Reply to Please tell me if this is completely insane (estimate from orthodontist)

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[quote=Anonymous][quote=Anonymous]In our (parent's) age, braces were done during/after puberty. What is now known as "phase 2".  Also the trend then was to pull teeth that didn't fit the mouth/jaw.  Lots of kids had teeth pulled.

The newer thinking/trend is to make room for the teeth you have.  So this involves expanding the palate of some kids because do to various issues many kids have a crossbite which can lead to a narrow palate.  Not as much a problem with baby teeth, but adult teeth are much larger and then there isn't enough room for them.  You can only use a palate expander before about 11 years old.  After that the top of the palate hardens and it can no longer easily be manipulated to encourage new bone growth and could require surgery to change.

So the current thinking for kids with narrow palates is to use a palate expander around 8-10 years old.  This spreads the palate along the top middle of the roof of the mouth and creates space among the teeth. But usually the spaces end up in the front and then you have to use some short-term bracketing (braces) to shift the space to where it will be needed for the adult teeth.

Then this sets up for an easier (or possibly avoidable) second phase later on after the adult teeth are all in. No way to 100% predict how that will go, but phase one generally shortens the 2nd phase substantially.

If your kid just needs a lingual arch placed, I would start with your children's dentist first.  In that way it could possibly be covered by dental insurance which has higher reimbursement rate than orthodontics (many people have no orthodontic coverage, we have 50% coverage up to $3500 and then we are on our own for the rest).  My daughter had a lower primary molar pulled last year at 9 and the adult tooth doesn't emerge until 11-12 so she had an arch placed by the dentist at that time to preserve the space until the adult tooth comes in.  The lingual arch is a standard dental treatment and if that's all your kid needs 9/10 times it will be way cheaper through the dentist vs the orthodontist. [/quote]

PP above, your answer is so helpful . Can you offer me any advice for my DC ?

my child ( 12 1/2) has just started complaining yesterday about what looks like an impacted upper  Canine ( emerging on outside of tooth row ) . I have been asking his dentist  for 2-3 years if he thought he had an overbite ( if his front teeth were too prominent ) and if it was a sign of something wrong that his adjacent upper teeth had big spaces ( I never had braces and have straight teeth / no gaps)

My DC's dentist has been telling me ( every 6 months for 2-3 years) at each visit , " no , looks like he has lots of room , lets wait and see what the adult teeth look like "

Two months ago I saw XRY's at his visit and asked " why are those teeth up their on top?" ( canines) and he sai d" oh, those are coming in"

Today they broke the gum on side and baby tooth is firm ( impacted)

My questions:

1) why did my DC's dentist not foresee this and do an extraction of the baby tooth in time and give my DC an expander ? ( he is now 12 1/2 )

2) who are the best orthodontists in the area as obviously, I can't keep taking him to this same dentist

3) same for Oral surgeon, cause i guess my DC needs that too

Thanks
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