Why is early orthodontic treatment necessary?

When we treat children before all the permanent teeth have erupted it is termed early treatment. This can be started when the four permanent first molars and eight incisors have erupted, generally ages 7-9.

Early treatment is usually called "Phase I Treatment". This term is used when orthodontic treatment is divided into stages to best suit the growing child. Phase I typically lasts 12-18 months and is then followed by a "Supervision" phase. With the eruption of the remaining permanent teeth "Phase II" can begin.

Phase I consists of an orthodontic appliance and sometimes a headgear. The bands are removed for the supervision phase and a retainer is placed. We continue to observe the child during this interim time and help guide the erupting teeth into their proper places. When the remaining permanent teeth come in, usually age 12-13, a second phase of active treatment is often necessary to finalize the tooth positioning.

Treating the child in the early stages is advantageous when there is a discrepancy between the upper and lower jawbones. These skeletal problems may show themselves as excessive overbite, crossbites, or the front teeth not being able to come together. Because the child is growing so rapidly these conditions can often be corrected quite rapidly and with an enhancement to their profile. The correction of tooth crowding can also be managed in Phase I treatment. When treatment at this age it is usually possible to correct crowding without having to remove permanent teeth, and again with the ability to shape the child's profile.

• Working with a growing child allows treatment options.



• Space can be created within the dental arch avoiding permanent tooth loss.



• Enhancing the facial profile.



• Patient cooperation is usually better at this younger age, especially if headgear is needed.



• More extensive treatment can sometimes be avoided