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early orthodontic treatment – orthodontics for kids


“Two-Phase Orthodontic” or “Early Orthodontic” treatment may be necessary in younger children to reduce the severity of orthodontic problems that could arise if left untreated. Not all orthodontic issues can be fixed in Phase 1, but the severity of problems can be addressed, self-esteem can be improved, and proper planning can be made to produce the best long-term outcome. The major advantage of a two-phase orthodontic treatment is to accomplish healthy, functional, aesthetic results that will remain stable throughout a child’s life.

Phase 1 Early Orthodontic Treatment

Phase 1 of the two-phase orthodontic treatment is often recommended to patients ages 7-10 who will benefit from beginning orthodontic treatment prior to the loss of all their primary teeth. The goal of this early phase of treatment is to develop the jaw size in order to accommodate all the permanent teeth and to relate the upper and lower jaws to each other.

This will the amount and complexity of treatment later, such as having teeth extracted. Children sometimes exhibit early signs of jaw problems as they grow and develop. An upper and lower jaw that is growing too much or not enough can be recognized at an early age. If children after age 6 are found to have this jaw discrepancy, they are candidates for early orthodontic treatment. Early growth guidance treatment can help coordinate this jaw growth. Phase I treatment is also recommended for children who have moderate to severe bite problems, such as a cross-bite (the upper teeth fitting on the inside of the lower teeth), an under bite, or an open bite. It may be recommended for severely misaligned, or crowded, teeth. Typically, a patient requiring early treatment will have a removable appliance (similar to a retainer) and/or 4-6 braces on the erupted permanent teeth. Treatment may also involve an expander if a cross-bite or significant crowding is present. Specifics of the orthodontic treatment will be discussed thoroughly with you and your child during an initial complimentary consultation with Dr. Greenberg.

Phase 2 Orthodontic Treatment

Phase 2 of the two-phase orthodontic treatment typically starts after all of the permanent teeth have erupted. This treatment period can be shorter and less complex than what would have otherwise been necessary. For example, the removal of permanent teeth may be avoided by having Phase I treatment.

This second phase of treatment is often just to align all the teeth into a perfect position, or detail the bite, because early correction was completed in the first phase. Timing and type of treatment are dependent upon the problem and its severity, but typically, Phase I treatment will take 6-12 months and generally occurs between the ages of 7 and 10. The remainder of the permanent teeth will usually erupt by the age of 13, after which your child will be ready for Phase II treatment. This second phase of treatment can take from 12-24 months.

American Association of Orthodontists recommends an orthodontist evaluate all children at age 7. By this age, the permanent teeth are starting erupt and Dr. Greenberg can tell if a patient has adequate space for the remaining permanent teeth. If there is a problem with crowding, then steps can be taken to make more room for the permanent teeth. Dr. Greenberg will also check to see if there is an imbalance in the jaw relationship and correct it early, before it becomes a significant problem. Early screening can help prevent more complicated treatment later, which, in turn, can save time and money in the overall treatment process.

Signs your child may need early Phase 1 orthodontic treatment:

  • Early loss of baby teeth (before age five)
  • Mouth breathing, snoring, signs of sleep apnea
  • If your child’s teeth do not meet when biting down
  • A speech impediment
  • Crowded or protruding front teeth
  • Biting/chewing difficulties
  • If your child’s jaw shifts when they open/close their mouth
  • If your child still sucks a thumb/finger past 5 years old

Bringing your child in for their first complimentary evaluation at age 7 will ensure that treatment needs are identified early, giving them a better orthodontic experience, with fewer complications, and the best outcome.

During this one hour evaluation, a member of Dr. Greenberg’s team will take photos of your child, plus a 3D Orthodontics Imaging scan to get a 3D model of their mouth to evaluate any jaw, teeth or airway concerns. Dr. Greenberg will come in and perform a thorough oral exam and review the photos and 3D imaging. He will explain your child’s growth and development and identify any issues where early treatment might be recommended. If early treatment options are necessary, he’ll outline your child’s custom treatment plan, and discuss timeline and costs. If early treatment is not recommended at this time, your child will be put on our “Observation & Growth Program” where every 6 months to 1 year we’ll notify you to come in for a follow-up consultation.

Age 7 is the best time for an early orthodontic (Phase 1) evaluation.

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