Early Treatment

When Should My Child Have an Orthodontic Evaluation?

The American Association of Orthodontists (AAO) recommends children be seen for their first orthodontic evaluation by age 7.  Dr. Derek Sanders, a board certified orthodontist in Miami, FL, follows the same recommendations and encourages the first orthodontic evaluation by age 7 or when the first molars erupt.  At Orthodontics Only in Miami, we have found that most children are not in need of active orthodontic treatment at this time, but if a child does need treatment, the benefits are significant.  A board certified orthodontist is best prepared to understand a child’s development and recommend the best course of treatment.

 

Why Do I Need an Early Orthodontic Evaluation?

The reason for an early screening is to diagnose problems with craniofacial growth and permanent tooth development at an early age.  Even when a child appears not to have any problems with jaw growth and tooth eruption, an x-ray may help to indicate any problems with the eruption path of permanent teeth and it can show possible jaw discrepancies.  The initial x-ray will also allow for confirmation of permanent tooth development.  In Miami, there are many instances of extra teeth or missing teeth.  The earlier a diagnosis can be made, the more predictable the treatment options will be.

An early orthodontic evaluation also allows an orthodontist the ability to evaluate possible habits that may affect facial balance.  The earlier physiologic balance can be restored, the more natural and predictable the treatment outcome can be.  Eliminating a habit at an early age will restore balance between the upper and lower jaws, which can allow for an functional bite and optimal facial esthetics when growth is complete.

 

What Causes a Bad Bite?

The causes of a bad bite may be genetic, environmental or a combination of both.  Environmental causes of a bad bite can include thumb sucking, mouth breathing and improper swallowing during infancy and childhood. Fortunately, dental or facial issues can be corrected before adolescence when facial appearance and attractiveness are so important to teenagers.

At an early age, Dr. Sanders is able to effectively guide jaw growth and the position of teeth, regulate the width of the upper and lower dental arches, gain space for permanent teeth, correct thumb sucking and protruding front teeth, and eliminate abnormal swallowing or speech problems.  When adequate space for incoming teeth is made through guided jaw growth, the extraction of permanent teeth can be eliminated and the incidence of impacted permanent teeth minimized.  Depending on the child’s circumstances, there can be many treatment options available.  If a child can benefit, Dr. Sanders will review each of the options in order to find the best individualized solution.

 

What are Functional Appliances?

Dentofacial orthopedic appliances, also called functional appliances, are used to promote and guide jaw growth.  The three most common reasons to use an orthopedic appliance in a child include a size discrepancy between the jaw bones that helped to cause an crossbite, underbite or overbite.  Functional appliances can be used to treat these conditions by enhancing the growth of an undersized jaw or increasing the width of a jaw bone.  Common examples include headgear, an expander or a Herbst appliance.

Dentofacial orthopedic appliances are most effective during the period of childhood before all of the adult teeth have erupted and when the child is rapidly growing.  There are two growth spurts that typically occur around age 7 and then again around age 12.  If the orthodontic evaluation shows that a child is not in a phase of rapid growth, Dr. Sanders may recommend re-evaluating at a later date in order to begin treatment at the right stage of bone growth so that orthopedic therapy can be most effective.

 

When Early Treatment is Not Needed

Keep in mind that early treatment may not always beneficial, as many types of problems can be solved more easily and efficiently during the second growth spurt, closer to the teenage years.  If there is no need for early orthodontic treatment, Dr. Sanders will advise parents about what type of orthodontics will be likely needed in the future and he will also establish a schedule for re-evaluation.  If there are no additional benefits of starting early, Dr. Sanders will usually wait to begin treatment until the most appropriate stage of growth.  Starting orthodontic treatment at an ideal time can increase the predictability of the result and lead to a lifetime of improved oral health, function and optimal esthetics.

 

Phase 2 Orthodontic Treatment

Early childhood orthodontic treatment, also called Phase 1 treatment, will likely not eliminate the need for braces during the teenage years.  Phase 1 treatment is only able to address permanent teeth that have erupted and there may be problematic areas in the twelve additional permanent teeth that usually erupt between the ages of 10 and 12.  If these teeth are not aligned properly, further treatment may be indicated and this phase is usually called Comprehensive Orthodontic Treatment or Phase 2 treatment.

The benefits of having Phase 1 treatment, when indicated, can simplify future orthodontic treatment, while preventing more serious problems from developing.  An additional benefit is a significant reduction in the treatment time of Comprehensive Orthodontic Treatment, which can be reduced by up to 12 months.  At Orthodontics Only in Miami, we have found that Phase 2 orthodontic treatment takes between 12-15 months, while the average treatment time for a child that did not have Phase 1 treatment is between 22-24 months.

 

Goals of Early Treatment

The long-term goal of childhood and adolescent treatment is to establish an optimally functional and cosmetically pleasing alignment of jaws and teeth, thus setting an environment for a lifetime of oral health and social confidence.  If an early childhood screening determines there is no need for early treatment, patients will be advised about what orthodontics may be needed in the future.  Patients will receive an invitation to establish a schedule of visits to monitor the eruption of the permanent teeth in order to start adolescent treatment at the best time for optimal tooth movement and jaw growth.

If you are thinking about delaying evaluation of your child, we would like you to kindly reconsider.  The initial orthodontic consultation is free and inevitably, it may actually cost less in the long run—in time, effort, and money, to address any present issues (visible or not visible to you) at the optimal time.

 

Second Orthodontic Opinion

Sometimes the prospect of needing treatment in childhood is unsettling. Sometimes parents wonder if there are any options.  If your child has been evaluated by another orthodontist or a dentist, and you have received news that concerns you, Dr. Derek Sanders of Miami is available to provide a second opinion evaluation.  He will spend time providing you with comprehensive information that will help you move forward with appropriate treatment.  Please feel free to call our office and schedule a complimentary consultation, (305) 598-3384.


About the Author: Derek Sanders is an Orthodontist at Orthodontics Only in Miami, FL. He has numerous publications and has lectured extensively on topics including braces and Invisalign. Dr. Sanders teaches at the University of Miami and is on the Craniofacial Team at Miami Children's Hospital. He has a blog and can also be found on Google+. See more articles by Derek Sanders.

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