Correcting malocclusion in children: modern braces, evidence and the right timing
How common are malocclusions in children
Malocclusions in children are frequent, but exact numbers depend on age and methodology. A large systematic review across Europe indicates that in children and adolescents, Class II occurs in about one quarter of cases, while crossbite is found in around 5% or more depending on the sample. These findings align with national studies: in several Eastern European and CIS countries, the share of children with orthodontic pathology exceeds 50%, and in certain samples reaches 60–70% or more. This prevalence highlights the importance of early assessment and timely correction, particularly during the mixed dentition period.
Why treatment is better in childhood: function, aesthetics, and facial development
Proper occlusion ensures effective chewing, clear speech, and harmonious facial growth. Children with pronounced malocclusions more often experience chewing and speech difficulties, increased enamel wear, and higher risk of trauma to the front teeth during active play. Across Europe, the cumulative burden of dental diseases remains high, making prevention and early orthodontics an issue of public health rather than just aesthetics.
When to start: age 7 and mixed dentition as a benchmark
The international benchmark is the first orthodontic visit at about seven years of age: by this time, permanent incisors and first molars have erupted, enabling reliable risk detection and optimal treatment planning. The American Association of Orthodontists provides detailed explanations: early evaluation significantly reduces the likelihood of costly and invasive interventions in the future (AAO: age 7; AAO: pediatric orthodontics).
Braces as the “gold standard”: types, indications, and specifics
Metal braces
The classic stainless steel system remains the gold standard of predictability. It provides full control of tooth movement and is optimal for most adolescent cases. Aesthetic wires and modern ligatures compensate for the metallic look; strict hygiene and regular activations are required.
Ceramic and sapphire braces
Aesthetic systems are chosen when discretion is important. Ceramic and monocrystalline “sapphire” brackets blend better with teeth while maintaining functionality. Higher friction of some ceramic brackets and caution during debonding must be taken into account; clinically these are compensated with proper archwire selection and treatment strategy.
Lingual braces
Placed on the inner surface of teeth, they allow “invisible” treatment but require high professional skill and careful patient adaptation. Lingual systems are especially suitable for high aesthetic demands, but biomechanics and hygiene are critically important.
Self-ligating braces: what the evidence shows
Self-ligating systems are promoted as “faster” and “more comfortable,” but systematic reviews and clinical studies do not confirm clinically significant benefits in treatment duration, number of visits, or alignment quality compared with conventional systems. References include: review with randomized trials (PMC6458043), commentary in Evidence-Based Dentistry (EBD 2014) and meta-analysis (Dental Cadmos). Updated 2025 data also confirm no significant differences in arch perimeter increase between passive self-ligating and traditional systems (BMC Oral Health, 2025).
Functional appliances and early interventions
Between ages 5–10, functional appliances help normalize jaw growth and correct harmful habits. Studies on early Class II treatment show that headgear and functional regulators improve intermaxillary relationships, with some effects comparable to treatment in later childhood. See details: EJO, 2017; PubMed (Ghafari et al.); review on treatment timing — JFC Tulloch et al.
The link between malocclusion and other aspects of pediatric dentistry
Malocclusions rarely exist in isolation: they are closely linked to the condition of teeth and gums. For example, severe crowding complicates oral hygiene, increasing the risk of soft tissue inflammation and emphasizing the importance of gum treatment in children. Prevention also plays a decisive role: proper dentoalveolar development is impossible without regular caries control, highlighting the importance of a comprehensive approach to caries prevention in children. This interdisciplinary perspective helps parents and doctors focus not only on smile aesthetics but also on its functional reliability.
What parents should know: timing, discipline, and hygiene
The average duration of orthodontic treatment with braces in adolescents is 18–24 months and depends on the type of malocclusion, bone density, patient cooperation, and oral hygiene. Early evaluation at ages 6–7 allows for staged planning: expanding the upper jaw, creating space for canines, adjusting smile profile, and preparing for a shorter and more predictable treatment course with fixed appliances.
Conclusion: braces remain the foundation of pediatric orthodontics
Despite the variety of appliances, fixed systems provide the most controllable biomechanics and stable results. The choice between metal, ceramic, lingual, and self-ligating braces depends on clinical indications, aesthetic preferences, and the child’s readiness to follow the treatment plan. Evidence-based data help separate marketing from real benefits and select the system that best suits each child.
Orthodontic treatment in children at Diplomat Med Center
At Diplomat Med Center, we provide evidence-based orthodontic treatment: we plan stages during mixed dentition, select the optimal type of braces for the child’s clinical needs and lifestyle, teach hygiene, and support until a stable outcome is achieved.
If you value combining aesthetics and reliability, we offer modern metal, ceramic, and lingual systems, and explain where self-ligation is truly appropriate. Our goal is a functionally stable occlusion and a confident smile without unnecessary compromises.
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