Early Treatment???

While we do feel like it is prudent to see children by age 7 to keep an eye on how your child’s teeth and face are developing, we have some strong feelings about “early treatment” or “phase 1 treatment”.  We have researched the topic extensively, going so far as to take part in a 2-week International Symposium on Early Treatment.  And guess what?  There are WAY too many young kids running around in braces!  Most will have to wear them again as teens (that’s why it’s called “phase 1” … because they will still need to do “phase 2” in a couple years).

The most bothersome part about the over-abundance of early treatment is that it isn’t helping anyone.  Parents end up paying more money.  Kids end up in braces a lot longer (they get to wear them twice instead of just once).  And the child’s teeth are at a much higher risk of being permanently damaged, since the oral hygiene of a 9 year old is usually marginal at best.  Yet parents are made to feel like they are neglecting their child if they don’t have them in braces by the third grade!  It’s crazy!

So what’s a parent to do?  How do they know if their child really needs braces early, or if they are just being talked into something unnecessary?  Here’s some good rules of thumb that we use:

Problems that DO require early treatment:

1)      Anterior crossbites (upper front teeth that bite behind the lower front teeth) = If not corrected, excessive gingival recession will occur on the front surface of the lower teeth, and chipping of the teeth can occur.

2)      Unilateral posterior crossbites (the upper back teeth on one side bite inside the lower teeth, but not on the other side) = If left untreated, the mandible (lower jaw) can grow asymmetrically, and asymmetry is bad!

Problems that DO NOT require early treatment:

1)      Crowding = Crowding can be corrected just as easily in a single phase of treatment as a teenager.  Treating crowding early in the name of “making phase 2 easier” or “to avoid extracting teeth later” isn’t backed up by the research.  Unless the child is really bothered by the appearance (social issues relating to the appearance of the teeth), let it go until they get all the permanent teeth in.

2)      Bilateral posterior crossbite = Since the lower jaw isnt’ shifting to either side (like the above scenario of a unilateral crossbite), this problem can wait until comprehensive treatment begins as a teen.

3)      Overjet (excess “overbite” where the top teeth are out in front of the lower teeth) = Early treatment leads to no improvement in final outcome vs. waiting and correcting the protrusion in a single comprehensive phase of treatment as a teen.  The only exception to this is if the upper front teeth are “in harm’s way” and the child is at a high risk of traumatizing the upper front teeth due to an active / injury-prone lifestyle.  In that case, we might consider treating early just to minimize the chance of injuring those teeth.  Otherwise, the child is much better off waiting.

I hope these rules of thumb help you determine what can and can’t wait when it comes to your child’s teeth.   But it’s always best to have a consultation from an orthodontist you trust, who can talk to you about the specifics of your situation.

Let us know if you have any questions about early treatment or if we can be of assistance to you in any way!  Thanks!