These days, it is common to see many younger patients with braces on both permanent and baby teeth.  However, not all patients benefit from early interceptive treatment, or two-phase treatment, instead of the traditional orthodontic treatment approach.  Appropriate orthodontic treatment is not a “one size fits all” approach.  Each patient has unique needs and requires a customized treatment plan to achieve an ideal result.  For this reason, the American Association of Orthodontists has educated the public for many years to seek an orthodontic evaluation no later than 7 years of age, or at the first recognition of the existence of an orthodontic problem.

By 7 years of age, most children have enough permanent teeth for Dr. Cook to determine whether an orthodontic problem exists or is developing.  Ideally, Dr. Cook wants to see them when the permanent teeth are first erupting.  When children are evaluated by Dr. Cook at this stage of dental development, they usually fall into one of three categories:

  • Category 1  –  The teeth and jaws are developing normally, although tooth alignment may not be perfect.  Dr. Cook may recommend periodic observation until the rest of the permanent teeth erupt to ensure that no other problems unexpectedly arise.  Later, traditional comprehensive orthodontic treatment (full treatment) will be offered once the permanent teeth have erupted.

  • Category 2 – The teeth have mild-moderate esthetic problems, but the jaws are usually developing normally.  Children in this category may have spacing or rotated teeth that are causing self consciousness or social anxiety.  These children could wait for treatment from a traditional orthodontic perspective.  However, their families are seeking early correction to relieve the self consciousness and social anxiety these problems have caused.  Two-phase treatment may be offered by Dr. Cook as an option.  This will require a second phase after the permanent teeth have erupted for a comprehensive result.

  • Category 3 – The teeth or jaws have moderate to severe problems.   This may include crowding, ectopically positioned permanent teeth, unfavorable early loss of primary teeth, cross-bites, underbites, or imbalance of the jaws.  In these cases, Dr. Cook may recommend early interceptive treatment or two-phase treatment at this age to avoid future problems.  This will require a second phase or full treatment after the permanent teeth have erupted for a comprehensive result.

Early interceptive orthodontic treatment is less involved than two-phase orthodontic treatment.  Early interceptive treatment may be limited to removal of select baby teeth to prepare for the eruption of permanent teeth, maintaining the space of a primary tooth that was lost too early, or a reminder appliance to help stop undesirable oral habits.

Putting off a check-up until a child has lost all baby teeth could limit the final result or require extraction of permanent teeth that could have been prevented. Some orthodontic problems are actually easier to correct if found early. Early detection gives you the opportunity to have Dr Cook recommend the appropriate treatment at the appropriate time. If early treatment is in order, Dr. Cook may be able to achieve results that may not be possible once the face and jaws have finished growing.

Signs your child may need early interceptive orthodontic treatment:

It’s not always easy to tell when your child has an orthodontic problem. Even teeth that look straight may be hiding an unhealthy bite. Here are some clues that may indicate the need for orthodontic

  • Early or late loss of baby teeth (your child should typically start losing teeth around age five, and will have all their permanent teeth 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

  • Jaws that are too far forward or back

  • An unbalanced facial appearance

  • Biting the cheek or biting into the roof of the mouth

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 lose all their baby teeth by age 13, and by the end of their teen years, the jaw bones will harden and stop growing. Orthodontic procedures for adults often take more time and can involve tooth extraction or oral surgery. Receiving early orthodontic treatment as a child 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.

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