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Best Age to Treat Overbite Varies

Your second-grader comes home from school sobbing, saying kids have been teasing him about his teeth. You call your dentist, who examines your son and sends him to an orthodontist. The orthodontist tells you your son has an overbite.

What does that mean? In vertical overbites, the top teeth overlap the lower teeth too much. In horizontal overbites, technically called "overjets," the top teeth protrude too much.

Either can cause problems. These include the fracture of a top front tooth, painful gum cuts, or tooth decay in hard-to-clean areas.

Many orthodontists treat the condition in two phases. Early treatment may involve the use of fixed or removable appliances that guide the growth of young bones as adult teeth are emerging. The second phase may involve braces to guide teeth into the correct positions.

You might expect your child's treatment to start right away. That may not be the case. Orthodontists consider the nature of the dental problem and how a child's permanent teeth, jaw, and face are developing to decide on the ideal time to begin treatment. Your orthodontist may choose to take a "wait-and-see" approach. This means your child will be checked periodically before starting treatment.

A large meta-analysis (which pools smaller studies to yield a larger sample) in the 2007 Cochrane Database of Systematic Reviews found early overbite treatment was no more effective than treatment starting in early adolescence. But this may vary on a case-by-case basis. A study reviewed in 2007 by the Alpha Omegan (journal of the Alpha Omega International Dental Fraternity) found benefits to treating overbite at age 8 or 9.

Since there is no consensus on the best time to begin, talk with your child's dentist or orthodontist about all the options. Ask questions so you understand the reason for the proposed treatment.

"Malocclusion of Teeth." MedLine Plus, U.S. National Library of Medicine, National Institutes of Health. http://www.nlm.nih.gov/medlineplus/ency/article/001058.htm. Accessed 2013.

"'Effects of Oral Habits' Duration on Dental Characteristics in the Primary Dentition." M. Warren et al. Journal of the American Dental Association. 2001, vol. 132, no. 12, pp. 1685-1693. Abstract: http://jada-plus.com/content/132/12/1685.short. Accessed 2013.

"One-Phase Versus Two-Phase Treatment." American Journal of Orthodontics and Dentofacial Orthopedics, volume 108 (5); pages 556-559, November 1995.

"Orthodontic Treatment for Prominent Upper Front Teeth in Children." J.E. Harrison et al. Cochrane Database of Systematic Reviews. 2007, Issue 3. http://www.cochrane.org/reviews/en/ab003452.html. Accessed 2013.

"Early Orthodontic Treatment: Current Clinical Perspectives." D. Musich and M.J. Busch. Alpha Omegan. 2007, vol. 100, no. 1, pp. 17-24. Abstract: http://www.ncbi.nlm.nih.gov/pubmed/17566300. Accessed 2013.

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