When to start orthodontic treatment.

In most cases, orthodontic treatment is commenced as soon as the last baby tooth has been shed. This usually occurs in the early teens.  In some cases, it is an advantage to start just before the last baby teeth are shed.

Orthodontic problems are usually apparent by the age of seven, when most of the adult front teeth and first adult molar (back) teeth have erupted .  However, sometimes we may detect an orthodontic problem earlier. 

Early examination allows us  to detect and evaluate problems and to plan an appropriate treatment schedule.

Early treatment may prevent more serious problems from developing or make treatment at a later age shorter and less complicated.

Early treatment may also achieve results that are not possible once the face and jaws have stopped growing.

When is the best time to commence treatment?

As teeth and facial bones in younger children are still developing and growing, they are easier to manipulate into their ideal position in a more rapid timeframe than fully developed teeth and bones.

Treatment at an early age can range from simple supervision and guidance of the maturing teeth and facial bone structure through the use of fixed or removable appliances.

The aim at this stage of therapy is to intercept and prevent a malocclusion (bad bite) from fully developing and to correctly develop your child’s jaw structure into the proper proportions, transversely (width) vertically (height) and profile to achieve the best facial balance and harmony.

What are the advantages of early treatment?

Whilst early intervention can be beneficial, we will always recommend treatment based on individual needs not a standard solution. Some direct results of early intervention treatment include:

• Creating room for erupting teeth to prevent crowding

• Creating symmetry by influencing jaw and facial bone growth

• Reduce the risk of injury to protruding front teeth, gums and face

• Significantly reducing the need for tooth removal due to crowding

• Reducing the timeframe in braces

Space maintenance or regaining is a commonly performed procedure in children. The early loss of a primary tooth may lead to a lack of space for its permanent replacement. Another common interceptive procedure is to orthodontically erupt a permanent tooth, which has failed to take its correct position in the gum-line.

Crossbite correction with a Rapid Palatal Expander is indicated when the back teeth bite in a reverse bite - the expander is a device which gently expands the upper jaw and moves the teeth and bones into a normal  position.

Anterior crossbites - when one or more front teeth bite in a reverse position - are sometimes corrected early especially if the teeth are in a potentially traumatic position.

Lower arch development may also be also undertaken in children so the lower jaw is able to accommodate all the permanent teeth in their correct alignment. This is usually achieved with a bonded appliance, which is gently expanded over a 9-12 month period.

Bite-planes removable plates can be used to help reduce deep overbites. A simple removable device is worn full-time to level the deep bite and thus prevent detrimental wear to the front teeth. 

What is Phase I and Phase II treatment? 

Phase I, or early interceptive treatment, is limited orthodontic treatment (i.e. expander or partial braces) before all of the permanent teeth have erupted. Such treatment can occur between the ages of six and ten. This treatment is sometimes recommended to make more space for developing teeth, correction of crossbites, overbites, and underbites, or harmful oral habits. Phase II treatment is also called comprehensive treatment because it involves full braces when all of the permanent teeth have erupted, usually between the ages of eleven and thirteen.

What is the advantage of two-phase orthodontic treatment? 

Two-phase orthodontic treatment is a very specialised process that encompasses tooth straightening and physical, facial changes. The major advantage of a two-phase treatment is to maximise the opportunity to accomplish the ideal healthy, functional, aesthetic result that will remain stable throughout your life.

First Phase Treatment: Your foundation for a lifetime of beautiful teeth

The goal of first phase treatment is to develop the jaw size in order to accommodate all the permanent teeth and to relate the upper and lower jaws to each other. Children sometimes exhibit early signs of jaw problems as they grow and develop. An upper and lower jaw that is growing too much or not enough can be recognized at an early age. If children after age 7 are found to have this jaw discrepancy, they are candidates for early orthodontic treatment.

Because they are growing rapidly, children can benefit enormously from an early phase of orthodontic treatment utilizing appliances that direct the growth relationship of the upper and lower jaws. Thus, a good foundation can be established, providing adequate room for eruption of all permanent teeth. This early correction may prevent later removal of permanent teeth to correct overcrowding and/or surgical procedures to align the upper and lower jaws. Leaving such a condition untreated until all permanent teeth erupt could result in a jaw discrepancy too severe to achieve an ideal result with braces alone thus jaw surgery may be indicated.

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