It's not always about braces

I guess the common perception of an orthodontist is that we fit braces. Of course that is a big part of what I do but I don't advise braces for every patient I see. Take two cases that I have seen this week.

S is 12 and not bothered by the appearance of his teeth. He is pretty adamant that he doesn't want braces, he has thought about this and lists several very valid reasons why. His teeth are a bit crooked, but not too bad and the main reason for doing treatment would be aesthetic. That's not to say appearance isn't important, but in S's case he was happy with his appearance. In his case treatment will still be possible if he changes his mind when he gets a bit older, even when he is an adult.

In this situation the patient's opinion is key. Wearing braces is a big responsibility and is not without risks. I need patients to be on my side to make the treatment easier for all of us. Apart from a few specific situations (for example where treatment timing is critical or dental health is an issue) I will never persuade people into treatment they don't want.

C is also 12 and has a very different situation. Her teeth aren't very crooked either but four of her adult teeth have failed to develop and one is in a poor position, that's her x-ray above showing the milk teeth remaining in position. Orthodontic assessment in a case like this is essential to plan what to do. If her teeth were really crowded we would remove the milk teeth and use the space to straighten the front teeth so that there won't be long term spaces, but in C's case this would be too complicated and wouldn't actually improve the position of her teeth by much, in fact she'd probably end up in a worse situation. So I didn't suggest braces for C either, she needs to take care of all her teeth, including the milk teeth that remain as they can sometimes last for years. Her dentist can plan how to replace these teeth when they are eventually lost but orthodontics can't really offer much to her.

So just because you need to see an orthodontist it doesn't mean that braces is the immediate or obvious solution. As an orthodontist I am trained to understand the development of the teeth, the jaws and the face, as well as knowing how to correct problems that can occur. So be honest with me about how you feel, listen carefully to my advice and don't be afraid to ask questions.