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Child/Teen Orthodontics
When does my child need to be seen for an orthodontic evaluation?
Orthodontic problems in general get worse, not better, with time. Modern, scientific based orthodontic research shows that in certain cases it is inappropriate to follow a developing malocclusion (crooked or poorly fitting teeth) until growth is complete without early intervention.
For this reason, the American Association of Orthodontists recommends initial examination by an orthodontist around the age of seven unless a problem is detected earlier. In certain cases due to rapid growth, young children may benefit enormously from appliances that balance the relationship between the upper and lower jaw, and develop room for and/or guiding the erupting permanent teeth.
Contrary to popular belief, you do not need to wait for your family dentist to recognize an orthodontic problem and refer your child for an appointment. A parent or patient can self-refer. There are some differing opinions as to what constitutes an orthodontic need, and it is best for your orthodontist to make the decision about treatment timing.
Many times, treatment is not initiated at age seven. If however, there is a need for treatment, being early and having us watch growth and eruption of teeth is much better than being too late!
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One Phase Orthodontic Treatment
Most patients only require orthodontic treatment in one phase in the early to mid teen years after all (or most of) the permanent teeth have erupted. Usually, this is best for mild or moderate crowding cases, and when significant changes in jaw size or position aren't required. Long term (indefinite) retainer wear at night follows this stage of treatment.
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Two Phase Orthodontic Treatment
Althought, some patients only require orthodontic treatment at age 11 years or older in one step after all baby teeth are gone (One Phase Treatment), some may benefit from having treatment completed in two steps. When indicated, Two Phase treatment separates orthodontic treatment into two time periods, with each period being the best time to correct specific problems. Certain conditions, when severe, are better treated in two steps rather than one. Some of these indications are the following:
- Severe Protruding Incisors (buck-teeth)
- Excessive Horizontal Overbite (overjet)
- All Underbites (lower front teeth in front of upper front teeth)
- Severe Crowding or Potential Severe Crowding that may lead to extractions of permanent teeth
- Openbites
- Crossbites
- Esthetically unpleasing tooth positions that are corrected for socialization
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Step ONE
During Phase One treatment there may be both permanent and primary (baby) teeth present. Think of this step as "building the foundation of the house", and usually takes 9-12 months. The goal of this phase is to create the healthiest environment possible for the eruption of permanent teeth. A retainer may be worn for 6 months after Phase One, and then discontinued to allow the remainder of normal growth to occur.
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Step TWO
All patients that undergo Phase One therapy do require Phase Two treatment to attain the desired functional and aesthetic goals. This step is "building the house" and typically takes 12-18 months. Usually the second and final phase of active treatment begins when the permanent teeth have erupted. Final correction of tooth position, space closure, bite correction, root paralleling and other refinements which are important to function and stability, are achieved during this stage. Just like One Phase treatment, long term (indefinite) retainer wear at night follows this stage of treatment.
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Some benefits of Two Phase treatment if it is indicated:
- Less need to remove permanent teeth
- Less need for jaw surgery
- Improved function
- Reduced risk of tooth fracture from protruding teeth
- Enhanced self-image during socially formative years
- Increased stability of adult teeth
- Helps eliminate adverse habits such as thumb/finger sucking, tongue thrusting and lip habits
- Enhances proper speech development
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At the end of orthodontic treatment, whether One or Two-Phase Treatment there's a common result: a great looking smile, improved self image, and benefits that will last a lifetime.
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