Let’s Time It Right!

The Question

When is the best time to begin orthodontic treatment?  This is the question often asked by parents especially as they see other young children in orthodontic appliances.  My specialty training in orthodontics places emphasis both on early treatment (7-10 yrs. old) as well as treatment occurring later with all of the permanent teeth present.


My Answer

I have been fortunate to have the opportunity to treat numerous patients with both techniques and then review them in the following areas: finished results, duration of treatment, number of appointments, loose appliances, cooperation and patient motivation/enthusiasm.  Combining this information with new wire and appliance technology, I have concluded that for the vast majority (approximately 80%) of young patients, it is best to delay treatment until most, if not all, the permanent teeth are in.


The Reasons

The five major advantages and benefits of waiting:

  1. Decreases time in braces and fewer appointments resulting in:  less chance of enamel decalcification and root shortening, less time absent from school or work and less opportunity for broken braces.
  2. Bone growth is occurring more rapidly during adolescent years, increasing treatment effectiveness.
  3. Understanding and cooperation are better when a child is mature.
  4. Completing treatment in one phase is less costly then a prolonged two-phase program.
  5. More stable results.

The most optimal time to realize these benefits will vary somewhat with the individual child, but for most children it is usually between the ages of 11 and 12.  Orthodontic treatment begun during this window of opportunity will usually result in braces being on for 24-28 months instead of 3 to 4 years or more.



There are a few orthodontic conditions that do warrant a brief period of early treatment.  These include:

  1. Cross bites causing the lower jaw to shift.
  2. Severe jaw imbalances (such as an upper jaw that is too far back).
  3. Space maintenance for the early loss of primary (baby) teeth.
  4. Excessive crowding causing damage to teeth, bone and/or gums.
  5. Airway problems.

Additionally, if a young patient is suffering psychologically or socially from crooked upper front, a brief period of partial braces can improve both the smile and self-image dramatically.  Although braces will typically still be needed when all the teeth erupt, I do feel this is a valid treatment indication for some youngsters.


Parting Words

Needless to say, the timing of orthodontic treatment is an important issue that can make orthodontics either a rewarding and enjoyable experience or one that is prolonged and tedious.  Our observation program is set up to allow us to evaluate the patient’s dental and overall development on a regular basis is order to begin orthodontic therapy at the appropriate time.


I hope this information has given you a better understanding of our practice and a positive introduction to orthodontics.  Additionally, I hope you can see that waiting is sometimes the best “treatment”.



Averting a Plaque Attack in Columbia MO

toothbrustGum disease can become a big problem for people as they grow older. Luckily, it doesn’t just happen by accident, and if you know a little about what causes it, you’ll be better able to avoid it in the long run.

As unpleasant as it may be to think about, our mouths aren’t the cleanest places in the world. As food is eaten, the remnants left on teeth form a sticky substance known as plaque, which is full of bacteria. If you brush your teeth and flush regularly, most of this plaque is removed. (A quick word of caution about brushing: be gentle with your gums when you brush, because overly vigorous brushing can actually contribute to gum disease over time!) However, if you aren’t regular with your brushing and flossing, the plaque collects near the gum line and hardens into tartar, the next step on the road to gum disease. If your teeth are crooked or crowded, it may be too difficult to remove the plaque the way you should, and the tartar can develop in hard to reach places despite your best efforts. Regular dental cleanings are very important to remove any tartar that has built up for whatever reason, since brushing and flossing alone can’t take care of it.

If tartar is not dealt with, over a period of time the gums may actually pull away from the teeth. This movement creates a space called a periodontal pocket, which is seriously bad news. The extra room is a ready-made home for more plaque and tartar, which then becomes even more difficult to get rid of. At this point, if left untreated, your gums will become red and swollen, the telltale early signs of gum disease, also known as gingivitis. As gingivitis progresses, you can eventually suffer bone loss in your jaw. This, in turn, makes your teeth wobbly because they don’t have the support that they need to stay solidly in place. Eventually, they can even fall out, a fate no one wants.

Robinson and Ries Orthodontics play a special role in the prevention of gingivitis. Remember how crooked or crowded teeth can make the plaque and tartar difficult to get rid of? Orthodontics, which is a special branch of dentistry, can fix this problem. By straightening the teeth out and ensuring that they are spaced properly, brushing and flossing become more effective at removing plaque. This can be achieved through braces, retainers, and other corrective appliances according to each person’s individual need. If you have hard time fitting floss in between your teeth, you are probably a good candidate for orthodontics. Fortunately, healthy teeth can be moved at any age, so there is no reason not to seek orthodontic treatment just because you’re an adult. In fact, about 1 in 4 orthodontic patients today are adults.

Dr. Scott Robinson and Dr. Dave Ries and the Team at Robinson and Ries Orthodontics are pleased to provide you with this helpful information and to offer you the finest state-of-the-art orthodontic care for you and your family. Give us a call for a free consultation at (573) 446-0700.