hygiene). These splints are made of transparent plastic with the shape of our teeth and every 15 days or so they are changed, which allows small movements to be made on the teeth that improve the bite, reducing crowding and aligning our teeth. This is the most aesthetic orthodontic option and is only noticeable in very short distances. In addition, it is the treatment that allows better oral hygiene, since to brush your teeth, the splints are removed and brushing can be done as if we were not performing any treatment, unlike braces.

  

  It is usual for the orthodontist to do the check-ups every month, but in patients who live abroad if they are treated with clear aligners, these could be extended a little more, but only if the orthodontist gives the approval and delivers several aligners so that these are changed every 15 days.

In our clinic in Madrid orthodontic prices are closed, that is, even if more visits are necessary, the overall cost of treatment is the same. Ask our staff about our 12- and 18-month interest-free payment facilities.

• As children continue to grow until about 12 years of age, it is possible to move the maxillary and mandibular bones, which cannot be done in adults. This makes it possible to solve important bite problems.
• It generates the necessary spaces for permanent teeth. Baby teeth are smaller than permanent teeth, so it is necessary that there is adequate space for them to erupt and there is no crowding or teeth retained in the palate.
• ·Facilitates oral hygiene, thus reducing the appearance of cavities and gum disease such as gingivitis and eventually periodontitis
• It improves the aesthetics of the face since it treats important malocclusions that alter the facial aesthetics of the child (and if not corrected, are maintained when they are adults).

For people with more aesthetic requirements there is the option of clear Aligners, which are transparent removable splints that must be worn 22 hours a day (we should only remove them when we eat and perform oral hygiene). These splints are made of transparent plastic with the shape of our teeth and every 15 days or so they are changed, which allows small movements to be made on the teeth that improve the bite, reducing crowding and aligning our teeth. This is the most aesthetic orthodontic option and is only noticeable in very short distances. In addition, it is the treatment that allows better oral hygiene, since to brush your teeth, the splints are removed and brushing can be done as if we were not performing any treatment, unlike braces.

For people with more aesthetic requirements there is the option of clear Aligners, which are transparent removable splints that must be worn 22 hours a day (we should only remove them when we eat and perform oral hygiene). These splints are made of transparent plastic with the shape of our teeth and every 15 days or so they are changed, which allows small movements to be made on the teeth that improve the bite, reducing crowding and aligning our teeth. This is the most aesthetic orthodontic option and is only noticeable in very short distances. In addition, it is the treatment that allows better oral hygiene, since to brush your teeth, the splints are removed and brushing can be done as if we were not performing any treatment, unlike braces.

Orthodontics with clear aligners or splints depends on the type of malocclusion the patient has and the number of months of treatment. There is a treatment option known as Invisalign® Lite, in which the duration of treatment is shorter, between 6 and 12 months, and is indicated for people whose bite is adequate at the molar level but who require small movements to align the front teeth and improve the aesthetics of the smile. The Invisalign® Lite in Madrid is priced from 3600 euros. If it is necessary to correct the bite and make more tooth movements to ensure a good meshing of the teeth of the upper and lower arch, in addition to aligning the teeth and correct crowding, treatment with Invisalign® Full will be required, the duration of which will be approximately 18 months, although in more complex cases it may be extended for more months. The price of Invisalign® Full in Madrid is usually from 5000 euros.

Many of our patients ask us this question. To clean the splints just buy a white or clear neutral pH soap, scrub it with a toothbrush, rinse them with water and dry them very well. Always keep the splints in their box so that they do not get lost and do not eat with them because they could be damaged.

Advantages of invisible orthodontics or Invisalign:

• The great advantage of treatment with aligners is aesthetics, since the splints are transparent.
• We can see the simulation of the treatment before starting it, through the visualization of the Clincheck
• It consists of removable aligners, so oral hygiene is much easier.

Advantages of Brackets:

• The quality-price of the treatment is very good: more economical treatment with very excellent results.