This parent section is part of a book written by A/Prof. Richard P. Widmer and Professor Emeritus Gerald Z. Wright for the 20th Congress of the International Association of Dentistry Congress, Sydney, Australia. It was produced with support of the Colgate Palmolive Company. The material is not IAPD-endorsed nor does it reflect IAPD policies.

1) When will my child get braces?

2) Will my child need second teeth removed if they get braces?

3) What is a panoramic (OPG) x-ray?

4) What is the best way to clean the mouth when wearing braces?

5) Why are my child's gums red around the lower teeth?

6) Is it O.K. that my teenager uses mouthwash regularly?

7) When do you get wisdom teeth?

8) When do children begin to floss their own teeth?

1) When will my child get braces?
Children vary in their development and so they will vary when they get braces. As well, the type of treatment being undertaken will determine when orthodontic treatment begins.

Orthodontics may be undertaken early, when there are both primary and secondary teeth in the mouth. Sometimes it is all that is required or it could be the first part of a lengthy treatment. Commonly orthodontics begins later (after 10 years of age) when the second teeth have come in and much of the facial development is nearly completed.

2) Will my child need second teeth removed if they get braces?
The decision to remove teeth will depend on the orthodontic diagnosis and treatment plan. There are different approaches to treatment. The decision on the need to remove teeth will be different for every child.

3) What is a panoramic (OPG) x-ray?
A panoramic x-ray is an x-ray film taken outside of the mouth by a machine that rotates around the head. This type of x-ray gives the dentist a good picture of the teeth and jaws. When dealing with children, its main use is to examine the developing dentition. The dentist can see the presence or absence of teeth without having to take x-rays inside the mouth. It is a good way for screening out all types of problems but is not good for tooth decay diagnosis.

4) What is the best way to clean the mouth when wearing braces?
We realize that cleaning the mouth while wearing braces is not an easy thing to do. It takes more time and requires more effort. The person who puts the braces on should spend time instructing you what to do.

Three things can be suggested for home care. (1) Brushing may require a standard brush for regular cleaning and a special brush (small end-tufted brush) to clean around the hardware. (2) Special dental floss threaders which enable cleaning between teeth that cannot be done with wires in place. (3) Fluoride mouth rinse should be used daily because children wearing braces are more prone to tooth decay.

Be very alert to having good hygiene and diet while wearing braces! Nothing is more disappointing to children, parents and clinicians than having to cope with gum problems and tooth decay when the braces are removed.

5) Why are my child's gums red around the lower teeth?
The gums around the lower teeth may become red and sometimes bleed easily when brushing for several reasons. The main reason relates to improper cleaning of the teeth. If the teeth are not straight, they may be more difficult to clean. The gums and teeth need to be brushed regularly at least twice daily. Dental flossing can help clear up the situation as the floss gets between the teeth and removes plaque from areas that the brush cannot reach. Parents and children can tell when the gums are getting healthier because the bleeding decreases and the gums become pink.

One special situation that should be mentioned is called pubertal gingivitis. This condition can persist even though the mouth appears well cleaned. It is due to the hormonal changes that occur in the body at puberty. We consider it a passing phase. The gums will eventually return to the healthy, pink colour.

6) Is it O.K. that my teenager uses mouthwash regularly?
Many teens start to use mouthwash regularly because they become more interested in their personal hygiene. The use of mouthwash should not be a substitute for regular, good tooth brushing. When using a mouthwash, it is good to use one with fluoride or proven anti plaque benefits. However, don't forget to brush the tongue as it can contribute to a stale mouth odour.

7) When do you get wisdom teeth?
This question usually is asked by older teens rather than parents. Wisdom teeth, or third molars, may come into the mouth as early as 16 years of age but usually they come in several years later.

The question is prompted by hearing stories about wisdom tooth problems. These problems often are due to inadequate space in the back of the mouth for these teeth. As a result they only partially come into the mouth. The gums around them tend to become infected causing pain and swelling. Under these conditions wisdom teeth are removed. If they need removal, we recommend that this be done early rather than waiting for years. Often the surgery is easier as the roots of the teeth are not fully formed.

8) Are mouth beads (rings) harmful in any way?
The current trend for young people to have facial jewelry can cause some dental damage. Tongue studs, for example, have contributed to breakage of back teeth. Lip rings can get caught in clothing or elsewhere and tearing of the lip can occur. The jewelry needs to be well-cleaned as it can be an area where infection begins. Whenever these items or tattoos are put into the mouth, they should be done under the cleanest possible conditions.