"One of the common misconceptions about orthodontic treatment is that most parents believe that their child needs to be at least 12-13years old before he/she is ready for braces treatment. In fact there is no such thing as a minimum age required to start braces. Orthodontic treatment is indicated on a case by case basis depending on the condition and compliance of the child."

Early Detection
" The common problems that most parents are able to spot in their children are protruding, teeth, crooked teeth and an underbite. Even if your child has straight teeth, an orthodontic check-up may reveal subtle problems with jaw growth and erupting adult teeth."

Key Age of 7 years old
" The American Association of Orthodontists recommends a check-up with an orthodontic specialist no later than the age of 7 years. Please do not be alarmed as in majority of cases, the orthodontist will reveal that your child’s teeth and bite are fine. Even if a problem is detected early on, they may recommend monitoring the child’s growth and development before intervening. In a few cases, orthodontic treatment may need to be indicated at an early age."

What to look out for?
" There is a long list of problems that can and/or should be corrected earlier on. If you notice that your child has difficulty biting or chewing, have lost their baby tooth earlier or too late or if he or she has speech impediments, it is worth obtaining an orthodontic consult. Other problems such as mouth breathing, sucking their thumbs after five years old or shifting of the jaw during opening or closing of their mouths may need to be examined too."

Prevention
" Early treatment, also known as interceptive orthodontics is important for certain teeth conditions. Although not common, early treatment can be used to intercept and prevent a serious problem from developing. In some cases it may even make treatment at a later age shorter and less complicated. A few benefits of interceptive orthodontics are encouraging jaw growth to the correct proportions, preventing worsening of protruding teeth and avoiding damage to the gums and teeth due to incorrect bite."

Timing is everything
" Early braces treatment is akin to early childhood education. Why do we start early childhood education even before a child can read or write but wait until all baby teeth are lost before we consider orthodontic treatment? There is no such thing as a minimum age for braces. In fact it is determined on a case to case basis. If you have a gut feeling that something may not be right about your child’s teeth, then do consult a specialist."

Other benefits
" The most important part of interceptive orthodontics is to prevent damage to teeth and gums. One good example is a tooth in crossbite. If a lone-standing tooth is in crossbite, it may cause damage to the gum support for that tooth and the adjacent teeth. If this condition is not detected early on, gum damage may have already occurred and it might be too late. Such cases can be treated fairly easily using braces within three months."

Self confidence
" It has been reported that a pleasing smile will improve confidence and in turn, improve the quality of life for an individual. This matter is true not only for adults, but for growing teens and even so, young children. Children in primary schools start to feel conscious about their ever-changing physical self and hence may feel shy about their smiles. We have had some children who are subjected to teasing and even bullying over their ‘buck’ teeth. What surprises us most is that when their ‘buck’ teeth is corrected, the confidence of the child sky rockets and it is one of the most job-satisfying parts of our career."

Better to be early than sorry
" Over time, we have seen many cases who present at our clinic a little too late, and hence more complicated or prolonged orthodontic treatment needs to be warranted. In this day and age, seeing the general dentist every six months is not sufficient. Please remember to schedule an orthodontic check-up for your child by the age of 7 years old. With the advances in dental technology, we are able to monitor and prevent certain types of complications occurring during the stage of erupting teeth. This in turn, will hopefully encourage a shorter and less complicated orthodontic treatment later in life."

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We don’t get it. We really don’t.

We don’t understand why girls would go for plastic surgery to raise their nose bridge and cut double eyelids but walk around with a really gummy smile. Or flip a switch over a single freckle or zit, and be ok about uneven gum margins and a totally lopsided smile?

Well, let’s take a poll here guys. Which is more unattractive? A single zit or an ugly smile? OK, we just asked our colleague’s five-year-old son and he said: “Ugly smile is uglier.” Not the best way to take a poll, but you catch our drift.

So perhaps, we tell ourselves, maybe it’s because the girls think gummy smiles cannot be fixed! Studies show that gummy smiles become noticeable when 3mm or more of gums show when smiling. The two ways to fix this is to prevent the upper lip from moving too far upwards or in-crease the length of the teeth to reduce the amount of gum shown.

There are many factors that cause a gummy smile like an over-active upper lip or excessive gums that cover too much of your teeth.

The treatment is based on the diagnosis and what is causing you to look too ‘gummy’. Here are some ways to get a better smile!

