Teething in babies is one of those mixed-bag experiences for most parents. On one hand, there is relief that your little one is on track with their milestones, and perhaps the crankiness over swollen, itchy gums is almost over.
On the other hand, you wonder how to take care of these little teeth, not to mention the occasional bits (shout-out to breastfeeding mums).
What may come as a surprise to most, however, is that beyond cleaning those tiny teeth, you should also start on orthodontic care. That means checking with a pediatric dentist to ensure your child’s baby teeth and jaws are aligned and that they have no bite problems.
"Orthodontics is not just about straightening teeth for aesthetics. It’s about jaw relationships, overall function, and building confidence early in life," says Dr Nicholas Gichu, a pediatric dentist.
By the time your child needs braces, which are recommended from the age of 12 after the permanent teeth have replaced the milk ones, you have waited too long to fix the issue.
"Sometimes a child may have a tooth growing behind another or a jaw that's not developing symmetrically. If we catch that early, even as young as three or five, we can intervene before it becomes a complex issue," explains Dr Gichu.
Starting orthodontic care may help identify some of the harmless habits that may contribute to the misalignment of teeth, such as thumb sucking, prolonged pacifier use, or bottle-feeding with sugary drinks.
Now, for the parents who seek early treatment, dentists may opt to use habit breakers that ‘remind’ the child to break habits like thumb sucking and tongue thrusting. These are typically plastic plates with wires that can be taken out during eating, brushing, or flossing. A common example is the myobrace, which works by expanding the dental arch from a narrow V-shape to the ideal U-shape.
A doctor shows how the system of braces on teeth is arranged.
Photo credit: Shutterstock
"It’s much easier and cheaper to guide the growth of a child’s teeth and jaw early than to correct fully developed problems later," notes Dr Gichu.
Remember the crankiness we mentioned that often comes with the teething stage? Out of frustration, one may decide to dip the tip of the pacifier in honey or some sweet stuff to soothe the child. Well, that harmless act could set them up for tooth decay. Dr Gichu also cautions against prolonged breastfeeding at night as milk residue remains in the teeth for long as they sleep.
"If you’re giving your baby a bottle or pacifier just to soothe them for too long, especially with sweeteners, you’re interfering with how their teeth will grow, not just in terms of cavities, but how their jaws will align."
Another issue is premature loss of baby teeth. It might not seem like a big deal since permanent teeth are expected later. However, Dr Gichu explains that when a baby tooth is lost too early, nearby teeth can drift into space, preventing the permanent tooth from erupting properly. "This often leads to crowding or impacted teeth."
To solve this, paediatric dentists use space maintainers or retainers, which preserve the space until the permanent tooth is ready to come in naturally.
Beyond the common alignment concerns, there are more complex issues parents should be aware of, like odontomes. These are clusters of dental tissue that can block permanent teeth from erupting. "You may not even know they exist until it’s too late," says Dr Gichu. "That’s why early dental visits are so important."
He recommends scheduling that first visit when the baby is between four to six months old. This early visit not only helps establish good oral hygiene habits but also allows the dentist to detect structural or developmental anomalies.
"Orthodontic treatment timeline varies depending on the child. Some may require just a few months of guidance, others may need monitoring and multiple stages of care until they are teens," says Dr Gichu.
The treatments are not always straightforward. One of the biggest challenges pediatric dentists face is dealing with children who are uncooperative or anxious. In some cases, certain procedures may have to be done under general anaesthesia, increasing the treatment’s risk and cost.
“Orthodontic treatment, especially at an early age, can be expensive, and unfortunately, most of these procedures are not covered by insurance.”
He encourages parents to budget for dental health and seek guidance on preventive care, which is often far more affordable than corrective treatment.
"True, straight teeth improve appearance. But it’s not just about looking good, it’s about eating comfortably, speaking clearly, and avoiding long-term dental complications," he says. "Children with properly aligned teeth are more confident and perform better socially."
Good dental hygiene begins at home. Dr Gichu advises parents to teach their children how to brush their teeth, encourage a balanced diet, avoid sugary treats frequently, and limit pacifier or bottle use.
Dr James Ngesa, a Consultant Orthodontist at JB Dental Clinic sheds light on the issue of braces as a corrective measure for misaligned teeth. He notes that orthodontic care doesn't begin with braces but with evaluation, ideally at age seven.
Dr Ngesa explains that by this age, most children have a mix of baby and permanent teeth (mixed dentition stage) that lasts until the child is about 12.
“Early evaluation is about prevention. If we detect malocclusion (misaligned teeth) at this stage, we can intervene before it becomes a bigger and costlier issue,” he says.
Early orthodontic evaluation is done through physical examination and sometimes X-rays to observe which teeth have erupted, which are missing, and how the jaws are forming.
Dentists and orthodontists know exactly when each tooth is supposed to come in. So when something isn’t on track, for example, a tooth is delayed, blocked, or erupting in the wrong place, they can act early to guide it into place or address the underlying cause.
