Orthodontics and bone grafting
Your child will first meet the Orthodontist when they are 5-7 years of age. Impressions of the gum and teeth are made to help plan future treatment.
For some children, simple orthodontic treatment with braces is all that is required to straighten their teeth. Good dental hygiene is necessary for this as otherwise braces will worsen dental decay, giving a poor outcome. Whilst the cleft orthodontist will plan and direct treatment, your child will have to continue attending your local general dentist for regular checks to ensure good oral health.
Children with a single (unilateral) or double (bilateral) cleft affecting the upper dental arch will require bone grafting of the tooth-bearing gums (alveolus), in order to allow the canine tooth (“eye tooth”) to erupt. Before this is carried out, the teeth must be brought into correct position, usually with appliances that expand the upper dental arch. The ideal age is usually between the age of 8 to 12 years and depends on the stage of dental development.
A video from Great Ormond Street Children's Hospital, on what to expect when having a bone graft, will soon be available again:
When all the permanent teeth are through (usually by the age of 13 years), full orthodontic alignment of teeth can start with the use of braces. The aim of orthodontic treatment is, where possible, to align all the teeth to maximise aesthetics and function.
Sometimes, when the jaw bones are in an incorrect position, surgery will be needed in combination with orthodontics to correct the position of the teeth and provide a better functioning bite. If this is recommended you will meet an Oral and Maxillofacial surgeon who will discuss this procedure in detail with you.
Once your active phase of orthodontic treatment is complete, you will be provided with a retaining brace. This may be removable or fixed. Your Orthodontist will advise you on the length of time this retainer needs to be worn.
Throughout orthodontic treatment, it is important that you still have check-ups with your regular dentist so your teeth can be checked for decay. In addition, if you play contact sports it is recommended that your wear a gumshield to protect your teeth.