Treatment for Kids

If you have school age children, determining the age of the first orthodontic visit may be confusing. You may see some first graders in braces and you may be wondering: "Why in the world are they wearing braces already? As a parent, am I missing something?"

It is very common for parents to ask me:

What is the best age to bring my child for their first orthodontic screening?

In my opinion, I believe the best time for a first visit is around their 8th birthday. At this age, children have a mix of both adult and baby teeth, and we can start to foresee how their teeth and jaws will line up in the future. Specifically, I am looking for:
- Cross bites (top jaw is too small)
- Excessive crowding or spacing of the teeth
- Overbites and underbites (mismatch of upper and lower jaw size)
- Missing teeth, late erupting teeth, extra teeth, abnormally shaped teeth
- Environmental factors (thumb sucking habits, mouth breathing, etc.)

While there are many things I am looking for at this age, it does not necessarily mean that I will treat them at this age. In fact, for most kids under the age of 11, I recommend waiting.  While every orthodontist is different, I prefer a conservative approach and I firmly believe "less is more" when it comes to orthodontic treatment.

Why do I take this approach? For many bites, we have studies that show we can get the same result if we treat in one stage instead of two. This not only saves time and money in orthodontic treatment, but it gives your kid the chance to be a kid without having braces from age 8 until 13. Additionally, we have to consider these are their adult teeth - they need to have them forever! Hygiene is very important, and I want to give every kid the chance to keep their teeth clean and cavity-free if possible.

Does this mean I wait in all cases? Not at all! It is true - some cases I do recommend a 2 step approach with early orthodontic intervention at age 8-10 years old. Often times, this is for bone growth issues that are best addressed at that age, or for teeth alignment issues that if left untreated will make for a more difficult treatment in the future. If this is the case, I try to do an early treatment for as little time as possible to help correct the problem. Then we can wait and approach the rest as a pre-teen or teenager. I sincerely look at every child as if they were my own, and if there is a situation that I would treat my son or daughter, then I let you know.

I take pride in our conservative approach to early treatment. Best of all, we do not charge anything for an initial screening - our first appointment is entirely free, and you do not need a referral from your dentist to check us out. Feel free to reach out anytime with questions - I am here to help : )

-Dr. Zach

Ever wonder what your smile will look like once you close that annoying gap or fix the crowding? While a doctor can explain the process of straightening your teeth and adjusting your bite, it may be hard to envision what YOUR teeth will actually look like once treatment is complete. Well, at ZFO we have great news for you – we have powerful technology to show you what your future smile will look like! With a clear picture of the expected results, you can  judge for yourself if orthodontic treatment is right for you or your child.

How are we able to show you the result before starting treatment? We use a high-tech iTero intraoral scanner to take a 3D model of your mouth (that’s right – no more goopy impressions!) and then we use software to move your teeth right in front of you on the screen. The software allows us to show you esthetic changes as well as bite correction changes that are needed for an excellent result.

At every complimentary consultation, I use our Smile Simulator technology to show patients what their final outcome will look like. Not only does it help you feel confident that the 6-24 month journey you’re about to embark on will be worth it, but it gives you and/or your child incentive to focus on the end goal with good participation. Everyone knows what we’re working towards from the very start, and seeing is believing.

I became an orthodontist for many reasons, but one of them is that I love building relationships and helping increase their self-confidence in patients. I see providing this glimpse into the future as an important part of each of those journeys. Knowing what our shared goal is helps me connect with you and helps you take pride in the treatment. 

If you’re considering orthodontic treatment for your child, tween or teen (or yourself), we’d love to meet. Zach Frazier Orthodontics is a no pressure practice and all consultations are complimentary. 

Come see us and see what the smile of your dreams might look like today. 

To schedule that complimentary consultation, click or call below.

-Dr. Zach Frazier

CLICK BELOW OR CALL US TODAY FOR A COMPLIMENTARY CONSULTATION. 

Adolescents are active, so it is no surprise that there are plenty of questions about mouthguards when it comes to orthodontic treatment. In general, a mouthguard is a great investment for protecting the teeth, especially in high-contact sports. They should be considered for many sports and activities, even if braces are not being worn. Here are some common questions and answers:

• Can you wear a mouthguard if you have braces?

