Why Do You Need Braces, but Your Sister Doesn’t?

Long Beach, CA – Getting braces is often a rite of passage for a teenager. But have you ever wondered why some people need braces, and others don’t? At my Long Beach orthodontic office, I treat many siblings and it isn’t uncommon to have one sibling require extensive treatment, while the other one just has a mild malocclusion. So why is that?

For some people, orthodontic malocclusions is simply bad genetic luck. Some malocclusions can be hereditary, so if you need braces but your brother doesn’t, you just drew the short straw. Genetics is, in fact, the number one cause of overbites, underbites and crooked teeth. Just as you can inherit your blue eyes or brown hair, you can also inherit a malocclusion. I always explain to patients that different genes determine the size and shape of teeth and the jaw bones. Therefore, if someone inherits big teeth from their father, but the small jaws of their mother, they will most likely present with crowded teeth.

Let’s take a look at some other common causes of bad bites that could lead to the need for orthodontic treatment.

• Losing baby teeth too early – Baby teeth fall out in a certain order and that’s important to ensure the permanent teeth can erupt properly. But sometimes, our teeth have a mind of their own and decide the Tooth Fairy needs to visit sooner than she should. This can lead to the need for orthodontics in the future. Another cause for early tooth loss is extraction due to a large cavity. For this reason, we always recommend 6 month checkups with the general dentist to monitor for cavities and treat them before they get too large. If the primary tooth is lost too early and the permanent tooth underneath wasn’t ready to come in, there will be a space in the mouth that other teeth could drift into and block the future eruption of the permanent tooth. This situation often leads to over-crowding and impacted teeth.
• Tongue thrusting or thumb sucking – These are habits that can alter the shape of the mouth and the alignment of the teeth. Both of these habits place a lot of pressure on the teeth – in fact, it’s estimated that we swallow as much as 2,000 times per day, with four pounds of pressure in each swallow. If your tongue is thrusting against your teeth or thumb putting pressure on them, it won’t take long for your teeth to become misaligned.
• Extended pacifier use – Pacifiers are wonderful for calming fussy newborns and infants, but terrible in the mouth of a toddler whose teeth are erupting. Children should stop using a pacifier by their second birthday, if not before, to prevent crooked teeth.
• Shape and size of the mouth and jaws – Sometimes, the mouth is just simply too small to contain all of the erupting permanent teeth, or the jaws are positioned too far forward or backward, resulting in a misaligned bite.
• Trauma – Facial injuries can result in teeth becoming misaligned or crooked, leading to the need for orthodontic treatment.

There are many issues that can factor in to whether one will need braces or not, but the only way to be certain is to schedule a consultation with an orthodontist. We recommend that children see an orthodontist for the first time by the age of seven, so we can begin to monitor the growth and development of the mouth and determine if, and when, orthodontic treatment may be necessary. If problems like over-crowding or undersized jaws are diagnosed at an early age, there are several interceptive options that can be considered so adequate space can be made for the permanent teeth to erupt and the jaws to develop normally.