Construction site dentures - all about braces

Elena's milk teeth actually look perfect - gleaming white, evenly grown and not the slightest gap between the teeth. The dentist's advice that Elena will one day need braces comes as a complete surprise to the six-year-old's parents. «Especially when the milk teeth appear to be flawless, parents are usually blindsided when they hear that their child will need braces,» says Dr Claudius Wiedmer, specialist dentist for orthodontics and President of the Swiss Society of Orthodontics (SGK). «But what looks good now can cause massive problems later on. A baby set of teeth without gaps simply offers too little space for the much larger teeth that follow, which then usually come out misaligned and crooked.»

Many health insurance companies require treatment to begin before the age of 16 - and otherwise refuse to pay benefits.

Jaw crowding is just one of many reasons why braces treatment may be necessary. Teeth can also be too far apart, twisted or tilted or even missing completely. The teeth may not be optimally aligned in the bite, may not meet, overlap or just graze.

The shape of the jaw or the position of the upper and lower jaws may also not match. «Depending on the malocclusion, this is referred to as an overbite, underbite, underbite, overbite, crossbite or open bite,» explains Wiedmer. These malocclusions are often genetic. «Very few people have perfect teeth by nature,» says Wiedmer. However, some malocclusions are also home-made. «For example, constant sucking on a dummy or thumb can deform the jaw in small children and should be stopped by the age of three to four at the latest,» warns Wiedmer.

Every second child has braces

«It is also important to take care of the milk teeth, as they are important placeholders for the permanent teeth that will follow.» If milk teeth fall out early or shift, the next teeth can erupt crookedly or in the wrong places. «In addition, bad habits such as cheek and nail biting as well as lip and tongue clenching can also lead to changes in the jaw and tooth position,» the orthodontist points out.

Orthodontic treatment is particularly medically necessary if the jaws are asymmetrical. «This can lead to temporomandibular joint problems and varying degrees of tooth wear ,» explains the dental expert.

«Swallowing, breathing and speech problems due to misaligned jaws or teeth should also definitely be treated.» Of course, aesthetic reasons also play a major role, as even rows of teeth are considered the ideal of beauty in our society.

Many parents want to spare their child possible teasing and boost their offspring's self-esteem by having braces corrected. «What's more, evenly aligned teeth are also easier to look after than teeth that are too crowded or crooked,» adds Wiedmer. «So caries and periodontitis have less chance here.» More and more parents are therefore opting for orthodontic treatment for their child. «Around every second child in Switzerlandcurrently wears braces,» says the SKG President.

Orthodontic treatment can be carried out at any time. Adults can also have their teeth straightened. However, it is no longer possible to change the adult jaw without further ado. Misaligned jaws should therefore be treated at an early stage. «The onset of puberty for girls between the ages of ten and twelve and for boys between the ages of eleven and thirteen is the optimal time for braces treatment,» explains the SGK President.

If the health insurance does not pay

«At this age, remodelling processes in the jaw can be achieved particularly quickly and without complications because an enormous physical growth spurt takes place during early puberty, which can also be used for jaw correction.»

In addition, many children and adolescents wear braces at this age, which means that the acceptance of treatment is particularly high at this time. «Last but not least, many supplementary insurance policies also stipulate that treatment must be started before the age of 16 and refuse to pay benefits if treatment is started later,» emphasises the orthodontist.

There are huge price differences

Depending on the findings and what needs to be changed, several different appliances are used to carry out the treatment. The best known are probably loose braces and fixed braces with wire and brackets, also known colloquially as snow chains or Gartenhag.

«In many cases, we start with removable braces to prepare the jaw in a targeted manner,» explains Wiedmer. «This is followed by the insertion of a fixed appliance, which can be used to change the position of the teeth in the mouth in a targeted and detailed manner.»

The industry offers a wide range of different systems, particularly in the area of fixed appliances, ranging from smaller or larger, tooth-coloured or transparent brackets to brackets bonded to the inside of the teeth. For a while, so-called self-ligating brackets, which do not require rubber bands to attach the wire, were considered particularly innovative.

Many parents want to save their child from teasing and boost their child's self-esteem by having braces corrected.

Correction with so-called aligners works completely without brackets and wire. «These are customised, fine plastic aligners that have to be worn almost around the clock,» says Wiedmer.

All systems have advantages and disadvantages in terms of treatment, wearing comfort, aesthetics and, of course, price. «There can be huge price differences from the simplest to the most expensive version,» emphasises Wiedmer. «It's difficult to make recommendations here, as each practitioner is particularly skilled in a particular system.»

Of course, the initial medical situation and personal preferences also play an important role. Wiedmer advises that you should always consult an orthodontic specialist for advice and braces treatment.

This is because orthodontists have several years of additional practical training, are familiar with the products on the market and know which appliances are particularly suitable for which indication. «This enables them to provide efficient treatment that doesn't take an unnecessarily long time.» This is because young people often no longer accept long treatments at some point, and they also drive up the price, says the jaw expert.

Braces treatment can cost more than CHF 10,000

This is because parents generally have to pay the costs of orthodontic treatment themselves. With an average treatment period of two to three years, the costs of a fixed appliance can sometimes run into five figures. In most cases, these costs are not covered by basic or disability insurance. «Basic insurance only pays for the treatment of dental damage caused by a serious, unavoidable illness. However, such cases are rare,» says Ivo Meli, Head of Health at the Foundation for Consumer Protection in Bern. «Disability insurance only covers certain treatments if there are congenital defects.»

Parents usually have to pay the costs of orthodontic treatment themselves.

Consumer advisor Meli therefore advises parents to take out supplementary dental insurance for orthodontic treatment if possible. «This should be done as early as possible, but certainlybefore the child reaches the age of four,» emphasises Meli. «From the age of four, many insurance companies require a dental certificate for admission or refuse it altogether.»

As the benefits offered by the various providers can vary greatly, parents should compare them with each other and take a close look at the respective insurance terms and conditions (AVB). Comparison calculators can also help with this.

«Important points that parents should pay attention to are, for example, the respective waiting period, the percentage of cost sharing and possible benefit exclusions,» explains Meli. Although this effort is admittedly a little annoying at first, it protects against unpleasant surprises when it comes to a claim and will hopefully be rewarded with a beaming child's smile afterwards.

Parents should pay attention to this when choosing dental insurance:

• Frühzeitiger Abschluss noch vor dem vierten Lebensjahr.
• Höhe der monatlichen Prämienkosten.
• Höhe der prozentualen Kostenbeteiligung.
• Karenzfrist beachten. Wie lange ist die
• Wartezeit bis zum Leistungsanspruch?
• Wie viel Geld wird pro Jahr erstattet?
• Gesonderte Bedingungen und
• Leistungsausschlüsse beachten.
• Familienrabatte erfragen. Mitunter wird es günstiger, wenn ein Elternteil bereits bei der Versicherung versichert ist.

Further information on the topic

Swiss Society for Orthodontics, www.swissortho.ch
Swiss Foundation for Consumer Protection, www.konsumentenschutz.ch

About the author

Read more:

• Wussten Sie, dass Milchzähne schneller kariös werden, zu früher Zahnwechsel zu Lispeln führen kann und elterliche Zahnputzkontrolle bis ins Teenageralter wichtig ist? Antworten auf Fragen, die Eltern zu den Zähnen ihrer Kinder haben.
  
• Erste Hilfe bei Zahnunfällen: Selbst Bagatellunfälle an den Zähnen können Komplikationen nach sich ziehen. Deshalb ist es wichtig, schnell und richtig zu handeln. Wir verraten wie.