5 facts about Early Orthodontic Treatment you should know

Should I wait for all of my child’s permanent teeth to erupt before seeking an orthodontic consultation?

This seems to be the common sentiment of most parents. In fact, I once had a father tell me that he was under the impression that his son could only get braces at the age of 15 or 16. It’s true that the majority of our orthodontic patients are teenagers and young adults, however, there are certain treatments that an orthodontist can and should perform at a much younger age to improve a child’s bite and jaw structure.

Here are some facts about early orthodontic treatment:

1. The American Association of Orthodontist advocates that a child should have his first orthodontic check-up as soon as an alignment or bite problem is noticed, and no later than age 7. At this age, usually, there are enough permanent teeth erupted to give a “Red Flag” to an orthodontist as to whether braces will or will not be needed.
2. An examination by an orthodontist does not always mean that your child will get braces. There are clear-cut specific indications for early treatment. Not all children undergoing an orthodontic examination will need early treatment. Only if your orthodontist notices one of these indications, will he/she advise early treatment? These indications typically include –
   1. If the teeth are highly susceptible to trauma – e.g. – teeth that stick out too much
   2. Growth problems, which are better corrected by modulating a child’s growth – e.g. – lower teeth sticking out too much, or a narrow jaw
   3. Crossbites – upper single or multiple teeth biting inside the lower teeth, especially if they result in a deviation of the jaw
   4. Aesthetic problems – IF the child is psychologically affected by the alignment and aesthetics of the teeth, being bullied because of his/her teeth, etc.
3. If my child has early orthodontic treatment, Will he/she need braces later? – Usually, YES…. Once all the permanent teeth erupt (around age 12), your child will need full braces treatment to perfectly align the teeth and correct the bite. That is why early treatment is performed only if any of the specific conditions mentioned above are present. For this reason, early orthodontic treatment is also often referred to Phase I
4. Duration of treatment – Early treatment is usually carried out with very specific objectives and to solve the major concern, NOT to achieve a perfect result. Hence active treatment usually lasts 6-8 months. (It may last longer for some more complex problems.) Typically, after the treatment, you would have to continue to visit the orthodontist periodically, to monitor the further development of the teeth and jaws, and to decide when to start with the complete orthodontic treatment (or Phase II)
5. What will happen when I take my child for an early orthodontic check-up?

Your orthodontist will have a brief interview with you and your child to find out about any particular concerns that you may have. He/she will then proceed to examine your child’s face, jaws, and teeth, and evaluate the current status of the child. Often, photos, x-rays or study models of the teeth may be needed. Thereafter, the orthodontist will choose to do one of the following:

• Do nothing if no problem exists
• Wait and watch –  follow up with you and your child every 3-12 months and monitor the growth and development of the child’s teeth and jaws
• Prescribe treatment – if any indications for early treatment are noticed, your orthodontist will advice one or more of a number of treatments, including fixed or removable braces, growth modification appliances, removal or milk teeth, etc.

For More information on Early Treatment:

An example of early treatment –

This 8-year-old girl had a ‘cross bite’ of the front tooth. This was not only an aesthetic concern; the crossbite was also putting excessive forces on the lower front teeth, which was causing Gum and Bone loss. At this stage, the problem was not serious, but if she were to wait till all her permanent teeth erupted (age 12 or so), the gum and bone loss would have been a serious concern.

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