What is the right age to take my child to an Orthodontist?

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As a specialist orthodontist, we like to see a child when they’re 7-8 years old. This also coincides with the eruption of the permanent front teeth, to asses if there is likely to be any need for treatment. Modern orthodontics takes a holistic approach to the overall wellbeing of a child, in addition to the teeth and jaws, we look at facial growth and development as well as function and breathing. It is a common misconception that orthodontics deals only with straightening crooked teeth – this is only one part of orthodontics!

At an initial assessment, we will evaluate any existing and potential problems. We can explain which issues are likely to resolve by themselves and identify any areas that may require monitoring. More importantly we can let you know, iftreatment is needed and when is the best time for it to be done. Recent techniques, when used in a timely manner, allow us to guide or modulate the growth of the jaws in such a way as to reduce and sometimes eliminate the need for complex future treatment or the need for extractions.

So all children should have early treatment if they need orthodontics?

No!! Timing is the key. Early assessment does not equal early treatment, it mainly allows us to time treatment correctly to be most effective as well as efficient. There are many stories floating around on the internet of 4-5 year long orthodontic treatments. In most cases these protracted courses of treatment can be avoided through well timed effective treatments.

Once a child is seen for an assessment they are usually enrolled in our growth and development follow up programme. Based on their needs they may be recalled if/when treatment would be necessary.

At Impressions Orthodontics, we strongly believe in minimizing the burden of treatment staying clear of “over-treatment.” We like to limit the amount of treatment delivered at an early age to that which delivers a proven long term benefit, and positively impacts future development.

So when is the best time for orthodontic treatment? 

It is a common misconception that orthodontic treatment should only be performed when all the adult teeth have erupted. In many cases this is too late.

Some bite and jaw development issues are best treated at a young age before puberty while baby teeth are still present. Other problems are best addressed during the growth spurt that accompanies puberty when the adult teeth are coming through. After all, the face and mouth are complex structures, and different parts grow and mature at different stages in a child’s development. Correct timing ensures that we benefit from natural growth to help the treatment and prevent certain bite problems from getting worse or negatively impacting the developing teeth and jaws.

Beware of marketing claims!

The internet is flooded with marketing claims by appliances that promise to achieve straight teeth without braces or claim to enhance jaw development. Most of these treatments are delivered by non-specialists and unfortunately many are a form of over-treatment in themselves. These appliances capitalise on the fact that most parents do not know that some of the things that may look weird or crooked in growing children are in fact normal and tend to rectify themselves naturally without any intervention. Many of the success stories on these websites are conditions that would have resolved if left to nature. What we prefer is a tailored approach where a child is assessed individually, and treatment that will deliver a beneficial and proven outcome will only be administered when necessary.

What are some of the issues that require early intervention?

Here are some examples: 

  • Excessive crowding: early treatment can reduce the need for extractions in the future

  • Crossbites (also known as “underbite”)

  • Large overbites

  • Extra teeth

  • Missing teeth

  • Delayed tooth eruption

  • Underdeveloped upper jaw

  • Obstructive sleep apnoea, excessive mouth breathing and snoring

  • Chronic “thumb or finger’ sucking habits

  • Protrusive front teeth at risk to trauma

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What are the benefits of an early intervention? 

  • Normalising the growth environment for both the teeth and soft tissue such as the lips and tongue.

  • Preventing abnormal tooth wear on the adult teeth.

  • Reducing or eliminating the need for extractions.

  • Reducing the risk of trauma.

An assessment with a specialist orthodontist that is taken between ages 7 – 8 years old allows us to make a tailored long term plan that ensures that the child has the best possible outcome with the least burden of care.

Should you clean your tongue?

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Even if you brush and floss your pearly whites twice or thrice a day, you cannot think of going cavity-free. This is because the bacteria residing on the tongue are not being addressed. Cleaning your tongue is recommended as it is beneficial in fighting bad breath as well as maintaining good dental hygiene. The tongue is a very important structure in your oral cavity and needs to be kept clean from food debris. It is advised to pay maximum attention to cleanliness of your tongue. 

Why is cleaning the tongue important? 

