Early/Interceptive Treatment

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Nowadays, it’s common to see younger patients with braces on both permanent and baby teeth. However, not all patients benefit from early interceptive treatment, or two-phase treatment, instead of the traditional orthodontic approach. It’s essential to understand that orthodontic treatment isn’t a “one size fits all” approach. Each patient has unique needs and requires a personalized treatment plan for the best results. That’s why the American Association of Orthodontists advises seeking an orthodontic evaluation by age 7, or as soon as an orthodontic issue is first identified.

By age 7, most children have enough permanent teeth to determine whether an orthodontic problem exists or is developing. Ideally, we’d like to evaluate them when the permanent teeth are first emerging. At this stage of dental development, children usually fall into one of three categories:

  • Category 1 – Teeth and jaws are developing normally, though tooth alignment might not be perfect. We may suggest periodic observation until the rest of the permanent teeth erupt to ensure no other problems unexpectedly arise. Traditional comprehensive orthodontic treatment will be offered once the permanent teeth have erupted.

  • Category 2 – Teeth have mild to moderate esthetic issues, but jaws are usually developing normally. Children in this category may have spacing or rotated teeth causing self-consciousness or social anxiety. Although traditional orthodontic treatment is an option, two-phase treatment may be offered for early correction to relieve self-consciousness and social anxiety. A second phase after the permanent teeth have erupted is required for a comprehensive result.

  • Category 3 – Teeth or jaws have moderate to severe problems, such as crowding, ectopically positioned permanent teeth, unfavorable early loss of primary teeth, cross-bites, or underbites. We may recommend early interceptive treatment or two-phase treatment in these cases. If there’s a real benefit in early treatment, we’ll suggest it. Usually, after an early phase one treatment, a second phase or full treatment is required to straighten all the teeth after the permanent teeth have erupted.

What causes orthodontic problems, and how will early prevention benefit my child?

Orthodontic problems like crowding, spacing, protruding teeth, and bad bites can be inherited or result from injury, early or late loss of baby teeth, or thumb-sucking habits.

If your child is between ages seven and eight and shows signs of needing orthodontic care, or if your family dentist directs you to visit an orthodontist, please contact our practice and schedule an appointment. Our team will provide an initial exam and discuss the best steps for your child’s smile.

Early interceptive orthodontic treatment is less involved than full comprehensive treatment. It may include removal of select baby teeth to prepare for permanent teeth eruption, maintaining space for a primary tooth lost too early, or a reminder appliance to help stop undesirable oral habits.

Signs your child may need early interceptive orthodontic treatment:

Identifying an orthodontic problem in your child isn’t always easy. Here are some clues that may indicate the need for orthodontic attention:

  • Early or late loss of baby teeth (typically, children start losing teeth around age five and have all their permanent teeth around age 12)

  • Difficulty chewing and/or biting

  • Mouth breathing

  • Thumb-sucking after age four

  • Protruding teeth (the top teeth and the bottom teeth extend away from each other)

  • Teeth that don’t come together in a normal manner or even at all

  • Shifting jaw when opening or closing the mouth (crossbites)

  • Crowded front teeth around age seven or eight

  • An unbalanced facial appearance

  • Biting the cheek or biting into the roof of the mouth

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