When is the best time to begin orthodontics?
Although many people associate orthodontic treatment with adolescence, orthodontists can spot subtle problems with jaw growth or with the teeth much earlier, while the primary or “baby” teeth are present.
Parents may incorrectly assume they must wait until a child has all of his or her permanent teeth before seeing an orthodontist. However, the American Association of Orthodontists recommends that every child get a check-up with an orthodontist no later than age 7. By age 7, enough permanent teeth have arrived for an orthodontist to evaluate the relationships between teeth, jaw and bite. If Dr. Baird does not detect a problem that would benefit from early treatment (orthodontic treatment between age 7 and 9 when baby teeth are still present), we will invite you to return for progress checks in order to pinpoint the ideal time to begin treatment if necessary.
Starting treatment after growth has slowed (or stopped) and all of the adult teeth have erupted may necessitate a more complex and time consuming treatment plan sometimes involving extractions and/or jaw surgery. Oftentimes, compromised results have to be accepted if initial treatment is delayed. Dr. Baird is trained to detect problems that if treated while children are still growing, can achieve results that otherwise may not be possible later on when they mature.
Some of the readily apparent conditions that indicate the need for an examination include:
- Early or late loss of baby teeth – this can cause the permanent teeth to come into the wrong position and block other adult teeth from growing in
- Difficulty in chewing or biting – without effective chewing abilities, nutrition and growth can be negatively impacted
- Mouth breathing – this can cause an abnormally shaped upper arch that will not grow large enough to accommodate all of the teeth without treatment
- Thumb sucking – this can also cause an abnormally shaped upper arch as well as causing the front teeth to protrude
- Crowding, misplaced or blocked-out teeth – if a tooth is blocked out and left untreated until all of the baby teeth are gone, we often need to remove permanent teeth to accommodate the blocked out tooth
- Jaws that shift or make sounds – this is very unusual in young patients and may indicate a significant bite problem
- Speech difficulties – it is more difficult to resolve speech problems in older children, the sooner the oral environment is improved for speech the better the result
- Biting the cheek or the roof of the mouth – biting the roof of the mouth indicates a deep bite, this can cause permanent damage to the gum tissue supporting the upper front teeth
- Teeth that meet abnormally, or don’t meet at all – an example is an open bite, in which the front teeth do not touch. It can be difficult to bite into foods properly
- Facial imbalance – the earlier a facial asymmetry is addressed, the more likely it can be completely corrected. This is because there is more growth potential in a 7 year old then a 12 year old
- Jaws that are too far forward or back – again, there is more growth potential in a 7 year old patient then a 12 year old. The more growth we have to work with, the closer we can get to an ideal result
- Grinding or clenching of the teeth – although it is common for young children to grind their teeth when they transition into permanent teeth, it is important to evaluate before it causes any permanent damage
At this early age, treatment may not be necessary, but an examination can help determine the most advantageous time to begin treatment when the goal is an incredible smile. Treatment of patients at this early age is sometimes known as Phase I treatment, interceptive orthodontic treatment, or early treatment.
A great orthodontic result requires two things: Correctly aligned teeth and correctly aligned upper and lower jaws. Incorrectly aligned jaws, resulting in overbites, underbites, open bites and asymmetries can be corrected only if the jaws are still growing. This occurs up until about age 12-13.
Aligning all of the teeth requires that all of the permanent teeth be erupted, and this occurs around age 12-13.
This means that if a child has crowded teeth and incorrectly aligned jaws, it may not be possible to achieve both in a single phase of treatment because the ideal time for treatment of one ends just as the other begins. However, once early treatment prevents or intercepts more serious problems from developing, treatment at a later stage is usually shorter and less complicated.
Phase I treatment allows us to:
- Create room for crowded, erupting teeth
- Create facial symmetry by influencing jaw growth
- Reduce the risk of trauma to protruding front teeth
- Preserve the space for unerupted teeth
- Reduce the need for tooth removal
- Reduce treatment time with braces
Early evaluation of children for orthodontic treatment provides both timely detection of problems and a greater opportunity for more effective treatment and a healthy, beautiful smile.