Early-Age Orthodontic Treatment Part 2

What is the Best Time to Start Early-Age Treatment?

There is no “best time” to start orthodontic treatment because the answer depends on your child’s unique situation. However, the American Association of Orthodontists (AAO) recommends that all children be seen by an orthodontist no later than age 7.  Many orthodontists recommend even earlier screening at the age of 4 or 5 because there are some problems and habits that are best treated as early as possible.

For the most part though, if your child needs an early-age treatment, the treatment will be started when all the 6 year old molars and all of the adult incisors have erupted. Waiting too long beyond this point could make the treatment less effective because the child’s growth will stop and many early-age treatments rely upon utilizing the patient’s growth. In other words, there is a window of opportunity to treat certain problems that should not be missed!

What are the Benefits to an Early-Age Treatment Approach?    

  • Improvements in Self-Esteem: During critical years of childhood and adolescence, front teeth play an important role in a child’s self-esteem and psychological well-being. Irregularities in the front teeth can cause teasing from classmates. Straightening the teeth during early-age orthodontic treatment  can cause improvements in self esteem during these years.
  • Less Overall Time:  Although the patient is technically an orthodontic patient for a longer period of time, because problems are more easily treated earlier, there will be longer periods between appointments and shorter appointments in general, which is important for busy parents in this day and age.  
  • Less Pain: Some tooth alignment problems and bite problems can cause pain for children when they bite down or speak, so fixing them early will have a positive effect.
  • Prevention of Chipping and Damage to Teeth:  Protrusive or “Bucked” teeth are more at risk for fracturing or chipping so fixing them will minimize this risk.
  • Fewer or No Extractions: Much of the crowding of teeth can be corrected by early expansion, or regaining of lost space from premature loss of baby teeth, which minimizes the need for permanent teeth extractions.
  • Making Problems Less Severe:  Early detection and intervention can make problems easier to deal with overall.
  • Greater Patient Compliance:  Kids around the age of 7 or 8 are much more excited to get braces and orthodontics than they are at the age of 13 or 14, which means that they are more likely to comply with doing the things that they are supposed to do.  
  • Stability of Results:  Tooth movement in early age treatments are more adaptive to change and the results are more stable.
  • Less Traumatic:  For the most part the younger the patient is the easier tooth movements are, so overall there is less force needed to get the tooth to move which means patients experience less pain.
  • Improvements in Esthetics:  Studies show that a wider smile is considered more attractive.  Early treatments that involve expansion can increase the width of a smile and make it more attractive.
  • Improvements in Airway: Early-age treatment can also improve airways in growing children which can help with or help prevent other medical and cognitive problems.
  • Lower Treatment Costs:  Although each orthodontic office has different pricing models, for the most part early-age treatment should reduce overall costs. Especially if the need for more extensive procedures, like surgery, are avoided. Sometimes the cost savings could be substantial if a 2nd phase of treatment isn’t deemed necessary.


Examples of Some Early Age Treatment:

Early Age Treatment with Braces to Correct Anterior Crossbite

Palatal Expansion of a Narrow Upper Jaw:

Orthodontic Palatal Expanders (obtained from deardoctor.com)

We hope this 2 part series has helped you understand what early-age orthodontic treatment really is and if it is right for your child.  Now you know why that 8 year old is getting braces!

Early-Age Orthodontic Treatment Part I

Why are so many 8-year-olds getting braces?  

For most parents it might seem strange to see so many kids starting orthodontic treatment at such a young age, especially considering that when the parents themselves went through orthodontic treatment, kids generally didn’t see an orthodontist until their teens.  So why is there now a shift in philosophy? When should a child first be seen by an orthodontist? And does your child actually need early-age orthodontic treatment?

What is Early-Age Orthodontic Treatment?

The first thing a parent might want to know is what is early-age orthodontics? Early-age orthodontic treatment, otherwise known as preventive orthodontic treatment, interceptive orthodontic treatment or phase I orthodontic treatment, encompasses all treatments that can be performed before the adult teeth develop. The purpose is to eliminate or minimize tooth or skeletal dis-harmonies that can interfere with normal growth and development of tooth structures, the bite, or the TMJ. Waiting to correct such abnormal growth patterns can lead to problems with the airway, esthetics or the psychological well being of the child. In other words, early-age orthodontic treatment is preventative in nature, is most effective during the growth period, and has the goal to prepare the oral environment to allow the best possible skeletal, esthetic and orthodontic result.    

The Controversy over One phase vs Two Phases of Orthodontic Treatment:

One problem parents might have in deciding if early-orthodontic treatment is right for their child is that orthodontists sometimes disagree about this subject. One orthodontist may recommend that every child needs to get early age treatment and another orthodontist may recommend that no child ever get early age treatment.

The answer is neither of these two approaches. It completely depends on your child’s individual orthodontic problems and needs. Despite the many new advances in technology and diagnostic techniques and improvements in our understanding of growth and development in children, many practitioners do not know how to diagnose or manage early-age orthodontic problems, or do not know the optimal timeline for treating them.

The risk to not doing early age treatment for your child who is in need of preventive care during the developmental stage could be substantial. It is technically easier and in the comfort zone for most orthodontists to wait until all the adult teeth have erupted to start treatment, however if there were early-age treatment needs that were not addressed, the  orthodontic treatment may now require more invasive procedures like tooth extractions or, even worse, jaw surgery to achieve the same result. Most likely the orthodontist will be forced to “camouflage” the underlying skeletal problem by compromising the positions of the teeth, and although the results may end up being “good”  they will not be “exquisite.”

Will My Child Need a 2nd Phase of Treatment?

The short answer is “it depends.” Because the goal of early-age treatment is to optimize the environment to allow the best skeletal, tooth, and esthetic results, there are some patients who don’t need the 2nd phase. However, the majority of patients will most likely need a 2nd phase to fix minor irregularities that happened during the normal growth and eruption process of the teeth.

Another way to view this is the 1st phase early-treatment is more orthopedic in nature which means we are normalizing the growth and position of the bones and the 2nd phase is orthodontic in nature so we are normalizing the position of the teeth. By doing two phases, we are making each orthodontic process much easier, shorter and more predictable for most patients.