The tongue is a muscular structure that has tiny bumps on it called as papillae and there are grooves between the papillae. These are the potential areas on the tongue where bacteria can build up. Bacteria, dead skin cells and food particles will settle on the tongue. This gets covered by a very fine layer of mucus which covers the entire tongue. The bacterium that gets trapped on the tongue creates bad breath and a whitish discoloration on the tongue. These bacteria can get deposited on to the gums and teeth, thus increasing the chances of plaque and tartar buildup.

Cleaning of the tongue should be made part of the daily regimen for the following reasons:

  • To remove the bacteria
    Tongue cleaning leads to removal of the bacteria and plaque that leads to gum disease. If this is not cleaned adequately, it can cause illness that can spread to other parts of the body. This improves the overall health of an individual.


  • Removal of bad breath
    The germs that causes bad odour settle on the tongue and produces bad breath in individuals with poor tongue hygiene.


  • Improve overall taste sensation
    By clearing the plaque and mucus layer formed on the tongue, the taste sensation improves. This will help you relish the food that you eat. The taste of food will increase with great intensity.



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Techniques to clean tongue

Just as you brush and floss your teeth, it is essential to follow a routine for tongue cleaning. It is best to make tongue cleaning a habit. The ideal time to clean the tongue is once in the morning and once in the evening. During the day, if any foul smell is noticed arising from the mouth then rinsing with mouthwash is advised as it kills the bacteria. This helps in maintaining a fresh smelling breath.

The technique used to clean tongue is important. It can be cleaned by brushing back and forth, side to side and by rinsing your mouth with water. It is important to take care not to over brush the tongue as it can cause a break in the skin of the tongue. The tongue scraper can be used to clean the tongue.

Cleaning your tongue is a very important daily routine that should to be followed. Just like brushing and flossing your teeth regularly, tongue cleaning should be cultivated as a habit. This extra level of care which is often overlooked helps you in maintaining good oral hygiene and health. 

Why do some people have crooked teeth and how do you fix them?

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Everyone wants to have a perfect smile that you see on models and people on television. But if you take a close look at people around you, you will see that people have crooked teeth more than the perfect straight.

What exactly are crooked teeth and its types?

Crooked teeth are those which are simply not the perfect straight ones. The pediatric dentist or orthodontist classify it mainly into broad categories of crooked teeth. They are crossbites and Class II malocclusion. Cross-bites are mainly seen very common among the kids. Cross-bites can also be classified into two categories.

  • Anterior cross-bite: This is most common due to thumb sucking where it results in the upper and the lower teeth are not meeting each other thereby leaving a gap. But the back teeth meet when bitten together. 

  • Posterior cross-bite: This is most common in mouth breathers and teeth are gapped with each other. 

And the Class II malocclusion is when the lower teeth are set far behind the upper ones. It is seen commonly in the mouth breathers. 

And the Class II malocclusion is when the lower teeth are set far behind the upper ones. It is seen commonly in the mouth breathers. 

Reasons for crooked teeth: 

  • Genetical development: Genetics is one of the most common reasons for crooked teeth. It is mostly related to the size of our mouth. Smaller the mouth, greater is the chance of crooked teeth. The jaw development, the skull and the vertebral bone involves the cranial disbalance. And hence raises as a factor for crooked teeth. However, misaligned jaws are the center of the facial growth and also leads to issues of the crookedness of teeth.

  • Imperfect habits: It is very commonly seen when breathed through mouth. The nasal breathing is mostly attached to the proper jaw and teeth development. The expansion of the maxilla and the upper jaw is by the normal breathing through the nose. But if we tend to breathe through the mouth and if it becomes a habit then the obstruction is created to increase the pressure in the airway of the nasal. At this point, it becomes utmost important to consult the doctor to have the breathing pattern corrected.

  • Incorrect lip and tongue posture: Poor lip and tongue posture is also a common reason for crooked teeth. Ideally, the lips should rest on each other but when it does not, its high time we must consult the doctor. 

  • Oral behavior: Thumb sucking and usage of pacifiers should mostly be restricted to avoid the crooked teeth.

    How to treat crooked teeth? 
    An orthodontist like Dr. Nizam would check the pattern of the teeth then she would recommend a solution with either braces or Invisalign. The treatment can be started at any age although there is a specific timing for the treatment duration. However, whenever you feel the first signs of crooked teeth, you should not make a delay in getting checked by a professional orthodontist. 

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