Braces offer health benefits, not just cosmetic
Published on Tuesday, July 1, 2025
By: Rachel Vanderford, rvanderford@umc.edu
A crooked smile might be easy to spot, but the real issue could be how the jaw is growing, how a child is breathing or even how they chew their food.
“Parents often think orthodontic treatment is only cosmetic,” said Dr. Marcos Lenza, professor and chair of the Department of Orthodontics in the School of Dentistry. “But in many cases, the problems we treat have just as much to do with oral function, jaw growth and long-term health as they do with esthetics.”
Orthodontic problems in children—like overbites, open bites, crossbites or protruding front teeth—can cause more than just a crooked smile. Left untreated, these issues may lead to speech difficulties, chewing problems, jaw pain, facial asymmetry or even sleep-disordered breathing. Braces and other appliances aren’t just for straightening teeth; they also help guide developing jaws, stop harmful oral habits and prevent future complications.
For example, a deep overbite where the upper front teeth overlap the lower teeth too much can lead to damage to the gums and palate, teeth grinding and even jaw joint stress, said Lenza. “By intervening early, we can correct the bite, improve chewing efficiency and prevent worsening problems as the child grows.”
Another concern is an open bite, often caused by thumb-sucking, tongue thrusting or prolonged pacifier use. “When there’s no overlap between the top and bottom teeth don’t align correctly—can also lead to muscle strain or even jaw growth. And children with protruding front teeth are at greater risk of dental injuries from falls or sports accidents. Appliances play an important role in redirecting the growth of the maxilla and mandible to their proper positions.
The early loss of baby teeth is another issue that can affect long-term oral health. Primary teeth play a critical role in maintaining space for permanent teeth and guiding their eruption.
“When a baby tooth is lost prematurely, it will affect all the oral functions,” said Lenza. “Adjacent teeth may drift into the empty space, which can lead to crowding, impacted permanent teeth and locked eruption. Early loss can also lead to midline deviation, uneven arch development and facial asymmetry over time. Space maintainers may be needed to preserve space until the permanent tooth erupts.”
Early orthodontic treatment, also called Phase I treatment, can address these issues when children are between the ages of 6 and 10. "This stage is known as the mixed dentition stage when primary and some permanent teeth are present,” said Lenza. “This phase usually lasts about 12 to 18 months, followed by a resting period while the remaining permanent teeth erupt.”
Phase I treatment may involve partial braces or fixed appliances for a year or so, followed by a resting period while the rest of the permanent teeth come in. Phase II, what most people picture as traditional braces, typically happens between ages 11 and 13 to fine tune the bite and alignment.
Needing a second phase doesn’t mean the first one failed. “Phase I is like laying a strong foundation,” Lenza said. “It helps make the second phase shorter and less complex, often avoiding the need for extractions or surgery.”
Orthodontists also work closely with pediatricians, ear, nose, throat specialists, and sleep specialists when other health concerns overlap. “We may coordinate treatment for children for children with breathing issues or sleep apnea,” he said. “And don’t wait until all the permanent teeth are in to get an evaluation.”
The American Association of Orthodontists recommends the first orthodontic visit by age 7, even if there aren’t obvious problems. That evaluation doesn’t always mean treatment is needed right away, but it can catch developing issues before they become more complex or expensive.
“The mentality of waiting until age 12, when all the child’s permanent teeth have all erupted to take them to an orthodontist for a first evaluation, must be discouraged,” said Lenza. “A lot of orthodontic problems won’t self-correct with time. But with early attention, we can support healthy growth and development and give kids confidence that comes with a healthy smile.”
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