Paediatric Orthodontics: When to Start and Which Types of Braces Are Recommended

Paediatric orthodontics plays a crucial role in the healthy development of a child’s smile and facial structure. Intervening at the right time can prevent future problems, improve chewing, and ensure balanced facial growth.

Dr Cláudio Alferes, a dentist specialising in orthodontics and occlusion, is dedicated to the follow-up of children and adolescents, with the aim of detecting malocclusions early and guiding bone and dental development in a harmonious way.

What Is Paediatric Orthodontics?

Paediatric orthodontics is the field of dentistry dedicated to the diagnosis, prevention, and treatment of alignment issues affecting teeth and jaw position during growth.

More than simply aligning teeth, the focus is on ensuring balance between function, aesthetics, and facial development.

During this stage, the orthodontist monitors growth and intervenes whenever factors are identified that may compromise dental fit, chewing, or breathing. There are, however, different phases and approaches in orthodontic care.

Preventive Orthodontics

Preventive orthodontics aims to avoid the development of malocclusions before they become established.

It includes actions such as:

• Monitoring the growth of the dental arches

• Controlling oral habits (such as prolonged pacifier use or thumb-sucking)

• Maintaining space for the eruption of permanent teeth

• Re-educating functions such as chewing or swallowing

  
  

This type of intervention is particularly important in children aged between 5 and 8, when it is still possible to guide bone and dental development with small corrections

Interceptive Orthodontics

Interceptive orthodontics acts when the first signs of malocclusion appear but it is still possible to correct the cause and guide growth.

This phase of treatment is essential to prevent simple problems from progressing into more complex structural issues.

Removable or functional appliances are frequently used to help correct habits, align teeth, and stimulate proper development of the jaws.

Corrective Orthodontics

When malocclusion is already established, corrective orthodontics comes into play.

In this phase, treatment aims to reposition the teeth and restore functional chewing and aesthetics. Fixed braces or clear aligners are used depending on the child's age and stage of bone maturation.

Even in corrective cases, early monitoring significantly facilitates treatment, reducing total duration and the likelihood of future extractions.

When Should a Child Begin Orthodontic Monitoring?

The first orthodontic assessment should take place around the age of 6 to 7, when the first permanent teeth begin to erupt.

At this stage, the orthodontist can observe whether there is a lack of space, bite deviations, or habits that may affect bone growth.

An early consultation does not necessarily mean immediate treatment, but rather monitoring of dental and facial development to intervene at the most appropriate time.

Reasons for Early Diagnosis

Early orthodontic diagnosis is essential to ensure that jaw development and tooth eruption occur in a balanced manner. At an early stage, it is possible to identify functional and structural alterations that, if treated promptly, prevent more complex problems in the future.

The main reasons for early assessment include:

• Identifying malocclusions before they worsen (crossbite, deep overbite, open bite, etc.)

• Correcting oral habits (thumb-sucking, prolonged pacifier use, tongue thrusting)

• Detecting lack of space for permanent teeth

• Assessing functional issues such as mouth breathing, chewing difficulties, or speech problems

• Preventing skeletal alterations that may compromise facial aesthetics and the temporomandibular joint (TMJ)

Benefits of Early Monitoring

Early orthodontic monitoring allows detection and correction of issues during the growth phase, when bone is more adaptable and interventions are simpler and more effective. This preventive approach offers multiple functional and aesthetic benefits, contributing to balanced development of the child's smile and face.

The main advantages include:

• Avoiding unnecessary extractions in future treatments

• Guiding facial growth, ensuring harmony between upper and lower jaws

• Preventing joint and muscular imbalances, promoting proper chewing function

• Reducing the duration and complexity of corrective treatments in adolescence

• Improving the child's self-esteem and confidence throughout development

Warning Signs That Indicate the Need for Evaluation

Parents and caregivers should be attentive to signs that may indicate the need for orthodontic assessment:

• Crooked or crowded teeth

• Difficulty chewing or biting food

• Open bite, crossbite, or deep bite

• Mouth breathing or snoring during sleep

• Thumb-sucking or putting objects in the mouth

• Chin deviations or facial asymmetries

• Permanent teeth taking too long to erupt after baby teeth fall out

Detecting any of these signs early is the first step towards ensuring balanced development.

Types of Paediatric Orthodontic Appliances

The ideal appliance depends on the child's age, growth stage, and the nature of the malocclusion. Dr Cláudio Alferes carefully evaluates each case before defining the most appropriate approach

Removable Appliances

Mainly used in younger children, removable appliances help guide jaw growth and correct minor alignment issues. They are comfortable, allow good oral hygiene, and can be removed for meals and brushing.

Conventional Fixed Braces

Indicated for children with mixed or permanent dentition, fixed braces are more effective when several teeth need to be moved simultaneously.

They allow greater control and precision and are often used in the corrective phase. Success depends on the child's cooperation and good oral hygiene

Functional Appliances

Functional appliances are designed to correct discrepancies between the upper and lower jaws by stimulating balanced bone growth.

They are particularly useful in children undergoing active growth and may be removable or fixed. Regular use and professional supervision are essential for successful treatment.

Benefits of Early Orthodontic Treatment

Early orthodontic treatment goes beyond aesthetics: it is a functional intervention that can positively influence long-term growth and oral health. By addressing the root of the problem rather than just its consequences, it establishes solid foundations for a healthy, balanced, and long-lasting smile.

Key benefits include:

• Correcting chewing function and improving breathing

• Promoting balanced growth of the face and dental arches

• Reducing the likelihood of complex treatments in adolescence

• Improving smile aesthetics and the child’s confidence

• Contributing to better oral hygiene and prevention of cavities and gingivitis

The Importance of Specialised Follow-Up

Every child has their own pace of growth and development. For this reason, orthodontic treatment must always be personalised and tailored to individual needs.

At Dr Cláudio Alferes’ practice, each assessment includes functional analysis, occlusal study, and evaluation of the temporomandibular joint (TMJ), ensuring that the treatment plan respects overall balance between teeth, muscles, and bone structures.

Continuous monitoring allows treatment adjustments and guarantees stable, long-lasting results.

When to Seek an Orthodontist

The visit to the orthodontist should not be postponed until adolescence. Ideally, monitoring should begin early, around the age of 6, even if there are no obvious signs of a problem.

A simple assessment can prevent long and invasive treatments in the future.

If your child has crooked teeth, altered bite, or persistent oral habits, schedule an orthodontic evaluation with Dr Cláudio Alferes and discover the ideal moment to begin orthodontic monitoring