Permanent fix: Exam today
means better teeth in future
By Donna Gehrke White
MIAMI HEROLD

San Antonio Express News
May 19, 2000

So you think taking your kids to the orthodontist is still a few years down the road, when they’re teen-agers, when they have all their permanent teeth.

Think again.

Now the experts recommend that children be examined no later than 7 or 8.

Some even advise that kids should be looked at when they’re toddlers.

There’s a new way of thinking that children’s mouths should be widened before their permanent teeth come in crowded and crooked. And new ways are being used to correct still growing jawbones so that children won’t have overbites or underbites.

It has never been more important: more than 3.5 million kids are being seen by an orthodontist – a 34 percent jump in just seven years, according to the latest statistics collected by the St. Louis-based American Association of Orthodontists.

Going early may save your children from having teeth pulled – or even having to wear braces. It may also save your children from having jaw problems as adults or premature aging around the mouth.

“They’ll have better-looking faces with wider smiles,” says Dr. Ray Greenfield, a Coral Springs, Fla., board certified orthodontist who has been leading the fight for the early treatment. He lectures in Japan, Latin America and Europe about widening children’s mouths to fit in their teeth instead of pulling as many as four of eight of their permanent teeth to make room in a smaller mouth, He developed one of many devices for widening palates wrote a textbook on straightening teeth without extraction for other orthodontists and developed a Web site, http://www.nextortho.com, for the general population.

Lisa and Martin Ginsburg of Pembroke Pines, Fla., brought their 8-year-old daughter Michelle to Greenfield.

“We Noticed early on that Michelle’s teeth were crooked in the front,” says her mom. “We were concerned.”

The first orthodontist the Ginsburgs saw said he eventually would have to poll four of Michelle’s teeth to make room to straighten her teeth.

Horrified Lisa told her boss, who then recommended Greenfield. Greenfield told the parents that Michelle wouldn’t have to lose any teeth as long as she got early treatment while her jaw was still developing: a wire, similar to a retainer, on the lower gums that muscles her bottom teeth back. For her top teeth, the doctor wants to use jaw expanders to widen her upper arches as well as use headgear at night that will create enough space for her permanent teeth.

Dr. Robert Stephens, a pediatric dentist who is one of five partners with Greenfield, calls early treatment the “cutting edge” of dentistry. While some parents fear early treatment will be a waste of time and money, Stephens says, “That is just the opposite.” He says it makes “braces less complicated” – or not needed at all because the problem has already been worked on by helping widen the mouth.

Debby Lichtner of Pinecrest, Fla., has already seen the difference. Her son, Stephen, 8, has been wearing a palate expander in the roof of his mouth to seven weeks, and “his front teeth are already moving into place,” she says. “It’s already correcting itself.”

Meanwhile, her daughter, Caitlin, 10, just had braces removed from her teeth.

It’s not like what it used to be when we were kids and got braces as teen-agers,” she says.

“Many of these major problems can be intercepted if the child is brought in early,” says the Lichtners’ orthodontist, Dr. Michael Mahaffey, a Coral Gables, Fla., board-certified orthodontist who is president of the South Florida Academy of Orthodontists.

Doctors, he says, can see problems as they are developing in a child’s mouth – X-rays even show how the late permanent teeth are positioned.

The St. Louis-based American Association of Orthodontists notes on its Web site, http://www. aaortho.org/, “By age 7, enough permanent teeth have come in and enough jaw growth has occurred that the dentist or orthodontist can identify current problems, anticipate future problems and alleviate parents’ concerns if all seems normal.”

The association says some doctors can see children as early as 2 or 3 – one orthodontist started treatment on a 4-year-old boy whose jaw was off center. The early treatment worked so well that the child ended up not needing braces.

Eric Kanigan of Coral Gables was 5 when Mahaffey fitted him with a retainer and headgear at night to correct his underbite and jutting jaw. Eric wore it for only four months and the problem was corrected, at least for now, says his mother, Susan Kanigan.

“It’s pretty amazing,” she says.

The dental work also helped his speech, she says. Before, he had trouble saying hi R’s “and he was self-conscious. Now he has no problem.”

Meanwhile, Eric’s sister, Rachel, 7, is wearing braces – with “really cool bright pink bands, which she thinks is a lot of fun,” her mother says. The braces benefit even her permanent teeth not in yet by helping properly align the existing teeth.

Dr. Enrique “Henry” Rozen, a Hialeah, Fla., orthodontist who is the incoming president of the local Orthodontics Academy, says early treatment means greater flexibility with helping expand the growing jaw to fit teeth in.

It also can help a child’s appearance, particularly one with an overbite or weak chin.

With the early treatment, today’s children will have “a beautiful smile from corner to corner of the mouth,” he says. “Aesthetically, we’ve made a lot of progress.”

Caren Weinburg of Coral Springs says her son, Zachary, 12, has been helped by the new orthodontics to straighten his teeth and to battle a receding chin.

“There’s a big difference in his face.” She says. “I feel grateful to have an opportunity to help him now.”

Orthodontists say that the early treatment also prevents problems that arise if teeth are pulled to make room for other. Some mouths rebel at losing teeth – but not until a decade or so after the braces come off.

“Years ago, a lot of extraction was being done and the patients’ chin and nose became accentuated,” Rozen says. “Ten to 15 years later (after the braces). The patients’ face have looked almost dished in, almost a grandma look from the lips looking too protruded.”