If the Gummy Smile is Due to an Over-active Upper Lip:

Lip repositioning surgery
The lip is cut from the inside and stitched closer to the teeth so the lip cannot retract as much. (Ouch.)

Numb the muscles of the upper lip
Luckily, nowadays, it’s easier to get that stiff upper lip. No need to smile in a certain way or stifle your laughter! We can give you and injection in that upper lip so the muscles are paralysed/semi paralysed and cannot move. Only thing is, this kind of injection wears out after a few months and you will need to get another one to keep that lip in its place.

If the Gummy Smile is Due to Excessive Gums:

Laser or scalpel gum gingivectomy
Your periodontist (gum specialist) can trim your excessive gums using a laser or a scalpel. It’s a very comfortable procedure and the results are immediate. Be warned though. If there is still too much bone underneath the gums in some patients, the gum will grow back to it’s original position and the gingivectomy procedure will have to be repeated a few months later. Much like the numbing procedure described above.

Crown lengthening with osseous surgery
This procedure basically means having your gums and bone trimmed to lengthen your teeth permanently. Some patients have excessive bone which causes excessive gums to form. So when we trim that bone away together with the gums, the final look is, well… final! You get nicely shaped teeth and less gums without having to repeat any procedures.

If the Gummy Smile is Due to a Long Mid-Face:

Vertical maxillary impaction
The surgeon will need to embark on corrective jaw surgery, where the whole upper jaw is reposi-tioned upwards. Needless to say, this procedure is much more invasive and you will need much more time to heal!

So there you go.

So many ways to fix a gummy smile, ranging from something temporary to “test the look” to see if you like it (kind of like getting your hair waved with a curler at the salon before you commit to a perm) to getting the gums fixed permanently in that position so it doesn’t become a hassle to go back to your periodontist for repeat procedures.
So remember, before going for that second nose job, why not fix your smile first?

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As a multidisciplinary practice, we often get have patients who want to straighten their teeth once their other dental issues are treated and their condition is stable.

As such, we work closely with the orthodontists (braces specialists) in our practice as it is always good to have straight, well-aligned teeth.

If brushing your teeth is not easy now because your teeth are crooked and trap a lot of plaque, things will only get worse as you grow older. In our old age, many of us lose our dexterity. Clean-ing crooked teeth then gets even more impossible!

So really, do plan for the future. It seems so far away when we still do headstands during yoga class, but soon enough my friend, the time will come when we find tying our shoelaces difficult!

So here are some common questions that many patients ask:

1. You are never too old to wear braces!

Well, that is almost always true. Age really doesn’t matter when you are moving teeth. Teeth can be moved healthily and safely regardless of age. It is only important to orthodontists that we are moving healthy teeth around. If you have active gum disease and you start braces, you could lose bone around the teeth and the teeth could loosen. Not a clever move!

2. You need to have healthy gums before wearing braces

You really need to have healthy gums and teeth before you get those braces on! There is a lot of inflammation in gum disease that makes the bone very soft. So when braces exert forces on the bone, the bone is unable to take the extra pressure and bone loss around the teeth occurs, causing it to shake and in severe cases, even fall out! The bottom line is, get a gum check be-fore starting braces and your dentist can coordinate with your orthodontist when you are ready for braces.

3. You need to have good oral hygiene while wearing braces

Good oral hygiene is needed to remove plaque and bacteria. If they accumulate on the brackets and teeth, the bacteria could cause gum disease to become uncontrolled again and your teeth could become loose while the gum disease worsens. Also, if you don’t brush, the bacteria get trapped on your teeth by the braces and when the braces are removed… Voila! You get teeth that are patchy and mottled from initial decay. Gross and not cool.

4. Braces do not need to be ugly

There are many different types of braces nowadays. You don’t need to look like a teenage metal mouth any longer! There are ceramic braces, which have natural-looking tooth-coloured brack-ets or for best aesthetics, go for Invisalign, a set of clear transparent aligners that help move teeth slowly but surely into its new position.

5. Braces are not that painful

Some people worry about the pain, and to be honest, the teeth do feel sore for a few days after tightening. But it eases up very soon.

So go ahead and take that leap to do braces if you have been dawdling about it. Or at least just visit an orthodontist for a consultation and ask all the questions you want. Age is not a factor when deciding if you should go ahead to straighten those crooked front teeth. Just make sure that your gums and teeth are healthy before you start!

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