However, even at this age, not every child leaves the clinic with braces.
Braces are only prescribed when necessary and based on specific problems identified by the dentist or orthodontist. They come in two main types, removable and fixed, each suited for different ages and issues.
“Removable braces are often used for early, less complex cases,” Dr Ngesa explains. “Fixed braces are usually recommended once all the permanent teeth are in place from the age of 12.”
Each type has its pros and cons depending on the child’s age, dental maturity, and the specific problem. “Some children might benefit from early braces to guide jaw growth or to break bad habits like tongue thrusting or thumb sucking. Others might need a two-phase approach, early intervention followed by full braces in adolescence,” he says.
“When jaws or soft tissues are involved, we try to intervene immediately,” says Dr Ngesa. “But if it’s purely a matter of how the teeth are arranged, we often wait until all permanent teeth have erupted unless it’s something that’s going to get worse.”
Like any medical intervention, braces come with potential risks if not done correctly.
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Dr Ngesa describes paediatric dentists as the gatekeepers. They supervise the general growth and development of your child’s teeth, monitor habits, and detect early signs of developmental problems. “They’re your first line of defence,” he says.
Once a concern is noted, say a jaw misalignment or a delayed eruption, the child is referred to a specialist orthodontist who focuses on correction and long-term care. The paediatric dentist ensures issues are flagged in time while the orthodontist handles the heavy lifting.
Does the child always need braces twice, that is, as an early intervention and later after all the permanent teeth are in?
“It depends on the reason the child needed braces in the first place,” Dr Ngesa says. “If early braces were used to fix a functional issue, and the permanent teeth come in well-aligned, then they might not need them again. But if it was part of a two-phase plan, then a second phase might still be necessary.” That’s why continuous monitoring is crucial.
Dr Kahura Mundia, the President of the Kenya Dental Association, echoes Dr Ngesa's statement that braces are typically fitted between the ages of 12 and 13, once a child’s permanent teeth have fully erupted. “Most children under five years of age still have their milk teeth, and at this stage, it’s uncommon to observe malocclusion,” says Dr Mundia.
However, this doesn't mean you should wait until the teenage years to pay attention. Some orthodontic problems can and should be detected earlier.
While some children’s teeth naturally fall into perfect alignment, others may show signs that call for early orthodontic attention. These include crowded or crooked teeth, prolonged thumb-sucking (beyond age 4), cross bites or under bites, mouth breathing and speech issues related to jaw alignment.
Orthodontic treatment options have evolved significantly. Depending on the child’s age and dental needs, one can choose from removable braces, which are best suited for minor issues or early-stage correction. They're less invasive and allow easier oral hygiene.
Fixed braces consist of metal brackets and wires affixed to the teeth. They are used for more complex alignment and bite issues and typically remain in place for a defined treatment period.
Like any medical intervention, braces come with potential risks if not done correctly. Some children may reject braces altogether, especially if they are fitted too early or without proper counselling. Others may experience issues during treatment, such as swelling, accidental swallowing of parts like wires, or pain from overly tight appliances.
And after the braces come off, the work isn’t over. Teeth can shift back to their original positions, often referred to as orthodontic relapse. “Teeth have memory,” Dr Mundia explains. “That’s why post-treatment care is important.”
Dr Mundia raises concern over the rise of unqualified individuals offering orthodontic services, particularly through online platforms. “No one who hasn’t been schooled or practised in dentistry should perform any dental procedure,” he warns.
Orthodontic mistreatment can lead to serious problems, including tooth mobility (loose teeth), pain from traumatic movement, and damage to the tooth’s blood supply. In severe cases, corrective surgery may be required.
Parents are urged to research thoroughly, ask questions, and ensure that treatment planning is comprehensive, ideally including X-rays and a full oral assessment before any braces are applied.
“Parents must also involve their children in the decision-making process. A collaborative, informed approach makes the treatment smoother and more successful,” he adds.
Dr Mundia points out a significant shortage of paediatric dentists in the country. “Kenya needs more specialised practitioners trained in treating children, as their dental needs are different from adults,” he says.
He recommends routine dental visits at least twice a year, even if no immediate problems are visible. Preventive care and early detection, he says, are still the most powerful tools in ensuring lifelong oral health.
Joseph Ndege, a Senior Risk Consultant, Medical Broking at Zamara Risk and Insurance Brokers Limited, notes that braces fall under orthodontic treatment, which is typically not included in the standard medical insurance or dental cover. “However, orthodontic coverage can be added as an enhanced benefit, usually under a specialised or higher-tier dental plan,” he says.
The full orthodontic treatment cycle for children can range between sh150,000 and sh300,000, depending on the complexity of the case.
“Because of the cost involved, insurers require higher dental limits to accommodate such treatments, which in turn impacts the overall premium,” he explains. “For individuals and organisations (group medical) interested in accessing such benefits, this remains a viable option, but one that requires planning and a willingness to invest in a more comprehensive cover.”
