Braces and Young Patients – Phase I Interceptive Treatment

The American Association of Orthodontists, and many other worldwide orthodontic associations, recommends that a child have his or her first orthodontic examination by age seven, or earlier if there are obvious signs of an orthodontic problem.

Some examples of noticeable problems include chewing, biting or speech difficulties, finger or pacifier sucking habits that continue after six years of age, protruding front teeth, tooth spacing or crowding problems, baby teeth falling out too early, chronic mouth breathing, jaw joints that click or are painful, misplaced or extra teeth, a weak or prominent chin or other facial imbalance. Just because your child doesn’t have any of these doesn’t mean he has no orthodontic needs. There are many problems that can occur even though the front teeth look straight, while some of these noticeable conditions, which look intimidating and complex, will resolve on their own.

Phase I, also called interceptive treatment, will usually begin when your child still has most of her baby teeth and perhaps a few of the permanent front incisors. This usually occurs around age seven and is referred to as early mixed dentition. The goal of interceptive treatment is to save space in the dental arches for permanent teeth and to help the upper and lower jaws relate to each other properly. Treatment may involve nothing more complex than a retainer-like appliance, used to guide the existing teeth into the proper positions so that permanent teeth can come in properly, or it may involve removal of certain baby teeth to allow adequate space for permanent teeth. Interceptive treatment could also include a combination of orthodontic treatments. The methods and timing used will be determined by your child’s specific orthodontic problem and unique personality.

Early orthodontic treatment takes advantage of a child’s growth, using it to make a difficult problem into a manageable one. Waiting until the baby teeth have come out and permanent teeth have come in or until facial growth is nearly complete may make correction of some problems more difficult. Leaving some conditions untreated, such as a misalignment of the upper and lower jaws, could result in a discrepancy too severe for braces alone to treat.

However, not all bite abnormalities require early intervention. Many can resolve naturally or can wait until most of the permanent teeth have erupted. Only your orthodontist can determine which problems require immediate treatment, which would be better treated at a later date, and which can be left to nature. That’s why it’s so important that your child have an examination at an early age. That way, you have the option of beginning treatment when it will most benefit your child.

The important thing to remember is that the end result of early interceptive treatment will be a more stable orthodontic condition and an attractive, balanced profile. The advantage for your child is incalculable. A future article will address Phase II or second alignment stage of treatment. This would also be the final stage of orthodontic treatment in children. Not all children will require Phase II treatment but most orthodontists will tell you to expect it. If your child doesn’t need it, you’re very happy! If your child does require additional treatment and you were not told to expect it, you are more inclined to be very unhappy. It is also important to remember: Phase II treatment is not to “redo” any corrections that were made during Phase I.

Typically, a patient has approximately sixteen new (permanent) teeth to erupt (come in his or her mouth) after Phase I treatment ends. This does not include the third molars or wisdom teeth.Sometimes nature gets it perfect to almost perfect. Sometimes she doesn’t and additional treatment is required. It is very difficult to get a parent to understand this as most thinks their child needs “two sets of braces” and the orthodontist should have waited. This is not always the case.During the orthodontic evaluation, ask the questions for which you need answers. If necessary, schedule a conference with the doctor and/or treatment coordinator to get any issues resolved. Any office should be happy to do this for you. If you have an office that hesitates for an instant, select another orthodontist!

© 2007 Avis Ward of AWard Consulting, LLC