By Dr. Jeff Beyer
This is a question I get asked almost daily in my practice, and quite honestly, it is a perfectly valid question to ask from a generation of parents who were never told to see the orthodontist (when they were kids) until middle school or even high school.
A little history here… during the ‘70s, ‘80s and early ‘90s, both pediatric and general dentists recognized orthodontic problems in their younger patients (age 6-10), but there was nothing they could do about it. So in the ‘90s, the orthodontic community decided it would be good to evaluate these young folks and offer them some options. Hence, the era of early, interceptive Phase I (there are more labels than I can write here) treatment was born.
As you can imagine, this created some confusion on the part of the parents who did not understand why they were taking their child in to see the orthodontist before they had all of their permanent teeth. Quite frankly, we as orthodontists did a very poor job of explaining this, and some parents saw this as nothing more than a ploy to fund the orthodontist’s 401K account by charging parents “twice” for braces.
The reality is that there are some children who can benefit greatly from having early treatment. The truth is, however, that there is no UNIVERSALLY accepted standard for who should get treatment and who should not. A more aggressive orthodontist may treat 80-90% of patients with Phase I, while a more conservative orthodontist may only treat 20-30%.
Over my 20 years of practice, I have settled in on three major reasons for recommending Phase I treatment. It’s when I observe at least one of the following…
The bottom line is this: If your orthodontist proposes Phase I treatment for your child, be sure to ask why, and what benefits it will have on your child’s orthodontic and dental health now. Ask what the potential ramifications are if you do not elect to proceed with treatment, as well as the financial implications (insurances have a lifetime maximum). In other words, be sure are comfortable with the treatment that is presented. If you are not, it is probably best to seek a second opinion. After all, if you proceed with Phase I treatment you are establishing what will become a long-term relationship with that particular orthodontist.
There are two final points I would like to make. First, over 95% of patients who undergo Phase I treatment will need full orthodontic care when they are teenagers. I cannot emphasize this enough. We tell patients’ parents this and have it in or consent forms and literature, but I am still surprised at the number of parents who seem surprised when we tell them their child is ready for full braces 2-4 years after we have completed Phase I.
Finally, the American Association of Orthodontists recommends ALL children have an orthodontic screening at age 7 to 8. We wholeheartedly support and agree with this. Your initial exam is always complimentary at Commonwealth Orthodontics, and you do NOT need a referral from your general or pediatric dentist to schedule with us. Many times your child will not need anything but an annual checkup until they are ready for full treatment as a teenager. However, if your child can benefit from early treatment and avoid potential future orthodontic complications, having the screening and your options presented to you is one of the best things you can do for your children.
By Dr. Jeff Beyer
Last month I had the opportunity to attend an American Association of Orthodontists symposium on Sleep Disorder Breathing and Sleep Apnea. It was a collaboration of medical and dental professionals sharing their expertise on a rapidly growing problem (dare I say epidemic?) that is becoming ever more prevalent in both adults and children across the U.S. and beyond. If you or a loved one are snoring at night, it could be part of a much more serious problem.
I received absolutely no training on sleep disorders in either my dental or orthodontic education, and wanted to have a better understanding of these disorders. That’s because many of my patients have indicated they suffer from sleep breathing disorders and the multitude of negative effects they can have on the body, up to and including death (yes, death). You were probably not aware that many celebrities — including Carrie Fisher (“Star Wars”), James Gandolfini (“The Sopranos”), Supreme Court Justice Antonin Scalia, Jerry Garcia (Grateful Dead) and NFL player Reggie White all died from complications from Sleep Apnea.
I was amazed to hear the following statistics:
There are some significant risk factors for adults, which include being male, over age 50, a BMI of over 30 (obese), and a neck circumference over 17”. Symptoms include nightly snoring, chronic tiredness during the day, a bed partner observing stopped or interrupted breathing, and elevated blood pressure. In children, snoring is the No. 1 indicator of a sleep disorder, along with enlarged tonsils, and some things you may not think about – chronic bed wetting, attention deficit disorder (ADD or ADHD), and trouble with comprehension at school.
Fortunately, there are many professionals who have dedicated their careers to specializing in diagnosing and treating patients with sleep disorders. If you feel as though you or someone you know may be experiencing these symptoms, it would be wise to alert your PCP or dentist, and they can help guide you to these professionals. A sleep study at an accredited sleep center is the single best way to make a proper diagnosis, after which treatment can be prescribed based on the findings. The single most effective therapy is a CPAP machine, but for those for whom that is not the answer, both dentists and orthodontists are making oral appliances to help these patients.
I can honestly say this symposium is probably the most informative and educational meeting I have ever attended. While I am by no means a sleep disorder expert now, I do have a more thorough understanding of the signs and symptoms. I will also begin to incorporate this into my clinical examinations and practice, now knowing when to make appropriate referrals to sleep disorder professionals for proper diagnosis and treatment.
If you would like to schedule an initial consultation with Dr. Beyer or have another question, contact us today.