At Wild About Smiles, a visit between young patients and Dr. Perry Francis will also include an extra bonus: early evaluation for potential orthodontic issues down the road.
“I see my role as the dental primary care provider to be more or less the quarterback for the child’s oral health team,” Dr. Francis says. “I have to make sure that the child will get appropriate care, at the appropriate time in their growth and development.”
He says he begins looking at spacing and jaw orientation in those first appointments (he recommends all patients have their first appointment before their first birthday), which means he can typically predict around age 2 if he believes a child will need to see an orthodontist at a later time.
The Benefits of Early Orthodontic Assessments
“The issues I see that need correction at an early age are underbite — when the lower jaw actually projects beyond the upper jaw — and severe crowding, where permanent teeth have no room to erupt,” he says.
With an underbite, the danger is that the lower jaw is too big compared to the upper jaw, which actually limits regular upper jaw development.
“The upper jaw usually grows first; but when you have an underbite, that growth is constricted,” he says. “We can get this corrected so normal physiological growth can happen from a skeletal perspective. When teeth are crowded and grow in in odd positions, this can compromise bone support around the roots of the tooth if you don’t address this early. Then you have potential for losing teeth early based on that poor bone support.”
Every child’s orthodontic needs are unique, Dr. Francis notes. “The things I keep in mind when I think about the orthodontic needs for a child are: 1. Is this the right time to do it?; 2. Is this the most cost-effective way to get it done?; and 3. Is the child and are the child’s parents in a place where they are ready to handle orthodontic treatment and the responsibilities that come with it?”
“I give a parent a heads-up, which most appreciate,” he continues. “Like I can see at age 2, and say to the parent, ‘Yes, you’ll likely need to see an orthodontist at about age 8,’ or another child at maybe age 12. Even that young, I can predict future issues. And that means the parent can prepare. I literally recommend they start saving now so they can have a healthy down payment when the time comes.”
Dr. Francis adds that when he refers to an orthodontist — that they remain in constant communication throughout the treatment time.
“There are times teeth need to be extracted, or when hygiene is not up to par, or an appliance is needed,” he says. “They’ll call me or I’ll call them, or we’ll see each other in our offices to discuss the cases. We’re always working together to determine the best course of action specific to this child.”
Orthodontic Assessments: A Simple Process
The process for these early orthodontic assessments looks like this: Dr. Perry examines the child during their routine visit, subsequently telling the patient’s caregiver the outcome and his thoughts on whether orthodontic referral might be necessary, as well as the estimated timeline. He will then provide the reasons to consider orthodontics for that child’s specific case.
“Then I tell them what improvement they can expect in terms of functionality and aesthetics should they proceed with orthodontic work,” he says. “Once that is laid out, and I give a little input about the financial aspect, I let them know I don’t want to put pressure on them – that I’m just giving them all the information for them to make the best decision for their child.”
If a parent is interested but needs time, Dr. Francis and his team will add notes to the patient chart to follow up.
“We are part of a team with the parent and the child, so this is just one of the ways we all work together to accomplish the best outcomes,” he says.
If you’re interested in scheduling a consultation with Dr. Francis, please call (775) 331-9477 in Reno/Sparks or (775) 423-9453 in Fallon.