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Most patients begin orthodontic treatment around age 14. This is because all of the permanent teeth have fully erupted and the jaw structure will not change drastically. In some cases, younger patients start orthodontic treatment around age 7. Although, not all young children benefit from early orthodontic treatment since irregular teeth positioning is common in those who still have primary teeth.
“Early” orthodontic treatment is also called “interceptive” treatment. It is completed when some baby teeth and some permanent teeth are present in the mouth (mixed dentition phase). The purpose of interceptive treatment is to prevent future orthodontic issues, not cure the current problems. This is because the teeth and jaw are still developing between ages 7 and 14.
To determine if early treatment is right for your child, the American Association of Orthodontists (AAO) recommends scheduling his or her first check-up no later than age 7. The earlier any discrepancies are caught, the better their dental health will be in the long run.
Your child may be a candidate for early orthodontic treatment if they have:
Children are most likely not candidates for early orthodontic treatment if they have:
While early treatment can help prevent future orthodontic issues and improve your child’s smile, it is not always necessary. For example, one study found that 75 percent of patients treated early with headgear or braces showed improvement. During the second phase of treatment, though, the previously treated patients saw little difference in teeth alignment and skeletal changes. In addition, the length of treatment did not decrease significantly.
Below outlines the pros and cons of early treatment:
Four common types of early orthodontic treatment include, but are not limited to:
The most common reason children receive orthodontic treatment during the mixed dentition phase is due to abnormal jaw formation. For example, if your child’s jaw is not wide enough for permanent teeth to grow in, they may need a palate (palatal) expander. In short, expanders create more space in the mouth by widening the upper jaw over time. When a child’s palate is extremely narrow, expansion also correctly aligns the upper teeth and jaw. A wider jaw also allows for more effective and quicker orthodontic treatment, such as aligners or braces.
Impacted teeth, crossbites, dental crowding, and breathing problems are common indicators for palatal expansion. However, expanders are only beneficial for younger children because their jaws are still developing. Teens and adults, on the other hand, already have fully developed jaws that cannot be expanded without surgery.
Traditional braces are the most popular orthodontic treatment that correct misaligned teeth, crooked teeth, and other bite problems. The most common age group to get braces are children and teens between 10 and 14 years of age. Children younger than 10, though, might need braces if they have severely crowded teeth, an underbite, gapped teeth, missing teeth, or other discrepancies.
Additionally, headgear may be necessary if your child’s jaw and teeth are severely misaligned. The appliance is usually attached to a patient’s head or face with a neck strap and is used in combination with braces. This is because braces only fix teeth positioning. Headgear actually influences proper jaw growth. Common types of appliances include:
Cervical Pull Headgear — treats overbites and underbites.
Reverse-Pull Headgear — treats underbites and crossbites.
High Pull Headgear — treats open bites.
Clear aligners, also called invisible braces, have grown in popularity since the 90s. In particular, adults prefer clear aligners over braces because they are removable, virtually invisible, and comfortable. However, some younger children are also candidates for invisible braces. For example, Invisalign—which is the most well-known clear aligner brand—has aligners for those who still have baby teeth.
According to the Invisalign website, phase I treatment for children in the mixed dentition phase has many benefits. They include:
“Benefits of Early Orthodontic Treatment.” American Association of Orthodontists, 23 Jan. 2019, https://www.aaoinfo.org/blog/is-there-a-benefit-to-early-treatment/.
Blue Ocean Publishing Group. The Million Dollar Smile, Changing Lives with Cosmetic Dentistry. 2018.
Keates, Nancy. “The 8-Year-Old With a Perfect Smile.” The Wall Street Journal, Dow Jones & Company, 16 Nov. 2010, https://www.wsj.com/articles/SB10001424052748703326204575616460332062620.
“Mix of Baby & Permanent Teeth (Phase 1).” Invisalign, https://www.invisalign.com/treatable-cases/invisalign-phase-1.
Patti, Antonio, and Guy Perrier DArc. Clinical Success in Early Orthodontic Treatment. Quintessence International, 2005.
Proffit, William R., et al. Contemporary Orthodontics. Elsevier/Mosby, 2019.