Pediatric Dental Appliances
Pediatric Dental Appliances
The American Dental Association (ADA), recognizes pediatric dentistry as a specialty, and therefore requires dentists to undertake two or three years of additional training after completing a general dentistry degree. At the end of this training, the American Board of Pediatric Dentistry issues a unique diploma (Diplomate ABPD).
Though many parents think of “teenagers” when presented with the term “dental appliances,” the use of such appliances in young children is very common. Some dental appliances may be recommended for preventative purposes, while others may be recommended for treatment purposes.
It can be extremely difficult to encourage young children to wear removable dental appliances regularly, but there is some good news. Pediatric dental appliances can prevent injury to the teeth and may also reduce (or even eliminate) the need for extensive treatment later.
What types of pediatric dental appliance are most common?
There are many types of pediatric dental appliances – each one fulfilling a different dental function. The major categories of pediatric dental appliance are described below:
The American Academy of Pediatric Dentistry (AAPD) and American Dental Association (ADA) recommend that children wear mouth guards when engaging in any potentially injurious activity, including sporting and recreational endeavors.
The pediatric dentist can craft a customized mouth guard for the child, or a thermoplastic “boil-and-bite” mouth guard can be purchased at a sporting goods store. Similar mouth guards are used for children who “brux” or grind their teeth at night.
Sometimes, primary (baby) teeth are lost prematurely due to trauma or decay. Adjacent teeth tend to shift to fill the space, causing spacing and alignment problems for permanent (adult) teeth. Space maintainers or “spacers” are inserted as placeholders until the permanent teeth are ready to erupt. There are two main types of space maintainer:
- Fixed space maintainers – Depending on the position of the missing tooth and the condition of the surrounding teeth, the pediatric dentist may adhere a “band and loop,” a “crown and loop,” or a “distal shoe” type of spacer to fill the empty gap. All spacers fulfill the same function; just the nature of the attachment to the adjacent teeth differs. Fixed spacers are usually made of metal and are highly durable. If a highly visible tooth is missing, an acrylic button may be added to reduce the esthetic impact.
- Removable space maintainers – Removable spacers are rarely used with young children. Working a little like orthodontic retainers, special plastic parts fit into the empty slot to prevent the “drifting” of adjacent teeth.
Thumb Sucking Appliances
The majority of children naturally outgrow their thumb-sucking habit. However, children who continue to thumb suck after the age of five or six (especially vigorously) risk oral complications. These complications include: narrowed arches, impacted teeth, and misaligned teeth. The “palatal crib” appliance usually stops thumb sucking immediately.
The “crib” is crafted and affixed to the teeth by the pediatric dentist, almost like a barely visible set of dental braces. Preventing the thumb from reaching the roof of the mouth reduces gratification – and breaks the habit very quickly. Removable variations of the “crib” are also available, and can be used depending on the age of the child and his or her willingness to cooperate.
An overbite, where the upper front teeth protrude over the lower front teeth, can be corrected with an expansion appliance, as can a crossbite. The expansion appliance is used to stretch and widen the arch, providing enough space for the teeth to be realigned in a straight manner. Expansion appliances are custom-made, and can be affixed to the inside or the outside of the teeth. Children born with a cleft palate may be required to wear an expansion appliance to prepare the jaw for oral surgery.
If the pediatric dentist suspects that the child’s jaws are not growing in proportion to one another, a bionator device may be recommended. In general, the bionator positions the lower jaw forward, helping the teeth to erupt and align properly. This dental appliance is successful in reducing extensive orthodontic treatments later on, and helps to promote natural-looking alignment.
If you have questions or concerns about dental appliances, please contact your pediatric dentist.