Misaligned teeth are more than an aesthetic concern for children: crooked, shifted, or overcrowded teeth are harder to clean, tend to accumulate more bacterial plaque, and can cause bite and jaw joint issues. Moreover, when the malocclusion is too severe, orthodontics may need to be complemented with pediatric oral surgery in Lihue.
When children have severe bite misalignments, we recommend a surgical procedure before starting their orthodontic treatments. This guide is here to help you understand your child’s needs and make an educated decision regarding surgery before braces.
Surgery Before Braces: When Is It Necessary?
Sometimes, using traditional orthodontic techniques like braces or clear aligners is not enough to achieve a beautiful, healthy smile. In these situations, surgery is needed to treat severe malocclusion and provide the foundation for a healthier smile.
Your child’s dentist will perform comprehensive examinations to determine whether surgery is actually required in your child’s particular situation. They will take detailed pictures of your child’s jaw and mouth using sophisticated 3D scans and X-rays.
With the help of these diagnostic tools, they can gain a thorough grasp of your child’s situation, considering all relevant aspects before suggesting the best course of action. Some cases in which a dentist may explore this path include:
Severe Bite Problems
Orthodontic surgery might be an option for your child if they have a severe crossbite, underbite, or overbite. These bite problems can sometimes make speaking, chewing, and breathing difficult. Over time, they may also exacerbate discomfort and jaw pain.
Impacted Teeth
Sometimes teeth, particularly canines, become lodged in the bone or gums and are unable to come out on their own. Thanks to surgical exposure, the orthodontist can better align these teeth with braces.
Jaw Pain or TMJ Disorder
If your child experiences jaw pain, especially in the temporomandibular joint (TMJ), orthodontic surgery might be necessary. Their jaw misalignment can cause tension and discomfort that is beyond the scope of simple braces.
Facial Imbalance
Because of the way their jaws are positioned, some patients have noticeable asymmetry or imbalance in their faces. This could be an elongated lower jaw or a receding chin. Orthodontic surgery can resolve these problems, improving facial harmony.
Problems Closing Your Mouth
A misaligned jaw can cause trouble for your child when closing their mouth. This issue can be resolved surgically by realigning the jawbones.
Sleep Apnea
Obstructive sleep apnea is a disorder in which breathing repeatedly stops and starts while you are asleep. This disorder can be exacerbated in certain patients by jaw misalignment. Orthodontic surgery might be a component of a larger treatment strategy to open the airway and enhance breathing while your child sleeps.
Types of Surgical Procedures Before Braces
To achieve the best results, orthodontic surgery might be required for patients with severe jaw misalignments, serious bite problems, or extreme crowding. The two types of surgical procedures that may be necessary include:
Tooth Extractions
In most cases, children can get braces without any trouble. However, we may have to extract some teeth to create space if there is excessive crowding. Children are less likely to have this procedure done. Adults who desire braces typically get extractions because their jawbones are more mature and less malleable.
Still, your child may require a safe and healthy extraction before considering braces. Simple extractions are typically completed quickly when the tooth has already broken through. The process becomes slightly more complicated if the tooth is impacted. The surgeon may need to make an incision on the gums to safely remove the tooth from the root.
The region surrounding the tooth is completely numbed before extraction, so there is only a slight pressure but no pain.
Exposure and Bonding of Impacted Teeth
When a child’s permanent tooth, usually a canine, fails to erupt properly and stays trapped beneath the gum line or bone, this minor surgical procedure may be required.
The surgeon makes a tiny incision in the gums to carefully expose the impacted tooth after numbing the area with local anesthesia (and occasionally sedation for comfort). A tiny bit of bone may also be cut away to reveal the tooth completely. Once the tooth’s crown is visible, a tiny orthodontic bracket with a gold chain is bonded to it.
After surgery, the orthodontist employs braces or other appliances to gradually move the impacted tooth into its correct position using the chain. Light pressure is used over a few months to pull the tooth into the dental arch and bring it into alignment with the neighboring teeth.
Though it requires patience and precise coordination, exposure and bonding are highly effective solutions for managing impacted teeth and achieving a healthy, functional smile.
Orthodontic Surgery
Orthodontic surgery, sometimes referred to as orthognathic surgery or surgical orthodontics, is a specialty procedure used to treat jaw abnormalities. Many people believe that the only options for orthodontic treatment are braces or clear aligners, but these conventional approaches are not always effective.
Surgery might be the best course of action to restore proper function and alignment if the positioning of your child’s jawbones has caused their bite to become significantly misaligned.
The procedure usually entails repositioning the jawbones to enhance facial structure and bite. A skilled oral and maxillofacial surgeon will handle these more complex orthodontic cases. Braces or Invisalign® are then used to finalize tooth repositioning, guaranteeing a straight and healthy smile for years to come.
Recovery Tips for Children After Pediatric Surgery
Some discomfort after surgery is common. During these times, you’ll become a pillar of comfort and support for your child, so be strong. To do so, being well-informed is key. Here are some key care measures to follow:
Pain Management
We’ll provide pain relievers, such as children’s ibuprofen or acetaminophen, to help them manage discomfort. Make sure to provide the prescribed dosage without going over it, and don’t stop if it is not indicated, even if they say they’re feeling well. To manage swelling, apply a cold pack to the cheek near the surgical site for 15 to 20 minutes at a time.
Your child should stay at home for at least two days after surgery. Avoid sports or vigorous activities.
Diet Considerations
Stick to soft foods like yogurt, smoothies, applesauce, mashed potatoes, soup (lukewarm, not hot), and ice cream.
After two to three days, you can gradually reintroduce soft solids like scrambled eggs, pasta, pancakes, and soft fruits (like bananas). Avoid crunchy, hard, spicy, or acidic foods that might irritate surgical sites.
Good Oral Hygiene
Maintaining good oral hygiene after surgery is crucial to preventing infections and oral diseases. However, make sure to brush gently, using a soft-bristled toothbrush, and avoid the surgical area in the first days after surgery.
After 24 hours, we recommend rinsing with a warm saltwater rinse to prevent infection and promote healing. Moreover, tell them to avoid swishing hard during the first few days, especially after extractions.
Conduct a Safe Pediatric Oral Surgery in Lihue
Surgery is sometimes part of the journey to a straight, even smile. While it may sound scary, dental offices like Kidshine Pediatric Dental Group offer safe surgical procedures and warm installations designed to ensure your child’s comfort.
Afterwards, we’ll explore straightening options together. If your child has severe misalignment issues, contact us today to schedule an appointment!
*Invisalign®, the Invisalign logo, and iTero®, among others, are trademarks and/ or service marks of Align Technology, Inc. or one of its subsidiaries or affiliated companies and may be registered in the U.S. and/or other countries.