  Yes, you can wear a mouthguard when you have braces. There are special mouth guards that are made specifically to fit over braces.

• What sports require a mouthguard with braces?

  Many high school sports associations require a mouthguard for football, hockey, field hockey, lacrosse, and wrestling. The ADA also recommends a mouthguard for other contact sports like basketball and martial arts, as well as other limited contact sports such as baseball, softball, and extreme sports.

• Is it recommended to use a mouthguard while in braces?

  Unless specifically required by your sports association, it can be a personal decision based on your comfort level and ability to breath adequately while performing. The benefit of a mouth guard is it will limit damage to teeth and soft tissues around the mouth when worn properly. Not only will it help protect the teeth, but it will protect the lips and cheeks from injury from any orthodontic appliances.

• What is the best mouthguard for braces?

  In our office, we have found that the Shock Doctor Braces Mouthguard has worked well for many patients. It has a strap so that it can be used in sports like football. The strap can also be removed so that it can be used in sports like basketball.

  [caption id="attachment_308" align="alignleft" width="300"] Shock Doctor ® Braces mouthguard[/caption]

• Can you use a boil and bite mouthguard with braces?

  No, you should not use a build and bite mouth guard with your braces. It may wrap around the braces and get stuck in place, or cause damage to the braces. Also, keep in mind that the teeth are continuing to move, so you do not want to have a mouthguard specifically molded to your teeth as they are changing.

• Can I use a custom made mouthguard while in braces?

  No, you will not likely be able to use a custom mouthguard since your teeth are still moving. The mouthguard will not fit for the duration of the treatment, and it may get stuck on the braces if it is forced in place.

• Where can I get a mouthguard for braces?

  You can find a mouthguard for braces online or in some sporting goods stores. Some orthodontists may also have them in their office for patients. At Zach Frazier Orthodontics, we have the Shock Doctor Braces Mouthguard available in office for our patients.

• Can I wear a mouthguard with Invisalign?

  If you are in Invisalign treatment, you should still wear a mouthguard for sports if it is recommended by your association or a sport with significant contact or injury risk (football, basketball, hockey). You can remove your Invisalign and use a general one-size-fits-all mouthguard while playing the sport. You will not be able to use a custom fitting or boil and bite mouthguard as your teeth are still moving. If you are in a non-contact or limited-contact sport, you should continue to wear your Invisalign while you are playing the sport.

• Can I wear a mouthguard with a palatal expander?

  Yes, you can wear a mouthguard with a palatal expander. It will need to be trimmed and adjusted around the expander to allow it to fit properly.

I hope this is helpful to provide some insight on mouthguard recommendations for braces. As always, if you need more information, please reach out to our office anytime - we are happy to help : )

Perhaps you have memories of sitting in a dental chair anxiously waiting for a dental impression (dental mold).  Memories of a cold, gooey mixture inching closer down your throat. Memories of drool hanging off the edge of your lip while the mold is held in place. The very thought of it for some people will make them gag!

We have good news for you: meet the intraoral scanner. While this technology has been out for some time, it is still not universally used. Here are some information about what it is and how it will make your trip to the orthodontist much better.

1. What is 3D digital intraoral scanner?

   1. It is a high-tech video camera that captures images of your teeth to create a 3D digital model of your teeth.

2. Does it use any radiation like an x-ray?

   1. No radiation is used - it is simply a video camera that stitches many images together to create the 3D image of your teeth.

3. How long does it take to have your teeth scanned?

   1. It depends on the experience of the user, but in most cases it will take less than 5 minutes to get a full scan of all of your upper and lower teeth.

4. What do you do with the 3D image?

   1. We can use the image in lots of ways. We can use it to diagnose your bite or create 3D printed physical models of your teeth. With the printed models, we can make all sorts of orthodontic appliances and retainers without ever having to take a dental mold.

