When is the best time to begin orthodontics?
The American Association of Orthodontists recommends that at age 7 children should be evaluated by an orthodontist. This visit will provide parents with information regarding their child's skeletal growth pattern and dental development, as well as advise parents on ideal treatment timing. In most cases the orthodontist will simply monitor the patient at a 6 to 12 month interval until the patient is either ready for treatment or it is determined that treatment is not needed. When early treatment is needed, children are typically treated in two phases.
Why is age 7 considered the optimal time for screening?
Usually by age 7 the first permanent molars and incisors have erupted sufficiently to allow the orthodontist to evaluate for crossbites, openbites, overbites, crowding, and skeletal problems.
When is early treatment needed?
While it is often best to wait until most or all of the permanent teeth have erupted before initiating orthodontic treatment, there are several situations where an early phase of treatment is indicated. These include the following:
Posterior Crossbites- When the upper teeth bite inside the lowers in the back of the mouth.
Anterior Crossbites- When one or more of the upper front teeth bites behind the lower front teeth; also called an “underbite.”
Severely Protruding Front Teeth- When the front teeth “stick out” it can make them susceptible to trauma, and it can also be embarassing to the child.
Impinging Deep Bite- Lower teeth biting into the roof of the mouth.
Thumb Habit- Usually accompanied by excessively flared front teeth and an “openbite,” where the front upper and lower teeth do not touch each other.
Early Loss of Baby Teeth- Often leads to asymmetries and/or loss of room for permanent teeth if left untreated.
Ectopic/Impacted teeth- Permanent teeth growing in the wrong direction instead of their proper place in the mouth.
Severe Crowding- When there is not enough room for the permanent teeth to erupt.
Benefits of Early Treatment
- Regulate the width of the upper and lower dental arches
- Gain space for permanent teeth
- Reduce the need for permanent tooth extractions
- Reduce likelihood of impacted permanent teeth
- Correct thumb-sucking and regulate abnormal swallowing or speech problems
- Simplify later treatment
- Improve the child's self image during formative years
What if I put off treatment?
The disadvantage of waiting for complete eruption of permanent teeth and having only one phase of treatment for someone with one or more of the above problems is facing the possibility of a long, difficult treatment during the teenage years in which patients are frequently less enthusiastic about wearing braces, and/or a compromised result that may not be stable.
What happens after Early Treatment?
Resting Period
When the objectives of early treatment have been met, the appliances are removed and a resting period begins. In this phase, the remaining permanent teeth are allowed to erupt. Retaining devices are usually, but not always, used to hold the result from first phase until the remaining permanent teeth erupt. A successful first phase will have created room for teeth to find an eruption path. Otherwise, they may become impacted or severely displaced.
Monitoring your teeth's progress
In other words, at the end of the first phase of treatment, teeth are not in their final positions. This will be determined and accomplished in the second phase of treatment. Selective removal of certain primary (baby) teeth may be in the best interest of enhancing eruption during this resting phase. Therefore, periodic recall appointments for observation are necessary, usually on a six-month basis.
Second Phase Treatment: Stay healthy and look attractive
The goal of the second phase is to make sure each tooth has an exact location in the mouth where it is in harmony with the lips, cheeks, tongue, and other teeth. When this equilibrium is established, the teeth will function together properly.
Movement & Retention
At the beginning of the first phase, orthodontic records were made and a diagnosis and treatment plan established. Certain types of appliances were used in the first phase, as dictated by the problem. The second phase is initiated when all permanent teeth have erupted and usually requires braces on all the teeth for an average of 14-20 months. Retainers are worn after this phase to ensure you retain your beautiful smile.
