health
Dr Derek Baram, specialist in
orthodontics and founder of
Central Smile, suggests
parents take their child for
their first orthodontic check-
up at seven or eight years old
A
s parents, we do everything we
can to see our children smiling.
We read pre-natal manuals and
take parenting classes, too.
So much information is available to help
us develop our child’s healthy body and
mind. In all this, though, matters of dental
care are often glossed over, perhaps
because we adore the gap-tooth grins
of our babies. But what happens when
our children’s baby teeth are long gone,
and their wide toothy grins become self-
conscious, tight-lipped smiles?
It helps to be reminded that the world
of peadiatric orthodontics is not the same
world we grew up in… and over the
generations, new types of problems can
emerge. For example, a little neighbour of
mine showed me that her new adult teeth
were growing in as predicted, but right
behind her deciduous “baby” teeth. A
quick trip to her dentist with her alarmed
mother – and some pliers – remedied
the situation, and the dentist suggested
the girl eat an apple a day to make sure
her baby teeth were getting the normal
amount of wear and tear needed to
avoid repeat visits. That is a simple fix,
of course, but parents need to be on
the lookout for potential problems even
before our children’s adult teeth grow in
because remedial work can often require
long-term strategies.
I was introduced to the world of missing
lateral incisors with my second child. Her
baby teeth were dropping out and growing
in as expected until, one day, the tooth
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next to her top-left-front came out… and
we waited. Over the next six months, my
daughter’s neighbouring bicuspid and
premolars parted ways. (Actually, she got
good at pulling them out herself.) Adult
teeth grew in, albeit slowly. But that space
right next to the top-left-front remained
vacant. Eventually I asked my daughter to
tilt back her head so I could inspect her
gums. There was no longer an opening
where her baby lateral incisor had been;
the gums had healed over. I had to accept
the probability that there was nothing
‘waiting in the wings’ so to speak. I vaguely
recalled my little brother having a small
tooth somewhere—and our vexatious
older brother teasing him by naming it
“Peggy”. I went onto Google and delved
into the fascinating world of “missing lateral
incisors”. This just happens to be one of
the most common genetically-inherited
traits. (And, by the way, the technical word
for “Peggy” is microdont.)
We broached the subject with our
family dentist. She x-rayed my daughter’s
teeth and with, I will admit, more than a
little nervousness, I waited for the verdict.
The dentist placed the x-ray film on the
lightboard, examined it for mere seconds,
then turned to me. “I don’t see it,” she
said. The observation was delivered
matter-of-factly, and not the least bit
apologetically. It sounded like no big deal.
I knew she was referring to the one on
the other side, which still had the baby
tooth in its place. She was telling me
that nothing was going to come down
there, either. I seemed to recall later on
that, in addition to my little brother’s top-
left microdont, my father had had one
missing lateral incisor. In due course, my
daughter’s orthodontist and I would have
a chuckle over the fact that my daughter
had been blessed with the ‘whole nine
yards’ version of a hereditary fluke from
my side of the family – two congenitally
missing teeth. It wasn’t great news, but
it wasn’t the end of the world either,
and mixed in with these feelings was a
sense of wonder about the human body,
the miracle of reproduction, and all its
idiosyncracies. My daughter and I are
now fully-versed in the wide variety of
methods that can be employed, when
the time is right, to ‘normalise’ her smile:
orthodontic work can shift her teeth to
close the gaps, and the teeth can then
be filled to mimic the shapes of the
incisors (and cuspids). Or we can try
a cantilevered prosthetic tooth, which
would then be replaced years down the
line with an implant. Orthodontists love
to post videos of corrective procedures
on Youtube. The fact is, my daughter
is feeling very empowered about the
whole scenario. She is accepting herself
for who she is. And she doesn’t hold
anything against Grandpa. It’s all good…
Dr Derek Baram, specialist in
orthodontics and founder of Central
Smile, suggests that parents take their
child for their first orthodontic check-up
at seven or eight years old. “Most will be
told to come back when they have all