Bullying is endemic among schoolchildren, and the effects can be devastating and long lasting. The persistently bullied kid shows a definite psychological type, with poorly developed social skills and a submissive nature. Physical appearance acts a major role in bullying. Teasing related to dental appearance is hurtful. Fortunately, there is evidence of a marked increase in self-confidence following early orthodontic treatment in youngsters.

During 1989-90, a research aimed to examine the motives why parents and third-grade schoolchildren seek early orthodontic treatment. These researchers inquired the parents of 473 kids in the study to complete the self-report forms. The form had questions about their children's dental and facial appearance. It also asked the parents about their reasons for seeking orthodontic care early for their children. Almost all parents asserted deep concern about their children's deficient dental appearance. About half of the parents informed their children had been cruelly taunted. Fourteen percent of the parents also reported that it was their children who had first sensed the need for orthodontic treatment.

The main reason for parents' seeking early orthodontic treatment is the unpleasant appearance of teeth. Other reasons comprise of dentists' recommendation and the poor facial profile. Of these, dental "overjet" (protrusive maxillary incisors) malalignment has been the most significant predictor of whether a kid might be ridiculed in school. Therefore, modern orthodontic intervention increasingly focuses on the overjet problem for these youngsters.

While the parents seek early orthodontic treatment mainly for improving their children's dental aesthetics, dentists and orthodontists recommend braces for the young children on the basis of clinical dental status. Their objectives for advising early orthodontic treatment are:

(1) to reduce the total treatment time;

(2) to prevent relapse (reverse to the original condition;

(3) to receive better result;

(4) to support in speech therapy; and

(5) to avoid future surgical intervention.

The dental specialists would most likely advise early orthodontic treatment (phase 1) for the youngsters for the following conditions:

(1) Crossbite: This malocclusion happens when the narcotic teeth is trapped inside lower teeth. Dentists start management about this condition on young patients of between the ages of 8 and 10. These young patients still have most of the baby teeth (early mixed dentition).

(2) Deepbite and mandibular inadequacy: Deepbite occurs when the upper front teeth covers almost all the lower front teeth. Also known as class II malocclusion or retrusion, mandibular inadequacy is characterized by early loss of mandibular canines by severe crowding. Dentists typically begin treatment for these two conditions in late mixed dentition (ages 11-12).

(3) Mandibular prognathism, diastema, and congenitally missing teeth: Mandibular prognathism, also known as class III malocclusion, refers to the excessive protrusion of the lower jawbone. Diastema is the dental term, meaning "gap between the front central incisors." In congenitally missing teeth, some permanent teeth fail to succeed the baby teeth. Most dentists begin treatment for these conditions in early adolescents (ages 13-15).

Today, there are two common methods used by dentists to correct dental malocclusion in phase 1 orthodontics. One is the dental orthodontic removable appliance and the other is the fixed appliance with 2 bands and 4 brackets. The fees, treatment times, and outcomes for these two methods are not significantly different. However, the removable appliance allows better dental hygiene and more comfortable. One disadvantage of the removable orthodontic appliance is that it needs a lot more patients' compliance.

In our dental practice we see that people with high dental-esthetics scores have more favorable oral-health attitudes. We also find the children who had early orthodontic treatment show greater dental hygiene, dental awareness, and self-esteem than those who had not. Although the long-term psychological benefits of early orthodontic treatment are difficult to measure, these findings suggest that favorable dental aesthetics from early orthodontic treatment is critical in framing and strengthening the children's overall health, social behaviors, academic achievement, and happiness. Therefore, it is important the children with low dental-esthetics scores are evaluated early and treated promptly.