When parents see their child's upper and lower teeth fitting together nicely when they say "ee," they tend to feel relieved. However, orthodontic treatment is not simply correcting irregular tooth alignment. It includes growth modification of the jawbone that holds the teeth and even orthognathic surgery. The need for pediatric orthodontic treatment varies considerably.

On the other hand, some parents hesitate due to concerns about visible orthodontic devices. However, teeth play an essential role in chewing food, speaking, and breathing, so delaying treatment is unsuitable for children. Kyung-A Kim, a professor of orthodontics at Kyung Hee University Dental Hospital, was asked everything about pediatric orthodontic treatment.

- What are some specific cases where pediatric orthodontic treatment is needed?

Orthodontic treatment is not just about correcting the arrangement of teeth but also a necessary treatment for jaw growth in children with undershot or protruded jaws. In addition, it is required to check whether orthodontic treatment is needed in cases such as ▲ primary teeth falling out too quickly and causing permanent teeth to come out at the wrong time, ▲ abnormal eruption path of permanent teeth, ▲ changes in the dental arch due to habits such as thumb sucking, ▲ functional problems such as open bite and mouth breathing caused by tongue protrusion habit.

- Children may have a certain age range to start orthodontic treatment.

Pediatric orthodontics typically begins around the age of 6-7 when permanent teeth begin to erupt. In the case of a protruding jaw, treatment may start earlier, considering the growth period of the upper jaw. In the case of a receding chin, treatment may begin from the early elementary school years, considering the lower jaw's growth period. However, children should consider their developmental age, and each child's growth rate is different. The best thing to do is to visit the dentist regularly from age 6 when permanent teeth start to come out, have regular check-ups of teeth and jaw growth, and begin necessary treatment without delay.

- How is the pediatric orthodontic treatment done? Is it different from adult orthodontics?

While adult orthodontic treatment aims to improve function and aesthetics by arranging the teeth in neat order on a completed skeletal structure, pediatric orthodontic treatment aims to create an environment where permanent teeth can come out well, and the jaw can grow properly, with a focus on functional recovery and aesthetic enhancement.

Orthodontic devices can be broadly divided into self-removable metal appliances and fixed appliances attached to the teeth. The choice between the two depends on the degree of the teeth eruption and the level of cooperation from the child. Adults typically have a higher proportion of fixed appliances, while children use self-removable appliances more frequently. However, children may require multiple design changes to their orthodontic devices due to the emergence of new permanent teeth.

In adults, orthodontic treatment can be performed at any time. However, in children, treatment should be started early enough, taking into account the growth phase of each jawbone, in order to achieve the desired improvement effect on the skeleton.

- What are the potential problems if the timing of orthodontic treatment is missed?

Tooth extraction may be necessary if treatment is required due to jaw disharmony and the timing is missed. In severe cases, orthognathic surgery may need to be considered. Most importantly, the benefits of orthodontic treatment go beyond cosmetic improvements and include functional aspects such as jaw function, breathing, and speech. Therefore, if treatment is delayed, children may experience problems with speaking, breathing, and chewing.

In addition, if problems with the eruption path or lack of space for permanent teeth are not addressed, teeth may come out like fangs, or permanent teeth may not come out at all. This can cause asymmetry of the dental arch or misalignment of teeth even if only one tooth fails to erupt. As a result, the treatment period may be prolonged because the overall position of the teeth needs to be changed.

- What are the benefits of getting orthodontic treatment at the right time?

Children with skeletal disharmony, such as a protrusive or retrusive jaw, can develop a harmonious jaw through orthodontic treatment at the appropriate time. Additionally, as mentioned above, severe skeletal disharmony can cause aesthetic issues and problems with functions such as speech and breathing, which can be prevented and improved through early intervention.

For example, a child with a habit of thumb sucking may have protruding upper front teeth, making it difficult to close their mouth and causing them to breathe through their mouth habitually. If this type of mouth breathing persists, the horizontal growth of the upper jawbone can be suppressed, and only vertical growth of the upper and lower jawbones can occur, resulting in a long face shape and a condition known as adenoid facies.

Starting orthodontic treatment at the appropriate time can improve the teeth' appearance and address functional issues and habits, ultimately aiding in the social development of growing children.

- What are the special considerations for orthodontic treatment for children, given that even adults find it challenging?

Since children are mainly brought to the hospital by their parents rather than themselves, their motivation for treatment may be limited. Therefore, it is crucial to help parents understand why orthodontic treatment is necessary and to explain it well to children.

In addition, when it comes to pediatric orthodontic treatment, it is important to focus on gaining the child's cooperation, especially when using removable appliances. Therefore, it is vital to explain the treatment at the child's eye level and encourage their interest and willingness to participate. Furthermore, feedback on proper brushing techniques is given at each visit to ensure that good oral hygiene habits are maintained to prevent cavities from developing during treatment.

- Recently, digital orthodontics has been a hot topic. What is different from traditional orthodontic treatment?

Digital orthodontics refers to conducting orthodontic treatment using 3D digital equipment from diagnosis to treatment. In the past, a physical model was made for orthodontic diagnosis and examination by taking impressions of the patient's oral condition, occlusion, and tooth arrangement.

Digital orthodontics is the process of using 3D digital equipment to diagnose and treat orthodontic cases. Furthermore, using a facial scanner, all teeth, skeletal, and facial data are captured in 3D shape and simulated in advance to predict both teeth alignment and subsequent skeletal and facial changes.

- What are the advantages of digital orthodontics?

While predicting growth is still challenging, simulations can predict changes in tooth alignment and jaw correction surgery. This can be actively reflected in treatment plans and patient consultations. The orthodontic appliances are also manufactured using digital technology based on the patient's data. The production of fixed bracket appliances, clear aligners, and retention appliances already actively utilize digital technology.

Furthermore, recent research has utilized accumulated dental data for training artificial intelligence. This allows the AI to predict a patient's diagnosis or the necessity of treatments such as extractions without the need for manual measurements or drawings.

- Are there any specific advantages digital orthodontics can offer pediatric orthodontic treatment?

Children with severe gag reflexes may have difficulty with traditional impression-taking techniques. However, these children can have their oral status analyzed through digital scanners used in digital orthodontics. In addition, with the scanned files, a 3D printing technology (a process of creating a three-dimensional object using plastic powder instead of ink) can reproduce a facial bone model and create a suitable orthodontic device for the child.

Connecting the diagnosis and device production process in one step through digital technology can help relatively smooth treatment, even for children with a strong gag reflex or poor cooperation, especially since the frequency of using fixed orthodontic devices is high for children. In addition, even if the permanent teeth have not all erupted, the accuracy of the treatment plan can be increased by stimulating the tooth arrangement based on the children's dental data.

- Is there any other advice for parents?

Regular dental check-ups from around the age of 6 when permanent teeth emerge are crucial for pediatric orthodontic treatment. We strongly recommend parents take their children to the dentist for regular check-ups. In particular, during the eruption of the first permanent molars, known as the "6-year molars," it is essential to take preventive measures against tooth decay by receiving a comprehensive oral examination to evaluate skeletal problems or tooth eruption. If any issues are detected, starting treatment at the appropriate time is highly recommended.

Regular observation is required after starting pediatric orthodontic treatment. It is necessary to regularly check the maintenance of orthodontic treatment effects and whether the child's incorrect oral habits have caused relapse until the permanent teeth fully erupt and the jaw growth is complete. Remember that the beginning of pediatric orthodontic treatment is just the beginning of another phase.

Translated by Jini Jung 다른기사 보기