Interceptive Treatment

The Importance of Early Diagnosis and Treatment

An early orthodontic examination can be a valuable preventive measure in controlling dental and skeletal irregularities in a growing child. Sometimes early treatment and management of a patient's skeletal growth before most of the permanent teeth have erupted, or simple interceptive treatment to control harmful habits is indicated. In many patients proper treatment timing can achieve results that can not be attained once the face and jaws have finished growing.

When should treatment begin?

 There is no one answer to this question because each orthodontic problem determines its own best starting time in terms of improvement that can be achieved with the least time and expense. For this reason, the American Association of Orthodontists (AAO) recommends that the proper age for a child's first visit to the orthodontist is 7 years or even earlier if a problem is noted by the parents, family dentist or physician. However, one should not assume that treatment will always begin immediately after a first examination. Dr. Johnson may simply want to check the child periodically while the permanent teeth erupt and the jaws and face continue to grow. In this way, the timing of treatment can be correlated with the best skeletal, dental, and psychological maturation level for the individual.

What causes a malocclusion or "bad bite"?

 The two general causes of malocclusions and facial irregularities are genetic inheritance and environmental factors. Inherited problems may include such things as the pattern of facial growth, crowding of teeth, too much space between teeth, cleft palate, and a wide variety of other issues involving the jaws and face. Environmental factors include thumb or finger sucking, lip biting, tongue thrusting, mouth breathing (an airway restricted by tonsils or adenoids), and the premature loss of primary or permanent teeth. Many of these factors can affect the entire face as well as the teeth.

 

Ages 2 through 6

Should treatment begin before the permanent teeth erupt?

 This stage of development includes children in the primary dentition "baby teeth" which continues until the eruption of the permanent incisors (front teeth) and first molars. At this young age, the severity of the problem will dictate the necessary treatment.

Preventive treatment such as space maintenance in a patient with premature tooth loss (due to trauma or dental diseases), may be required. Controlling harmful habits such as finger or thumb sucking is often best done before the eruption of the permanent teeth, depending on the child's willingness to stop. In addition, a child who breathes primarily through the mouth should be evaluated for a restricted nasal air flow, because chronic mouth breathing can possibly lead to future developmental skeletal problems.

As a general rule, treatment during this age period is kept simple, since the child has a limited understanding of the problem and limited ability to comply with the prescribed treatment.

 

Ages 6 through 12

What problems can and should be corrected?

 This stage of development follows the eruption of the permanent incisors (front teeth) and first permanent molars (six year molars), and is commonly referred to as the "mixed dentition stage". This stage represents an excellent time for the correction of dental and skeletal problems because: 1) During this time, sixteen permanent teeth will erupt and guidance of this eruption can facilitate the correction of many malocclusions. 2) Skeletal disharmonies may require the orthodontist to have as much control as possible over the direction and magnitude of the facial growth pattern. 3) Psychological development, understanding of treatment goals and patient cooperation is better handled at this stage.

Problems that are commonly treated during this stage of development include:

(1) Excessive overjet- This bite may be caused by protruding front teeth and/or an underlying jaw discrepancy.

2) Underbite- This bite may be caused by the upper and lower teeth being out of position and/or an underlying jaw discrepancy.

3) Deep bite - The upper and lower teeth may vertically overlap excessively when the back teeth are biting together.

4) Openbite -  The front or back teeth may teeth fail to meet when biting together.

5) Crossbite -  The upper teeth are inside the lower teeth when the patient is biting together.

Other problems that can be treated during this stage are prolonged thumb and finger sucking habits, abnormal swallowing habits, mouth breathing, and excessive crowding.

Treatment planning for these individuals usually emphasizes correction of severe skeletal problems (orthopedics), as well as severe dental problems. Custom made appliances are prescribed and designed according to the problem being treated. The appliance may be removable or fixed (cemented/ or bonded), and may require the use of extra-oral orthopedic forces (headgears). The appliance can be  made of metal, plastic or both. All treatment modalities during this stage of development strive to correctly align the teeth and jaws so that the remaining facial growth will be balanced. Following this interceptive treatment phase, the patient will normally be monitored on a regular basis as they continue to grow and develop.

Adolescent treatment (permanent teeth)

This stage of development constitutes the majority of orthodontic patients being treated in the United States. There are two primary reasons: 1) The patients in this age group are undergoing pubescent growth, and this represents an excellent time for correction of most mild skeletal and dental problems. 2) The permanent dentition is now present and the orthodontist has control over the development of the final occlusion. Normal pubescent ages for females are between the ages of 10 to 13, and between the ages of 11 and 16 for males.

It should be noted however, that individuals demonstrate wide variations in their physiological, psychological, and dental development. Delayed or accelerated growth in an individual is not unusual and will not necessarily maintained throughout their development. Consequently, an individual may experience growth spurts varying in both intensity and duration throughout their developmental years.

Braces, or comprehensive fixed appliance therapy, is the most common treatment of choice in this age group. These appliances may be augmented by any number of other removable or fixed appliances depending upon the orthodontic problem.

Why is early orthodontic treatment important?

Every parent wants his or her child to have a beautiful smile, and everyone should have a healthy one. The goal of the orthodontist is to help achieve both for the patient.

Untreated malocclusions "bad bites" may contribute to conditions that worsen with age. Crooked and crowded teeth are more difficult to clean and maintain which may contribute not only to tooth decay, but eventual gum disease and tooth loss. Other orthodontic problems can cause abnormal wear of tooth surfaces, excess stress on the supporting bone and gum tissue, or even misalignment of the jaw joints with resultant chronic headaches or pains in the face and neck.

The importance of an attractive smile should not be underestimated. A pleasing appearance is a vital asset to one's self-confidence. A child's self esteem often improves as treatment brings teeth, lips and face into harmony. In this way, early orthodontic treatment gives the child a sense of control because it provides an opportunity to participate in the improvement of his or her appearance.

Encouraging good dental health habits and providing professional dental care at an early age produces benefits that will last a lifetime. Remember that your child should begin regular visits to the family dentist at age 2. At age 7, or earlier if a problem is suspected, your child should have an orthodontic examination. This allows the orthodontic specialist the best opportunity to prevent serious problems from developing and to provide corrective treatment at the best age for your child to have the most beautiful and healthiest smile possible.

An Important Message to the Parents of Young Children:

PRE-ORTHODONTIC GUIDANCE PROGRAM

If the child you have in orthodontic treatment now has younger brothers or sisters, or if you have a child between 7 and 9 years old, this information may be of help to you.

Often children within a family will exhibit certain predictable patterns of growth in much the same way they inherit similar eye and hair color. Like other family traits, particular patterns of tooth and jaw development also "run in the family".

As a preventative orthodontic office, we like to examine children by the age of 7. Usually no orthodontic treatment will be needed at this time. However, by making use of early interceptive methods when needed, better and more complete corrections can be attained.

Major orthodontic problems can be present behind perfectly acceptable smiles, and these problems, if left untreated, can severely jeopardize the health of teeth, gums, and jaw joints.

With these facts in mind, we hope you will have all your children examined by age 7 so that we can give your family the maximum dental care they deserve. In the interest of prevention, we are happy to offer all initial examinations and follow-up visits at no charge. If you would like to take advantage of this offer, please call our office or tell our Scheduling Coordinator. She will be glad to set up a convenient time for you.