Early Orthodontic Treatment

Early Orthodontic Treatment for Children

Orthodontics is both an art and a science which can benefit patients of virtually any age. Dr. Carcara provides orthodontic treatment for adults, adolescents and children. The timing of orthodontic treatment is extremely important, particularly with younger patients which is why we follow the guidelines established by the American Association of Orthodontists which recommend all children receive an orthodontic evaluation at age seven.

Dr. Carcara implements many progressive treatments for patients as early as age seven which provide significant benefits, especially when jaw irregularities are present. Early diagnosis and treatment can help guide facial growth and tooth eruption, preventing irregularities from worsening. Treating children with these types of problems early, during their growth stages, allows us to achieve results that may not be possible once face and jaw bones have fully developed. Our goal with early treatment is to reduce treatment time in full braces and provide the best and most stable results possible.

What is the difference between early orthodontic treatment, and regular orthodontic treatment and why might my child need early treatment? How will early treatment benefit my child in the long-run?

These are just a few of the questions surrounding the topic of early orthodontic treatment for children. The American Association of Orthodontists recommends that children see an orthodontist as early as age seven. At this point the orthodontist will evaluate whether your child will need orthodontic treatment.

Early treatment (also known as Phase-One) typically begins around age eight or nine (Phase-Two will begin around age 11 or older). The goal of early treatment is to correct the growth of the jaw and certain bite problems, such as underbite. Early treatment also helps to make room for permanent teeth to come in properly, lessening the chance of extractions in the future.

How to tell if your child may need early orthodontic treatment:

Early or late loss of baby teeth (your child should typically start losing teeth around age five, and will have all their permanent teeth in around age 13)
Difficulty chewing and/or biting
Mouth breathing
Your child continues sucking their thumb after age five
Speech impediments
Protruding teeth (the top teeth and the bottom teeth extend away from each other)
Teeth that don't come together in a normal manner or even at all
Shifting of the jaw when your child opens or closes their mouth (crossbites)
Crowded front teeth around age seven or eight

What is Phase I (Preventive/Interceptive/Orthopedic) Treatment?

Phase I Treatment usually starts while the child has most of their baby teeth (primary teeth) and a few of their permanent front incisors. This stage in development usually begins around 7 to 8 years old. The problems corrected in Phase I include skeletal dysplasia, crossbites and crowding. Phase I Treatment takes advantage of the early growth spurt and turns a difficult orthodontic problem into a more manageable one. This may help reduce the need for extractions or surgery, deliver better long-term results and treatment options, and usually results in less time in full braces during Phase II. Most Phase I patients require Phase II treatment with braces to complete the tooth and jaw alignment that was started during the first phase of treatment once all of the permanent teeth have erupted

What are the advantages of Phase I Treatment?

Some of the most direct advantages of Phase I Treatment include creating room for crowded or erupting teeth, creating facial symmetry by influencing jaw growth, reducing the risk of trauma to protruding front teeth (thus preserving space for un-erupted teeth), reducing the need for tooth removal and reducing treatment time with braces.

The goal of Phase I treatment can be any of the following:

Prevent a problem from developing (preventive treatment)
Intercept a moderate or severe orthodontic problem early in order to reduce or eliminate it (interceptive treatment)
Guide the growth of the jawbones which support the teeth (growth modification)

Does everyone need Phase I Treatment?

Absolutely not! Only certain bites require early intervention. All others can wait until most if not all of their permanent teeth erupt. An orthodontic evaluation by Dr. Carcara at the age of seven can help determine if any early treatment is needed. When orthodontic intervention is not necessary, Dr. Carcara can carefully monitor growth and development and begin treatment when it is ideal. There is no charge to have your child monitored in our Growth Guidance Program

Can I wait on starting Phase I Treatment until my child is older?

Waiting on starting Phase I Treatment is not recommended. If your child needs Phase I Treatment this usually means he/she has a difficult problem that requires attention now. If no orthodontic action is taken, treatment options become limited, more difficult, and the long-term stability may be compromised. In addition, waiting may lead to extractions, oral surgery and increased costs.

What is Phase II Treatment?

Phase II Treatment usually occurs several years later when most or all of the permanent teeth have erupted. This most commonly occurs at the age of 12 or 13. The goal of Phase II Treatment is to complete the tooth and jaw alignment that was started during the first phase of treatment.

What is Full or Comprehensive Orthodontic Treatment?

This is another name for orthodontic treatment in the late mixed dentition (the last baby teeth are about to be lost) or in the permanent dentition. It is more commonly used when a Phase I Treatment was not needed.

What causes orthodontic problems, and how will early prevention benefit my child?

Orthodontic problems such as crowding of the teeth, too much space between the teeth, jaw growth problems, protruding teeth, and bad bites can be inherited or caused by injury to the mouth, early or late loss of baby teeth, or thumb sucking habits.

Most children have lost all their baby teeth by age 13 and by the end of their teen years the jaw bones will harden and no longer continue to grow. Orthodontic procedures for adults often take more time and can involve tooth extraction and the possibility of oral surgery. As a child, receiving early orthodontic treatment can help prevent the need for orthodontics as an adult, leaving little to no chance of extraction or surgery in the future.

If your child is between the ages of seven and eight and shows signs of needing orthodontic care, or if you have been directed by your family dentist to visit the orthodontist, please contact our practice and schedule an appointment. Our team will provide your child with an initial exam, and discuss with you the best steps to take toward caring for your child's smile.