THE PRICE OF DELAY: BRACES
” The other dentist said we can wait until after she is through with university.”
I looked at her quizzically.
” She is now 13 years old. Her canines are sticking out and she is unable to smile without covering her mouth. You tell me she has been asking for braces since she turned 11, and you wish to postpone this until ….”
We fell silent. Her father rubbed his hands restlessly.
” Doc I am a very strong disciplinarian. I don’t want any excuses for poor school grades. If she has to come from Boarding school in for monthly visits because of the braces it will interrupt her class work!”
“What if I told you that for the past twenty-five years, we have been managing boarding school students by only seeing them during Half term; end of term and beginning of term?”
His head shot up in surprise.” Really?”
” Oh yes. In Orthodontics we can tailor the movements to coincide with the available time frames to a certain extent and still attain our final goal of a beautiful smile.
But; let’s talk about what would happen if you postponed your daughter’s treatment to when she is 21 years old.
Her jaw growth will have ceased by age 16. That means that we will be carrying out Adult orthodontics at age 21.
Which is cool, but in her particular case we will be limited in the following ways:
-Braces work much more slowly in adults than in children and teens because the jaw bone is denser. Her treatment would take up to three times as long as an adult.
-We would have to use much lighter forces on her teeth as well, because stronger forces risk causing the “death” of the perio ligaments which surround the tooth. Worse still, strong forces will cause the roots of her teeth to be earn up by her own white bone cells called osteoclasts.
-Closing gaps will be fairly easy but we will have to extract her premolars instead of expanding her upper maxilla. And then, moving her canines will require at least a year after that.
Not to mention, the effect of herself confidence: what will going through her teenage years with these “fangs” as she calls them, do to her?”
He sighed.
I guess we need to re consider.
Promise me that you will not require her during the term!” He looked at me sternly.
” I cannot give you a 100 percent assurance of that. With dental treatment of this kind, sometimes the patient may have some discomfort from say, a wire that extends out when teeth have moved faster than expected. Or she may drop a bracket during contact sports etc etc. If she needs to see me for any reason, I am here!
Please note that I only use non metal brackets for Orthodontics in my practice and this will give your daughter superior esthetics and better retention than metal brackets do.”
One week later, later his daughter lifted the hand mirror and smiled at her purple tinted teeth.
Her mother said” Wow, Moraa! You look lovely!” She giggled and lifted her left hand to hide her mouth, in her habitual self-conscious gesture, now no longer needed.
I gently moved her hand away.
” You don’t need to do that anymore Moraa. It’s a new season! Time to” floss for all your friends, and enjoy changing the color of your elastics every few weeks. Remember to brush with your Ortho Brush three times a day and you are off stuff like chewing gum, sweets biscuits toffees and chocolate.
The good news is you will look like a movie star in nine months!
Welcome To the world of teenage braces!”
