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Part i

early-age orthodontic treatment

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.