Treatment Timing

Early Treatment

The American Association of Orthodontists recommends that children be screened for orthodontic treatment at age 7. At our office we provide this screening at no charge. Although many of the children we see at this age are not in need of early orthodontic intervention, there is often a significant positive impact on the oral and psychological health for the kids that do receive the early treatment they need. Even considering the children for whom we can achieve an equally excellent result by waiting and doing braces later, starting a relationship with our office early gives us valuable insight into their growth pattern. Also, it enables them to feel very familiar and comfortable with our office environment prior to the start of treatment.

For those patients who could benefit from early treatment the following is achieved:

Influence jaw growth in a positive manner
Improve the width of the dental arches
reduce the need to extract permanent teeth
Reduce or eliminate the need for jaw surgery
lower the risk of trauma to protruded front teeth
Correct harmful oral habits
Improve esthetics and self-esteem
simplify and shorten treatment time for definitive orthodontic treatment (phase 2)
Increase stability of final treatment results
Reduce likelihood of impacted permanent teeth
improve speech development
Improve position of first molars
Guide permanent teeth into more favorable positions
improve lip competence
Preserve or gain space for erupting teeth
Improved compliance before the busy teenage years

Treatment Phases

Patients for whom early intervention is indicated go through a 2-step process of treatment, and those not receiving early treatment get braces when their permanent teeth are in as a single, comprehensive treatment plan (similar to "Phase 2", but usually a longer treatment time)

Phase I

The goal of the First Phase Treatment is to develop the child's jaw size to make room for the future eruption of permanent teeth and to improve the relationship of the upper and lower jaws. Children sometimes exhibit early signs of jaw problems as they grow and develop. An upper or lower jaw that is growing too much or not enough can benefit from early orthodontic treatment. The early correction can prevent later removal of permanent teeth due to excessive overbite or overcrowding. Leaving such a condition untreated until all permanent teeth erupt could result in a jaw imbalance too severe to achieve an ideal result with braces.

Rest Period

Between phases retainers are often worn at night to maintain the First Phase Treatment results while the remaining permanent teeth to erupt. Starting at age ten, children lose twelve primary (baby) teeth and by age twelve or thirteen they gain sixteen permanent teeth. During this period occasional appointments for observation and/or retainer adjustments are recommended, usually every six months.

Phase II

The goal of the Second Phase Treatment is to position all the permanent teeth to maximize their appearance and function. This is best accomplished by placing braces on all the upper and lower teeth. Due to the improvements made in the First Phase Treatment, the Second Phase Treatment usually eliminates the need for removing permanent teeth and greatly reduces the time spent in full braces.