Need advise: 7-yr old daughetr starts ortho treatment

[sachivalay]

This is a wonderful message board that I discovered.
We are starting Ortho phase 1 treatment for our 7-year old daughter.
Step 0. Her teeth
Step 1. Remove 4 baby teeth (upper and lower canine )
Step 2. Phase 1 braces with head-gear like one shown at
Step 4. remove 4 permanent teeth when she is 11-12
Step 5. Phase 2 of braces.

I am looking to hear about experiences from parents of kids that went through similar treatments. I am concerend about her willingness and ability to wear the head gear at home and while sleeping.

[Lisa65]

Headgear compliance is usually going to be a problem. High pull headgear like the one in the picture is especially difficult to tolerate as it's very visible and uncomfortable to sleep in. I wore one for a few months recently as a stopgap to hold my back teeth in place, but I found it hard to manage more than 12 hours a day, and for actual tooth movement, you need 16 hours a day at least. I would think a 7 year old might have trouble grasping the potential long term benefits of wearing a HG and be put off by the obtrusiveness and discomfort. I assume the HG is to hold back the growth of her top jaw to allow her lower jaw to catch up? She's going to be in active growth for a good while yet, so encouraging correct jaw growth might actually make enough space for her to avoid extractions in the future.

Of course I don't know the details of your daughter's case, but I'd be tempted to ask about a functional appliance rather than headgear for phase 1. Usually functional appliances are better tolerated as they are entirely in the mouth, unobtrusive and can provide the necessary forces 24/7. Some are removable and can therefore be taken out for cleaning. Headgear, with the best will in the world, cannot be worn all the time, so the forces will be intermittent.

[Lisa65]

My ortho told me he'd have used a twin block appliance to encourage lower jaw growth if I'd gone to him as a young teen.

[sauerkraut]

My daughter wore headgear (night time only) when she was a year or two older than yours,sachivalay, and she was pretty good with it. But it was quite a different kind, by the looks of it. More like a face mask kind of thing. She had a fixed expander as well, and elastics going from that to the mask - nothing across the top and back of the head as such, like in your picture.

Anyway, she wore it faithfully almost every night and it was quite a novelty when she went to sleepovers! She could sleep OK because she's a very deep sleeper, but she would never have described it as remotely comfortable!

I guess so much depends on getting the child to accept it and if it's likely your child won't be compliant then maybe check out if some of the alternatives suggested would work?

I've no experience of extractions for any of my children so can't really comment on that I'm afraid. As others have said, there's no going back once it's done, so maybe a second opinion to be 100% sure it's necessary?

[Folk Ballad]

I suppose as this point, I'm just going to sound like a broken record, but I agree with what everyone else above me has said. A second opinion can never hurt. Maybe it'll make you more sure that the treatment plan that your ortho has in mind for your daughter is the right one. Or make you aware of possible alternatives that can be used instead of headgear.
Speaking from personal experiences, I had to deal with headgear when I was in middle school and was fairly compliant. However, I didn't have a high-pull HG, but the type of facemask sauerkraut is talking about and only ever wore it at night. It wasn't all that comfortable, but I managed to sleep fine and was a fairly compliant patient, since I knew that the more often I wore it, the more quickly the day would come when my orthodontist would tell me head gear wasn't needed anymore.
My best friend had high-pull HG when we were in elementary school (that, too, was nightly wear only) and she wore hers faithfully. I remember she used a really large and fluffy stuffed animal as a pillow to make sleeping more comfortable.
I think at the end of the day it really depends on the child, because some kids are going to balk and others are going to deal.

[sachivalay]

Update...
We got her 4 baby canines extracted.
She got braces on upper teeth to reduce overjet.
She wears head gear for 10 hours at night as asked by our ortho.
She realized that head gear is cost of her thumb sucking and is very compliant to head gear routine.

I am happy and looking forward to improvement in her teeth.

[jaswi]

The only thing I would really be concerned about would be the decision at age 7 to remove 4 permanent teeth 4 years down the line. Seems like that would be plenty of time to facillitate growth and make room to avoid extraction.

[sachivalay]

We just came back from adjustment appointment. Her teeth are better. Overjet is almost gone. Still she has slight overbite but when she wants, she is able to line up upper teeth with lower teeth. I can see that she is able to chop food much easily. Head gear usage is very well and ortho is happy with her progress.

She is half way through her phase I treatment and going good.
New perm teeth have filled up space created by removal of baby teeth and those new ones will be wired next time she goes to ortho.

More later..

[bbsadmin]

I would strongly advise you to think very carefully about having her permanent teeth removed when she is older. Removal of permanent teeth in children is very "old school" thinking. It used to be done a lot. It is still done a lot in Australia. But in the US and England, it is rarely done anymore.

The reason is: removing permanent teeth before the jaw stops growing often results in a "flat" face" and leads to less than desired facial asthetics. Please do your research before giving your orthodontist the go-ahead to remove permament teeth before she is an adult and has stopped growing!

In some severe cases, removal of teeth may be the only way to achieve the best bite. However, it shouldn't be done at the sacrifice of facial asthetics!