Braces for your child can be troublesome and costly. Not forgetting uncomfortable experience. But then again, braces on teens and adults can be a major source of embarrassment (as well as costly and uncomfortable).

We spoke to orthodontist Dr Enrica Sham for her expert advice on braces for children.

Dr Sham says, “The common reason that kids in Singapore need braces are crowding of teeth, ‘increase overjet’ (upper teeth sticking out) or reverse bite (lower teeth sticking out), which could be caused by teeth erupted in the wrong position or a discrepancy between the upper and lower jaw position.”

Is there a right age for braces?

It is most common for patients to get braces when they have a full set of permanent teeth, usually around the age of 13. However, there can be incidents where a child may need braces at an earlier age in order to prevent trauma to the teeth. For example, when front teeth are erupted in the wrong position, which can cause the lower jaw to shift sideways or forward. Dr Sham recommends that children should see an orthodontist to be assessed at age 7.

Picking a type

1. Traditional metal braces: Cheapest, fixed, predictable result, most visible, can choose various colours of rubber band.
2. Ceramic braces: Predictable results, less visible, more costly, staining of rubber bands.
3. Self-ligating braces: Predictable results, some cases may be treated as “non-extraction” as opposed to “extraction” (treatment using traditional braces), more costly, less painful
4. Removable aligners: Easily cleaned, removable, almost invisible, however results are totally dependent on patient compliance, very costly
5. Lingual braces (braces behind the teeth): Costly, invisible, difficult to clean.
Ask your orthodontist for suggestions and pay attention to how cooperative your child is with maintaining, cleaning and such details.

Preparing your child for the first visit

This helps to put your child at ease, mama and papa too of course. The orthodontist will get to know your child and find out their concerns followed by an examination of their teeth’s condition. X-rays are necessary to have a thorough examination of the condition of your child’s teeth, jaw and surrounding structure such as the airway. The orthodontist will then explain the options available.

Now that my kiddo has braces, what should they be cautious of?

* Food: According to Dr Sham, generally, patients should avoid eating hard, chewy or sticky food. Examples of hard food to avoid include nuts, biting of ice, crab shells, corn chips, popcorn; as well as whole fruits such as apple (if you do eat them cut them into smaller slices) to prevent braces from coming loose. Sticky food such as chocolate and biscuits are likely to stick to the braces and increase the chances of tooth decay and gum disease. Not following the orthodontist’s instructions can also lead to increase treatment time and non-ideal treatment results. Aka “Why did I pay and your teeth are still crooked?”

* Activities: There will be an initial adjustment period, but there is no need to stop playing sports or musical instruments when you are on braces! There are special mouthguards which fit right on braces which can be worn when playing contact sports, be sure to ask your orthodontist about them!

* Pain: Dr Sham tells us that a general ache is a normal part of orthodontic treatment. The level of pain differs from person to person — expect teeth/gums to feel sore for around 1 week after putting on braces. Patients may also feel sore for a few days after adjustment follow-ups. Over-in-counter pain medication should be sufficient to ease the pain, and a soft diet helps!
Your child may also experience some ulcers on their cheek or lip where it rubs against the braces. The soft tissues take a while to get accustomed to the braces. You may ask your orthodontist for orthodontic wax to put onto the braces help to relieve the discomfort and irritation.

To find out who’s qualified to do braces, check the Association of Orthodontists, Singapore website.

Photo: iStock

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