Decades ago, most patients started orthodontic treatment (i.e., braces) between the ages of 12-14 when all their permanent teeth were in. If crowding was present, four permanent teeth were often extracted to make room, especially if growth was almost complete. If you had an underbite, surgery may have been recommended and if you had a short lower jaw or large “overbite”, you may have needed to wear headgear and elastics.
Early (interceptive) orthodontics, otherwise known as Phase I treatment, is a more recent concept where certain dental problems can be treated early to take advantage of the fact that a child’s jaw is still growing. In addition, compliance is usually much better than with teens. Phase I or early treatment occurs mainly when the child still has a mixture of primary and permanent dentition. Treatment usually starts between the ages of 7-11, though ages can vary depending on when the child’s permanent teeth erupt. Phase I treatment typically lasts about 6-18 months.
The American Association of Orthodontists recommends that children be evaluated for any signs of orthodontic problems no later than age 7. That way, if any orthodontic problems exist, phase I may be initiated or at least anticipated and a close eye kept on the continuing development of the child.
You may be asking, what exactly is done during Phase 1? Most of the time, a specific functional appliance is made to correct the identified problem. There are a myriad of appliances each correcting a specific problem. For example, if a child has a problem with the upper and/or lower jaw being too narrow, a special appliance called a palatal expander can be made to expand the jaw to create space for the rest of the permanent teeth to erupt, thus, possibly eliminating the need for later extraction of permanent teeth. In addition, it increases nasal breathing and eliminates airway constriction which will improve the child’s overall health. They may also be less likely to develop sleep apnea as adults. Other appliances can also assist the growth of underdeveloped jaws, thereby reducing the possibility of needing jaw surgery in the future. Protruding front teeth are not only uncomfortable, but they are also more susceptible to physical trauma, especially if your child is physically active. Chances of severe damage may be reduced with early orthodontic intervention.
Other benefits of early orthodontic treatment (Phase 1) include:
- Improve profiles, smiles and self-esteem
- Correct harmful habits such as thumb sucking, tongue thrusting, cheek biting
- Improved speech
- Reduction of time in fixed braces (Phase 2)
- Creates beautiful broad smiles
- Prevents headaches, neck pain, earaches, clicking
- Eliminates grinding of teeth at night
Once Phase 1 has been completed, your child may need to wear retainers or a space maintainer to hold his/her treatment progress. Then, once all the permanent teeth from molar to molar have erupted, the child can now enter phase 2 orthodontics (i.e., full braces). This phase typically starts around 11-13 years of age. Since the dental development of girls happens sooner, they may be ready for full treatment 6-12 months earlier than boys.
In summary, early intervention orthodontics, which in most cases involve the use of functional appliances, can help correct underdeveloped jaws, narrow arches, crowded teeth, deep overbites, thumb sucking/tongue thrusting habits and jaw joint problems. It also reduces the time that a child will have to be in fixed braces and it is usually less expensive and more desirable to correct a problem when the child is younger rather than wait until it becomes more serious in the future.. If you think that your child may have any of the above listed problems or are not sure, ask your dentist for an evaluation.