5. Do you still have to take a mold to get retainers?

   1. No way : ) Our patients do not have to have dental impressions taken at any time.

6. Can this be used for Invisalign clear aligner treatment?

   1. Yes! Additionally the aligners will be better fitting as a 3D intraoral scanner is more accurate than traditional dental molds.

We absolutely love the 3D intraoral scanners in our office. Treatment is dramatically more comfortable for our patients leading to a better experience. Additionally, we are getting more accurate orthodontic appliances which leads to better treatment and reduced time spent at the orthodontist. Finally, it is great form an environmental standpoint as there are fewer steps, fewer appointments, and less waste by using the scanner.

If you're interested in pursuing braces treatment or you are considering Invisalign clear aligner treatment, make sure you visit an orthodontist with a 3D intraoral scanner. You will thank me later ; )

All of us are born with the innate sucking reflex. It is needed to survive as an infant and helps us eat as babies. As we develop, some babies will use a thumb, finger, or a pacifier as a comforting mechanism. However, at some point, this habit can start to cause harm to the developing teeth and bones of the mouth.

At what age do kids need to stop sucking thumbs or using pacifiers?
- Depending on how much sucking pressure your child uses on his thumb or pacifier, you may start to see changes as soon as age 2-4 years old. You may notice flaring of the front teeth and changes to the shape of the smile. Typically, these changes can self-correct if the child is done with the habit by age 6 before the adult teeth start to erupt.

Why do we need to break the habit?
- The habit can permanently change shape of bones of the mouth and permanently change the shape of the smile.  Some long-term habits can cause irreversible changes that cannot be fixed with orthodontic treatment alone. Additionally, it will create issues that can make orthodontic treatment more time-consuming, more complex, and more expensive.

How can we start to break a pacifier habit?
Typically a thumb habit is more challenging to break than a pacifier habit because you cannot take a thumb away : ) In most cases, you will start this process at a younger age while the child is still a toddler, and in many cases they will stop on their own. Avoid harsh words or punishment as this is not effective for this age group. Praise progress and use rewards charts to help encourage them to quit. Beware - in some cases, a new thumb or finger habit may emerge!

How can we start to break a thumb habit?
- Be conservative at first! If your child in pre-school or early elementary school, start by talking about it. Kids must be on board to quit; if they do not want to quit, conservative approaches may not be successful, and you may have to revisit it again after waiting a few months. The earlier you start the conversation, the better of you are since the upper front adult teeth will come in around age 6-7. I recommend starting out with simple reminders such as wearing a Band-Aid on the thumb or finger.

My kid is now on board - what can we do to help him quit his thumb habit?
- While they may relapse at times to find comfort, you may need to use additional items to help kick the habit. You can try a baseball batting glove, thin winter glove, or sock over the hand at night time. You can loosely add medical tape around the wrist to make it more difficult to remove, but please be sure it is not too tight. Another product is Mavala Stop which is a sour tasting nail polish to serve as a reminder. Always remember - couple the reminders with a tracking and reward system to celebrate the small wins. Praise will help keep the kids motivated - remember they want to make you happy!

What if the conservative habit break measures don't work?
- More aggressive physical reminders in addition to the above may be needed. An Ace bandage wrap around the elbow will make it more difficult to bend the elbow which will restrict their ability to bring their hand towards the mouth. You may also consider a wrist guard thumb habit appliance (TGuard brand) that is fixed to the wrist and plastic around the thumb/fingers

What if everything else does not work - what is our last resort?
- Orthodontic appliances are the last resort. If all else fails and we see the habit is causing significant bone changes, we can make what we call a "habit appliance" and cement it to the molars in the mouth. It is like a metal cage that fits near the roof of the mouth and difficult to remove. Typically, we will keep it in place for 9 months, but no less than 6 months in order to break the habit. If this appliance is needed, many times a palatal expander will be needed afterwards to correct the changes that have occurred due to the habit.

Orthodontists are skilled in helping you and your child with their habit issues. Additionally, we are skilled at correcting the problems that prolonged habits may cause. Be sure to talk to your local orthodontist early about breaking the habit - it will certainly make a difference in the long run!

