When Should My Child Have Orthodontic Treatment?

The age at which a child needs teeth straightening depends on the type and severity of the orthodontic problems that are present.  Some orthodontic problems are more effectively treated at an early age, while others are best treated once the majority of permanent teeth have erupted.  Disproportional growth between the upper and lower jaws is one type of orthodontic problem that is best treated at an early age (8 to 9 years old).  Orthodontic functional appliances can redirect growth so that the upper and lower jaws grow in better proportions.  Early treatment can achieve a better skeletal balance, fit the teeth together properly and improve facial esthetics.  Mild growth discrepancies between the jaws may still be corrected in older children (10 to 13 years old), but more severe problems may not be corrected totally with orthodontic treatment alone.  Jaw growth is largely completed by age 13.5 in girls and age 14.5 in boys.  After these ages, skeletal imbalances can be treated, but different techniques are used.  Teeth can be moved to compensate for the skeletal problem or a combination of orthodontics and jaw surgery may be necessary.

Severely crowded (crooked) teeth is another type of orthodontic problem that is best treated at an early age (8 to 9 years old).  Orthodontic appliances can align crowded teeth and develop more space in your child’s mouth so that the rest of the permanent teeth can erupt in better alignment and in better position.

On the other hand, not every child needs orthodontic treatment at an early age.  Mildly crowded teeth are best treated once the majority of permanent teeth have erupted.  Mild tooth crowding can be corrected in young children without causing any harmful effects to the non-erupted permanent teeth.  However, this sometimes necessitates wearing retainers for an extended time period (years) in order to hold the tooth alignment while other permanent teeth erupt.  For most children with mild tooth crowding, waiting to start orthodontic treatment until the majority of permanent teeth erupt is a more practical option.  Children should have their first orthodontic evaluation by age 7 to determine if any orthodontic problems are present and to determine the best timing for teeth straightening.

Understanding Phase I and II Orthodontic Treatment

Children with significant orthodontic problems at an early age (6 to 9 years old) may require two phases of orthodontic treatment.  The goals of phase I (interceptive) treatment are to improve growth discrepancies between the upper and lower jaws, to correct immediate dental problems that may be present (crossbite, open bite, severe crowding, etc.) and to minimize the severity of the developing malocclusion. 

After phase I treatment, a child may need a second phase of treatment at a later time once the majority of permanent teeth have erupted.  Phase II usually involves a full set of braces (upper and lower) to align (straighten) the teeth and perfect the bite (occlusion).  Whether or not a child needs a second phase of orthodontic treatment depends on the size and position of the teeth that erupt, the manner in which the teeth fit together, the effectiveness of phase I treatment and the dental expectations of the child and the parents. 

Successful completion of phase I treatment does not guarantee that teeth will erupt in perfect alignment and good occlusion, but it may make phase II optional.  However, if the child and parents desire perfect tooth alignment and an ideal bite, a second phase of orthodontic treatment is usually necessary.

Not every child requires two phases of orthodontic treatment.  Mild orthodontic problems can be treated with a single phase of orthodontic treatment.  However, severe orthodontic problems that are treated with two phases of orthodontic treatment may produce more esthetic and more stable orthodontic results than only one phase of treatment.

Please schedule an orthodontic consultation with Dr. Staggers to see if your child could benefit from Interceptive Orthodontic Treatment.