To prevent more complex problems or minor abnormalities, children may need early, partial Orthodontic treatment. This early intervention can prevent or intercept future problems, before they get worse.
When do you need Interceptive Orthodontics?
Typically, when we see that the patient shows a potential threat to a normal occlusion.
Why Should It Be Done?
By taking advantage of patient growth and development, we can guide and control these natural forces to assist Orthodontic treatment.
Benefits of Interceptive Orthodontic Treatment
Treating the problems early, helps reduce total treatment time and final treatment cost.
Why do I Recommend Early Partial Orthodontic Treatment?
Without early treatment, the existing problem may get worse, become harder to treat and increase the likelihood of the need for teeth extractions.
Treatment helps create a more normal environment, allowing better control and guiding of more normal jaw growth and development.
Future treatment, if needed will be easier and take less time
The natural growth of the patient is utilized to assist correction. Often a headgear is used to accomplish this.
Early treatment allows growth to help treatment progress faster and easier
Normal, aesthetic teeth arrangement can be achieved with less time and effort, reducing treatment cost.
Treatment Time Alternatives
True Orthodontic Treatment Time: the time the patient wears bands and wires on the teeth, with active and planned procedures.
Rest Period or Waiting Period(s): are not considered Orthodontic treatment time, when discussing how long a patient has Orthodontic treatment.
Full treatment starts when all of the permanent teeth have erupted, and the patient shows teeth crowding. Often, borderline no-extraction cases become extraction cases, if early partial treatment is not done.
Early Partial Treatment
This type of treatment takes place at an early age, to reduce crowding and control growth direction, to assist the patient.
Treatment Time (Phase I) 9 – 15 months
Early Partial Treatment Phase II
This is a rest or “waiting” period, where the patient waits for the remaining teeth to erupt, to evaluate Phase I accomplishments.
Time: Variable (we must wait for the remaining teeth to erupt).
Finishing Phase – Phase III
(After rest period, if necessary)
The finishing phase may be necessary after re-evaluating the growth and habit response to early partial treatment. Why?
If the habits persist to undo the corrections.
If the growth remaining is greater than the expected and uncontrollable.
The finer details are not incorporated into the adult dentition.
The erupted teeth are not in their best positions.
Treatment time estimates
0 months (no treatment necessary)
24 months – if extractions become necessary.
Can You Guarantee Phase III (finishing) Will Be Eliminated?
No, but Phase I Partial Treatment is under taken the following may occur:
Phase III should be quicker and easier than if Phase I had not been tried
Phase III planning will take into account habits or growth patterns that work against Phase I corrections, such as habits that did not change with growth or therapy.
Successful early partial treatment should result in a shorter Phase III finishing treatment time. Minor corrections may be necessary for the teeth that were not under control in Phase I because they had not erupted.
Early Partial treatment can act to guide growth so that it is beneficial.
New 2019 Study Further Supports Early Treatment Effectiveness
A new retrospective data study of a 205 mixed dentition patients, who received early phase orthodontic treatment, showed the following benefits:
1. Less than 1% needed permanent teeth extracted, due to the greater potential to guide and modify growth in mixed dentition patients
2. 71% did not need secondary phase treatment
3. 20% of those that needed further treatment, received contiguous treatment from their early phase
4. 9% of those that needed further treatment received a second phase of treatment.
5. Was effective at treating a variety of malocclusions
More studies should be done, to confirm these findings and to add additional data, to substantiate the statistically significant numbers described in this study.
In my practice, I have found many patients benefit from early treatment because we are able to take full advantage of growth and control eruption patterns that need modification. For example, sometimes an adult tooth may be blocked from coming in, by the baby tooth, due to the poor eruption angle. By simply removing that baby tooth out early, we prevent a larger problem in the future. We try to re-establish the proper eruption sequence. Other times, the tooth foundation has a discrepancy that needs modification by appliances to modify the quantity and direction of the upper and lower jaw growth.
The Orthodontist should be the custodian for the child’s growth and development of teeth and jaws. The optimum time to evaluate these sorts of cases begins at age 7.
See also American Association of Orthodontists (AAO) article on Early Orthodontic Treatment published in my blog: AAO Early Treatment Article
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