Orthodontic separators (also known as “spacers”) are small latex-free rubber bands that fit in between two teeth to make space in preparation for fitting an orthodontic band or ring around the tooth. These are commonly placed before a palatal expander is placed.

What can my child expect after the separator or "spacer" is placed?

1. Mild soreness from the spacer is expected – use over the counter pain medications as needed.
2. Pressure or feeling of something stuck between the teeth is normal.
3. If the spacer falls out a few days before the next appointment, that usually means enough space has been made.

Tips:

1. Do not try to remove the spacers at home – this may delay fitting the orthodontic band or appliance at the next appointment
2. Avoid sticky and chewy foods that may dislodge the spacer
3. Brush the area normally but do not floss the area with the spacers

If the spacer falls out before your next appointment, the ring around the tooth should still fit in most cases so there is no need to come in for a separate appointment. If you have any questions or concerns about the spacer, please call our office, as we are happy to help!

We receive lots of questions every week from people interesting straightening their teeth to improve their smile and to create a healthy bite. Here are a few of our most popular questions and answers : )

1. What is an orthodontist, and how is he/she different than my regular dentist?
   An orthodontist is a dental specialist who focuses only on treatment with braces, clear aligners (Invisalign), and retainers. An orthodontist has pursued 2-3 years of additional training beyond dental school in order to specialize in the growth and development of facial structures.
2. What problems does an orthodontist fix?
   Common orthodontic problems include crowding or spacing of teeth, uneven smile, impacted or unerupted teeth, and improper jaw alignment.
3. Will getting braces or orthodontic treatment hurt?
   Generally, there is a short period of discomfort for a couple of days in your teeth, gums, and cheeks as you mouth gets adjusted to the braces. Dr. Zach will discuss with you or your parents the best way to manage this discomfort.
4. What is the best age to see Dr. Zach for a consultation?
   In general, anyone wishing to improve his or her smile can schedule an exam at any age, from children to adults! Most full orthodontic treatments will begin around age 11-13 to coincide with the start of adolescence and the loss of remaining baby teeth. However, some problems can still develop before this age and require a form of early treatment as early as age 7.
5. How do I take care of my braces?
   Excellent brushing and flossing habits are necessary to take care of your braces and teeth. Also, you will need to follow our instructions on how to avoid any broken appliances and problems.
6. How long will I have wear braces or Invisalign clear aligners?
   Treatment times will vary on an individual basis depending on your goals and how challenging the tooth movements will be. Treatment times can range from 6 months to 30 months, and the most common treatments average about 18-20 months for a beautiful smile.
7. Do I still see my regular dentist every 6 months?
   Yes! It is absolutely necessary to see your general dentist every 6 months for regular check-ups and cleanings. The health of your teeth is our number one priority, and your dentist is essential in the maintenance of your teeth before, during, and after treatment.
8. Will I have problems playing sports or musical instruments?
   Although there is an initial adjustment period, you should not have problems participating in your normal activities with braces. We recommend wearing a mouth guard during contact sports.
9. Will I have to wear a retainer at the end of treatment?
   Yes, at the conclusion of orthodontic treatment, a retainer is required to maintain the result and keep your smile beautiful.

Still have more questions? Feel free to contact us here or call/text us anytime : ) We are happy to help!

Teeth genetics are weird. There is so much variation in size, shape, and color teeth. There is also a lot of variation when it comes to timing of when baby teeth are lost. We are all so different from one another, with a few exceptions: our teeth are very much like those of our parents and siblings.

Teeth abnormalities are pretty common in the general public, and many people are affected by them. For example, approximately 30% of people are missing at least one tooth. This is most commonly a wisdom tooth. Also, approximately 2-3% of the population has an impacted canine, where the canine is stuck in the bone and does not want to come in. It is more common on the left side than the right side (how weird!) and it is more common in girls than boys (sorry ladies!).

As a parent, it is important to keep this in mind. Are you missing an adult tooth, or was your brother or sister missing a tooth? Do you still have a baby tooth in your mouth? Do you remember having braces to fix an impacted canine? Your kids will be more at risk for similar problems. Impacted canine teeth can damage other adult teeth, and missing teeth can be a dental problem in the future if not addressed early.

