With Dave and I both having had braces as adults, we are aware that our kids are probably going to need them as well. Just looking at Tyler's smile, you can see that his teeth haven't exactly come in where they're supposed to. He's only 9 though, so it didn't seem like something to worry about just yet. We went to the dentist a few weeks back for the kids' six month cleanings, and they found some interesting stuff on Tyler's x-ray. He's missing 2 of his permanent molars on his bottom jaw. He has baby teeth there now (it's his second molar from the back), but there is no permanent tooth below it. The dentist told us there were a couple different ways that could be handled, and recommended we get an orthodontic consultation early. She referred us to an office in Mesa, and I set up an appointment for Tyler.
First of all, it was the fanciest, most creative and patient-friendly office I've seen. We pulled up to a personalized parking spot by the front door, fun beach themed decor, and very friendly staff. They showed us around the office--the Apple bar (computers/ipads), the frozen yogurt machine, video game area, the prizes you can win...and then they took Tyler back for x-rays. After showing us a fancy video about their practice, they pulled up Tyler's photos and x-rays on a giant tv screen. It was actually really helpful to see what they were talking about.
Here's the just of what Tyler has going on....his main problem is that he has a cross bite. You can see it in the bottom two pictures on the left. Your top teeth are supposed to overlap your bottom teeth just a little bit--like Tyler's do on one side of his mouth (the right, if you're looking at the picture). On the left side, however, his top teeth sit inside his bottom teeth. This is bad. Apparently it can lead to a lot of dental issues, teeth/jaw development problems, and much more. Side note, on the x-ray on the bottom right picture, you can kind of see where he's missing the molars on the bottom jaw. There is just a blank space below where the permanent teeth should be in the jaw. Isn't he handsome?! Also, I hope this is the only "mugshot" he ever takes.

You're probably wondering what they recommended for these issues. Well, after getting the recommended treatment plan and cost at this fancy schmancy orthodontist office, we decided to get additional opinions. I wanted to try out the place that our nephew Talon recently had his treatment done, and also the place I went for my braces. I was very happy with them, and wanted to see what they recommended. It was interesting seeing the different offices and hearing the differing treatment plans they suggested. All 3 recommended something called an "expander" to fix the cross bite. They all had either different appliances and different timelines for treatment. The second place we went (Talon's doc) recommended the expander, pulling 4 baby teeth to make room for permanent teeth to come in, AND braces on the top and bottom 4 teeth now. The first place and the last place both said no braces until he's 11 or 12. The first place said to just leave the baby molars in as long as they last, and let him deal with it (implants or a bridge) if needed when he's an adult. The last place said they might pull those molars and suggested another method to close that gap.
So, after all of that information, we decided we liked the plan at the 3rd place best--the same place I went for my treatment. First of all, I really like the doctors there and I had a great experience. Second, we'll get a discount on braces when that time comes, and third, I liked their method for dealing with the cross bite better. Simply put, the expander is going to suck for Tyler. He'll hate it, we'll hate it....but it has to happen. This method seems the least miserable. The
type of expander the first two places use is even more miserable. It's a giant piece of hardware at the roof of the mouth, and twice a day, we have to go in with a little key and turn it to expand the jaw. OUCH! G & M (the place we're going with) uses a different type of expander that is smaller and doesn't need to be turned. It is sort of spring loaded and expands more gradually on it's own. It looks like this. Still not fun, but if you clicked that link above to see the other one, you'll agree it's better.

G & M doesn't want to make any other treatment plans until they see how the expander works. Ideally, it'll open up his jaw enough to make room for his other teeth to come in properly. He'll still need braces eventually, and we'll have to decide what to do about the missing molars, but I rather wait to make that decision until we see how this works. The other places wanted to push us into more advanced treatment plans right now. The cost was also much, much more reasonable here. The doctor at G & M also made some interesting observations about Tyler's apparently larger than normal tonsils and adenoids. He asked if he gets frequent sore throats and if he's a mouth breather...yes and yes. He said these things could all be connected--something about because of the large tonsils and mouth breathing, his tongue isn't sitting where it's supposed to, which could play some role in the cross bite. He recommended seeing someone about removing his tonsils--which we've wanted to do since the 3 bouts of strep throat last winter.
Anyway, very long story short, Tyler will soon be getting this lovely expander at the roof of his mouth, and he'll have to have it in there for 9-12 months. He has been a very good sport about all of this so far, and is somewhat excited about getting it done. I personally think he's just looking forward to earning tokes to put towards prizes and playing x-box when he goes in for appointments. I'll keep you posted!