Parenting: Preteenagers

As for most children, 13-year-old Sara's transformation from a child into a preteenager could be best described as a whirlwind. At a time when this St. Louis preteen was venturing into the realm of adolescence, as most preteens adorn wrists with silver stackable bracelets and hang dangling earrings from their lobes, along came the dentist to add another set of silver to Sara's look, this one not nearly as "cool" and far more expensive.

Sara needed braces – and head gear – to straighten her teeth.

"I am not wearing that thing," she told her mother after a first meeting with the awkward head gear. "It looks like something a Martian would wear."

If you've not already experienced the struggle, you might soon be calming your child, selling the future benefits of a mouthful of metal. But after some amount of discussion between doctor, patient and parents, you and your preteen will see that orthodontic braces aren't so bad.

Dr. Michael Mahaffey, president of the South Florida Academy of Orthodontists and member of the American Association of Orthodontics, estimates that although prices may vary across the country, full orthodontic treatment falls into the range of $3,500 to $4,200, depending on the condition of the teeth. He says most orthodontists will offer a variety of payment plans and for most families, braces will be affordable.

Upon learning the cost and possible inconveniences of braces, some parents may opt to have their kids go through life with crowded, crooked teeth. But what many don't realize is that orthodontic problems often go well beyond a patient's dissatisfaction with the way his teeth look. Malocclusions, or orthodontic problems, can be very serious, and letting them go untreated can result in receding gums, bone damage, tooth wear and biting and chewing difficulties. The AAO explains that because crooked and crowded teeth are hard to keep clean and in good condition, "this may contribute to conditions that cause not only tooth decay but also eventual gum disease and tooth loss." Certain problems that go untreated can even result in chronic headaches and pain in the face and neck.

It is for this reason, among others, that the AAO recommends that all children have an orthodontic screening by age 7. Although this might sound young, it's the best way to manage many orthodontic problems that require careful monitoring of growth and development. Seven is an appropriate age to begin correcting problems such as discrepancy in the length of upper and lower jaws. Because the jaws are still growing, an orthodontist can use appliances to guide the jaws in a way that will even them out. Some malocclusions, if caught early, will require less intrusive and shorter treatment (and less expensive treatment) than they would if caught at a later age. If a parent, physician or dentist notes a problem at any age, it's a good idea to schedule an evaluation.

If your child has no choice but to get braces, one of the best ways to ensure successful treatment is to cooperate with the orthodontist. The key is to take care of the braces and keep teeth clean. But if your child has to wear a bigger, more obvious appliance like head gear, you might have a hard time convincing her. After a year of braces and head gear, 13-year-old Sara says she doesn't mind them, although the head gear still makes her feel a little self-conscious. "I really didn't want to wear the head gear in public at all," she says, "But the orthodontist said I had to wear it sometimes if I wanted my teeth to get better, so I agreed to wear it to school because the girls in my class are nice and I feel comfortable with them." Sara and her parents made a compromise: She doesn't have to wear the head gear in any public place aside from school.

A common complaint of kids who wear braces is soreness after braces are adjusted. Dr. Mahaffey explains that "today's braces are smaller, and we use lighter, more flexible modern wires which do not cause as much pain as they did 10 to 20 years ago. Soreness lasts about three days after each adjustment." He recommends Tylenol to relieve any pain. Another common complaint is that the wires jab into cheeks and gums. Dr. Marc S. Lemchen, D.M.D., suggests that kids ask their orthodontist for a wad of wax. "If a brace breaks, [wax] can be a lifesaver once the damage is done. Shape a bit of wax around any rough bits to shield your mouth from damage until you can get to the orthodontist to fix the broken brace." Prevention, though, is the best medicine. Kids should "become involved in the treatment," he says. "Ask about the process, and understand what is going on... recognize when something is wrong and learn how to handle emergencies, avoid sticky and hard foods and refrain from biting on pens or other objects to minimize breakage."

Perhaps the main concern for kids with braces is the way they look. Preteenagers are already self-conscious, and braces certainly don't help. A child about to get braces may feel better knowing that today's braces are less noticeable than they used to be, and a patient can even choose the color of the brackets. The AAO says "some of today's wires are made of space-age materials that exert a steady, gentle pressure on the teeth, so that the tooth-moving process may be faster and more comfortable for the patients."

Another bit of good news from the American Association of Orthodontics is that a clear orthodontic wire is currently in an experimental stage, so braces might soon be hard to notice. The AAO can even provide a patient with a free computer-generated picture of what your preteen will look like with braces. Seeing herself with a flawless smile may reduce much of the tension that your preteen is feeling.

Dr. Mahaffey says many preteens feel better when told that countless people they see with straight teeth were rewarded them by wearing braces. He feels that parents should help their kids to take pride in the fact that they have the opportunity to have their teeth straightened, and that kids should in fact thank their parents. "Help kids get through the process by encouraging their progress," Dr. Lemchen says. "And of course, always teach them to have good self esteem."

Most importantly, Dr. Mahaffey suggests that parents encourage kids to be confident. "Go ahead and smile," he says. "Laugh and enjoy life."