Early Orthodontic Treatment

Timing is everything – even when it comes to your child’s orthodontic treatment. “Early” treatment, also called “interceptive” treatment, means treatment that is performed while some baby teeth are still present.

The American Association of Orthodontists (AAO) recommends that your child’s first check-up with an orthodontist be performed when an orthodontic problem is first recognized, but no later than age 7. Why age 7? By then, your child has enough permanent teeth for an orthodontist to evaluate the developing teeth and the jaws, which in turn can provide a wealth of information. Dr. Guthrie Carr is trained to spot subtle problems even in young children. You may view photos of such problems here:
Problems to Watch for in Growing Children.

There are generally three outcomes of an initial check-up:

  • No treatment is expected to be necessary.
  • Treatment may be needed in the future, so the child will be followed periodically while the face and jaws continue to grow.
  • There is a problem that lends itself to early treatment.

While there are many orthodontic problems that orthodontists agree are best treated after all permanent teeth have come in, early treatment can be in a patient’s best interests if their problem is one that could become more serious over time if left untreated. The goal of early treatment is to intercept the developing problem, eliminate the cause, guide the growth of facial and jaw bones, and provide adequate space for incoming permanent teeth. A patient may require a second course of treatment after all permanent teeth have come in to move those teeth into their best positions.

The kinds of problems orthodontists may recommend treating while a child still has some baby teeth include:

  • Narrow dental arches with airway restrictions
  • Underbites – when the lower front teeth are ahead of the upper front teeth
  • Crossbites – when the jaw shifts to one side
  • Very crowded teeth
  • Excessively spaced teeth
  • Extra or missing teeth
  • Teeth that meet abnormally, or don’t meet at all
  • Thumb-, finger-, or pacifier- sucking that is affecting the teeth or jaw growth

Some of these orthodontic problems are inherited, while others may result from accidents, dental disease, or abnormal swallowing.

Early orthodontic treatment can take many forms. The orthodontist could prescribe a fixed or removable “appliance” – a device used to move teeth, change the position of the jaw, or hold teeth in place in order to bring about desirable changes. Sometimes no appliances are necessary. Rather, removal of some baby teeth may help the permanent teeth erupt better. The extractions will be timed to take best advantage of a patient’s growth and development.

Regardless of how treatment goals are reached, the bottom line is that some orthodontic problems may be easier to correct if they are found and treated early. Waiting until all the permanent teeth have come in, or until facial growth is nearly complete, may make correction of some problems more difficult.

Dr. Guthrie Carr offers complimentary evaluations, No referral needed!

Now a word about the overuse of early treatment: Caveat Emptor
Parents need to be aware than some orthodontic offices make it a practice for almost every patient to receive early orthodontic treatment. They often characterize this a “special kind of treatment”. They are “the only ones who can help you with this special treatment”. The most common example would be the over use of early expansion.

Early expansion is important for airway problems in young children, cross bites and severe crowding. It is probably not needed for mild to moderate crowding when the bite is correct. If you visit an office where every young patient “needs 7 millimeters of expansion”, or they threaten you that they will have to pull 4 permanent teeth in the future if you do not do this now, get a second opinion!

Also, another unfortunate occurrence is to over charge for the first phase of early treatment with a promise of a credit at the second phase. Early treatment should be less than half the cost of current full treatment. If you pay more than this at the start, you have already prepaid for the second phase and the office is holding your money. What if you move, or do not need a second phase, or want to go to another office after the first phase? The fee should be proportional to the treatment provided at the time it is delivered and not come with a future promise tied to a second phase of treatment.