Early Phase Orthodontic Treatment: What Parents Need to Know

People think of orthodontic treatment or braces as treatment mainly for kids who are in middle school or older. While that is a common age for full treatment, it is also possible to treat some orthodontic problems at a younger age. This is referred to as early phase orthodontics or interceptive orthodontics. This type of orthodontic treatment is usually done when there are adult and baby teeth present, typically the adult front teeth and the first back molar. Early phase orthodontic treatment should have a very specific goal and a limited timetable. 

The current recommendation from the American Association of Orthodontists is that a child should be evaluated by an orthodontist either at the first recognition of an orthodontic problem or by age 7. At this age since all the teeth have not erupted and the children are still growing, a second phase of treatment will usually be necessary. Despite this, many children will benefit greatly from early orthodontic treatment that can help make their second phase more predictable, or shorter. 

Planning for Early Orthodontic Treatment

The key to early phase orthodontics is appropriate diagnosis or good planning. Often, the orthodontist will work with the pediatric or general dentist to plan treatment. Early treatment usually requires an examination, face and dental photos, x-rays and molds or scans of the teeth.

Some patients will benefit if they have specific problems such as:

• Having extra teeth or teeth coming in the wrong spot
• Missing permanent teeth
• Permanent teeth that will not erupt on their own
• Upper front teeth are behind the bottom front teeth instead of in front (anterior crossbite)
• Upper back teeth are inside of the bottom back teeth instead of on the outside (posterior crossbite)
• Upper front teeth that stick out with lips that cannot close and there has been an injury to those teeth.
• Upper front teeth that are sticking out that are the reason for teasing or bullying
• Finger or thumb sucking habit with a child who has desire to stop
• Children with syndromes, a craniofacial condition or cleft lip and palate

Some patients are watched for growth changes and monitoring of the eruption of teeth. Other patients will benefit from an appliance such as an expander, or braces on a few upper or lower teeth. Not every patient will need to have braces on every tooth like with full orthodontics. Early phase orthodontic treatment often lasts one year or less.

It is important that the teeth and gums are healthy prior to starting orthodontic treatment. A recent cleaning and exam, good brushing and flossing habits will be an important part of successful treatment.

You can always follow up with your pediatric dentist or orthodontist if you have questions.