As parents, ensuring your child’s dental health is a top priority, and understanding the best time to start orthodontic treatment can be a bit overwhelming. Many people think orthodontic care begins when a child is older, once permanent teeth have mostly all come in and gaps and crooked teeth are evidently presenting a problem. The truth is, however, early assessment and intervention can be incredibly beneficial. Early phase orthodontic treatment, often occurring around age seven, can help address developing issues before they become more serious. In this article, we’ll explain why early orthodontic evaluations are so important, what Phase 1 treatment involves, and how the different phases of orthodontic care can help set your child up for a lifetime of healthy smiles.
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Why Should My Child See the Orthodontist by Age Seven?
According to the American Association of Orthodontists, and Palmetto Kid’s Dentistry’s own Dr. Caylin McCullough, children should have their first orthodontic evaluation by age seven. This is the best age to see an orthodontist for the first time because at this point, issues with jaw growth and permanent tooth eruption can be detected and treated if necessary.
By this age, a child’s baby teeth have begun to fall out and permanent teeth are beginning to emerge. An early assessment helps identify any potential orthodontic issues such as crowding, misalignment, or jaw discrepancies. Detecting these problems early allows for timely intervention, preventing more severe issues later.
Early visits are not just about braces. Orthodontists can monitor your child’s oral development and recommend steps to guide proper jaw growth. Dr. McCullough is keen to watch your child’s jaw growth over time to ensure the upper and lower jaws aren’t growing too far forward or too far back relative to one another, and that the palate itself is wide enough to accommodate the full set of adult teeth trying to emerge. This proactive approach can minimize the need for invasive treatments, like oral surgery, in the future.
A comprehensive assessment at age seven will give you a clearer guide to what orthodontic treatment now or in the future can look like. At Palmetto Kid’s Dentistry, we’ll always give our professional recommendation for the best course of action for your child at the time, with the future oral health of their smile in mind.
Watch Dr. McCullough discuss the importance of visiting the orthodontist by age seven.
What Is Phase 1 of Orthodontic Treatment?
Phase 1, or early phase treatment, begins while a child is at the “mixed detention” stage, or where they still have a mix of primary (baby) and permanent teeth have started to erupt. This phase typically occurs between ages six and ten. The goal is to address significant orthodontic concerns early, such as jaw growth problems, severe crowding, or crossbites.
During Phase 1, orthodontists use appliances like expanders, space maintainers, or partial braces to create more space for teeth or guide the jaw’s development. These treatments can improve oral function and make the next phase of treatment more straightforward.
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Indications for Early Phase Orthodontic Treatment
Not every child needs Phase 1 treatment. However, there are specific cases where it can be beneficial. Common indications include:
- Narrow Upper Jaw: A narrow upper jaw leads to severe crowding where there is not enough space for the permanent teeth to come in. This is a common issue and one that is easily addressed with an early phase treatment plan to help the teeth come in the way they should.
Here is an example of a narrow upper jaw that is causing inadequate space for the upper lateral incisors, leading to an anterior crossbite. If left untreated, this anterior crossbite may cause damage to not only the tooth in crossbite but the tooth and gums of the opposing tooth!
- Functional Shift: A functional shift is a result of having a narrow upper jaw where the patient’s bite doesn’t align properly or comfortably. In order to close down more comfortably the patient will shift their lower jaw to one side or the other, developing a habitual and potentially permanent shift. This is a big problem especially if the functional shift is developed while your child is still growing as it can lead to asymmetrical jaw growth.
Here is an before and after of a narrow upper jaw that is causing what is known as a functional shift. If left untreated, this functional shift can cause asymmetric growth of the lower jaw and the patient can develop a facial asymmetry.
- Undeveloped Upper Jaw: When the upper jaw is not developing on pace with the lower jaw it can be set too far back. This is an indication for early phase orthodontic treatment where we will address any misalignment and also help influence the growth of the upper jaw to match the lower.
- Crossbite: Crossbite is when some or many of the upper teeth fit inside the lower teeth instead of outside. Crossbite can cause gum recession requiring future intervention. Early phase treatment can correct crossbite so when all of the permanent teeth come in, they are in their proper placement.
- Missing Teeth: Sometimes your child may lose a baby tooth and the permanent one just isn’t coming in. The permanent tooth may be impacted, meaning laying sideways in the gumline, or twisted, unable to descend properly. In this case, we’ll attach a button and chain on the tip of the impacted tooth and gradually guide it down into position.
- Early Tooth Loss: When a baby tooth is lost especially early, perhaps due to an accident, the space needs to be preserved for the permanent tooth.
- Protruding Front Teeth: Because they are often the first to emerge, sometimes the front teeth can grow a little wild. Protruding and/or crooked front teeth can be more prone to injury and can cause overcrowding for their tooth neighbors that may take longer to come in.
If your child shows signs of an overbite, underbite, open bite or any of these signs, an orthodontist may recommend starting treatment earlier to prevent further complications.
Watch Dr. McCullough discuss the most common indications for early phase treatment
Is Phase 2 Braces Necessary After Phase 1?
In most cases, Phase 2 treatment is necessary after completing Phase 1. Phase 2 focuses on aligning all permanent teeth and fine-tuning the bite for optimal function and appearance. While Phase 1 addresses specific issues, it does not completely eliminate the need for comprehensive braces or aligners later.
Phase 2 typically begins when most or all of the permanent teeth have erupted, usually around age 11 to 13. It ensures the teeth and jaws work harmoniously for a healthy and confident smile.
Did you know that expanders are only effective until a certain age and are most successful when done early?
This is another reason why it is important to have an orthodontic evaluation at age 7 even if no treatment is necessary at that time!
What Are the Three Different Phases/Stages in Comprehensive Orthodontic Treatment?
Orthodontic treatment often progresses through three key stages:
Phase 1: Early Intervention
- Focuses on addressing significant developmental concerns.
- Guides jaw growth and preserves space for permanent teeth.
- Uses appliances like expanders, partial braces, or space maintainers.
Phase 2: Comprehensive Treatment
- Begins after most permanent teeth have erupted.
- Corrects alignment, bite, and spacing issues.
- Involves full braces, aligners, or other orthodontic devices.
Retention
- Maintains results achieved during active treatment.
- Uses retainers to keep teeth in their new positions.
- Helps prevent relapse as the jaw continues to grow.
Hear what Dr. McCullough has to say about braces vs. retainers for kids
Why Staying Informed Helps Everyone
Each stage plays a vital role in achieving a well-aligned and functional smile. Skipping or delaying treatment at any phase can compromise the final outcome.
Early orthodontic evaluations are crucial for identifying potential problems and planning effective treatment. Phase 1 treatment, when necessary, can set the stage for a smoother Phase 2 and ensure long-term oral health. By understanding the three phases of orthodontic care, parents can make informed decisions for their child’s smile.
