Orthodontics - getting an early start

Posted by Dr. Edward Magida | Filed under , , ,

"Doctor, Johnny's just eight years old, but his teeth and bite are so crooked. Can't we do anything but wait?"

Increasingly, parents are asking their dentists for earlier treatment so their children's teeth are straight as soon as possible.

And since 60 percent of the child's face is developed by age eight and 90 percent of the face is developed by age 12, I think it's important that orthopedic and orthodontic problems be treated early in order to guide the growth of young patients.

The mixed dentition stage of a child's dental development is the most neglected area in orthodontics. This is the time of the child's life when they have lost some of their baby teeth, but not all, and some of the adult teeth have started to erupt. It is between the ages of approximately six years until 12 on average.

It has been estimated that approximately 70 percent of patients in the mixed dentition stage could benefit from some form of orthodontic or orthopedic treatment. The majority of orthodontic patients tend to have treatment started when all their baby teeth are gone. For practitioners trained with a preventive philosophy, this approach doesn't make sense. Statistics show that problems left untreated tend to worsen with time.

Throughout the years, the orthodontic profession has been divided into two different philosophies of treatment.

The North American approach is to treat patients primarily with the use of brackets and wires when they have full permanent dentition. Extractions of certain teeth, usually the premolars, are sometimes done to allow movement of other teeth.

The European approach is to treat patients earlier with the use of removable appliances while there are still some baby teeth present. Patients with abnormal habits such as thumb sucking or tongue thrusting, snoring, airway problems, mouth breathing or abnormal skeletal problems are treated early in order to prevent the problems from getting worse.

Presently, general dentists are fabricating most functional orthopedic appliances.

Let me state the objectives of early treatment:

  • Corrections of crossbites, where the lower teeth are outside of the upper teeth (normally the upper teeth are outside of the lower teeth.)
  • Expansions of a constricted maxillary arch (palate), which will allow for adequate room for the eruption of all the permanent teeth, most times without any extractions.
  • Allow a child with a retruded lower jaw to move it forward to improve the facial profile.
  • To improve a child's breathing - increase nasal breathing and decrease mouth breathing
  • To allow more room for the tongue, which helps to eliminate speech problems.
  • To develop a broad beautiful smile.
  • To correct the position of severely protruding upper front teeth, which are more prone to injury.
  • To close anterior spaces caused by finger sucking.
  • To improve deep bite, where the lower teeth cannot be seen when the child closes down because the upper teeth cover them.

If you have any questions about your child's teeth in regards to improper spacing or bite problems, the sooner you ask a dentist to evaluate the situation, the better off your child will be.