What is the difference between early and regular orthodontic treatment and why might my child need early treatment?

The American Association of Orthodontists recommends children first see an orthodontist at the age of seven. Even though the majority of children start orthodontic treatment when most of their adult teeth have erupted between the ages of 11-12, there are some special patients that need to start earlier and need 2 phase treatment. The doctor will perform the initial consultation to evaluate the need for treatment at this point in time. The reason for such early evaluation is to monitor growth, prevent trauma to teeth, and help permanent teeth come in properly to lessen the chance for extractions in the future. Your child may need early treatment if you see the following:

  • Moderate crowding of anterior teeth. Moderate spacing is normal for children who do not have all their adult teeth.
  • Early or late loss of baby teeth. Most children typically lose all their baby teeth around 12 years old and have all their adult teeth by 13.
  • Asymmetric eruption of adult teeth that are more than 6 months apart.
  • Continuing thumb sucking habits after age 5. This could cause a narrowing of the upper jaw, create bite problems and crowding.
  • Shifting of the jaw when your child opens and bites down (crossbites).
  • Upper teeth are behind lower teeth (crossbites and underbites). This could cause damage to teeth and gums if it is a dental crossbite. With an underbite, the doctor will discuss the options of treatment depending on the severity of skeletal involvement.
  • Difficulty chewing and/or biting.
  • Protruding teeth (upper teeth jut too far out compared to lower teeth – this is often associated with a habit) that are causing social problems at school.

What if I put off treatment?

Putting off treatment may result in the damage of healthy teeth and gums and also result in a need for more invasive treatment later in life, including extractions and surgery that may not completely fix your child’s smile.

What is 1 phase vs. 2 phase treatment?

If you child has any of the above characteristics, he or she would need 2 phase treatment. Phase 1 aims to correct the above problems with a resting period to wait for the remaining adult teeth to come in. During the resting period, a retainer may or may not be recommended depending on your child’s specific situation. If required, the retainer should be worn as directed by the doctor. The doctor will then continue to monitor your child’s growth and tooth eruption with 6-12 month recall appointments.

When the majority of adult teeth have erupted, your child will start phase 2 treatment. The goal of phase 2 treatment is to align the arches together, correct your child’s bite and finish with a beautiful, healthy and lasting smile. Retainers will be prescribed at the end of treatment.

Phase 1 treatment takes approximately 6-12 months, while phase 2 treatment takes approximately 24 months, depending on case severity, appointment attendance and patient cooperation.

What causes orthodontic problems?

Orthodontic problems are caused by a combination of factors that include inherited traits such as skeletal relationships, small teeth, big teeth and environmental causes such as thumb sucking, early or late loss of baby teeth and injury to the jaws or teeth. Whatever the reason may be for the malocclusion, we will work together to create a final beautiful and healthy smile.