So what do you do? It's simple - get a screening early. I recommend having an orthodontic  screening at age 8 to evaluate for these conditions early. We take a panoramic x-ray that looks at all of the developing teeth so that we can see if any of these problems may occur. Most orthodontists do not charge for this screening, and it basically informational to help you understand your child's current or future needs.

Is it OK to have a screening even if you didn't have these problems? Yes - definitely! You may not know that grandma or great-uncle was missing 4 adult teeth. Additionally, we are screening for more than just missing teeth. We look for crowding issues, spacing issues, overbites, underbites, cross bites, and much more.

At the end of the day, please do not lose sleep over any of these issues. Genetics is out of your control, but we are here to help however we can. We can correct impacted teeth, missing teeth, and bite issues in many different ways with braces and Invisalign®. Feel free to reach out with any question : )

Take care and love your smile!
Dr. Zach

When you hear the words sleep apnea, you probably don’t think much about kids. However, sleep apnea affects 2-3% of kids, and the symptoms are subtler than they are in adults. Children with sleep apnea may appear totally normal at a physical exam, but there are some signs to watch out for. This list is not all-inclusive, nor does it mean that any one of these indicates a problem. However, if some of these describe your child, it may be a good idea to consult with your family doctor about the possibility that sleep may a problem.

• Snoring – No child should snore – period. An occasional load breath may be heard, but your child should not be snoring or breathing loudly at night on a regular basis. Snoring in children goes hand-in-hand with sleep apnea, and this should definitely be brought the attention of your family doctor.
• Teeth grinding – Grinding teeth at night may be a defense mechanism for the body. If your child is struggling with proper airflow at nighttime (due to a collapsed airway, tonsils, adenoids, allergies, etc.), pushing the lower jaw forward often helps open the airway to allow a better passage of air down the throat. This protective measure for the body is helpful for breathing, but can really cause long lasting harmful effects on the teeth.
• Bedwetting – Typically, by around the age of 5, most kids will be able to sleep without wetting the bed. An accident here or there is much different than an older child who is wetting the bed frequently. Although this can be due to other medical conditions, bedwetting can be linked to sleep disorders as the body fails to awaken when the bladder is full.
• Mouth breathing – While humans are able to breathe through both the nose and the mouth, we are technically “obligate nasal breathers” as a species, meaning we are supposed to breathe through our nose. Deviated septum, allergies, and other nasal airway obstructions can make it difficult to breathe through the nose. Mouth breathing can affect the development of the face, jaws, and teeth position, often times leading to orthodontic treatment to normalize the effects of letting the mouth hang open all the time.
• ADHD – Sleep issues may contribute to problems relating to attention span. When some kids don’t get enough sleep, they actually act opposite of what we would expect – they actually become hyperactive rather than tired. Additionally, they may be irritable, unfocused, and easily distracted, and these consequences can have a very negative effect on school performance. Studies have shown that 1/3 kids with ADHD also snore while sleeping.
• Morning headaches – If your child’s airway is partially blocked while sleeping, the amount of oxygen in the blood will be reduced. This reduction in oxygen level may lead to headaches, specifically in the morning after waking from a poor night’s sleep.
• Sleepwalking and sleep talking – Typically if these are observed, they are usually shortly after going to bed and associated with “confused arousal.” This means that something startles the child awake, but they are still subconscious and may not be fully awake. This arousal may be from other medical conditions, but it may also be from airway obstruction that causes sleepwalking and/or sleep talking.

The bottom line is this – sleep is obviously important for all of us, but many kids with sleep issues are not being identified. As an orthodontist, I am a specialist in facial growth and development, and my job is to simply screen for some of these issues. I can fix some of the side effects on the teeth and jaws, but ultimately a physician (sleep specialist or ENT physician) needs to put all the pieces together to make a diagnosis. So, if you see these issues at home, or your dentist or orthodontist has mentioned some of them to you, make sure to follow up with your physician. Improving your child’s sleep very well could change their life, so the sooner we do it, the better : )

- Dr. Zach