Orthodontic Treatment for Adolescents & Teens (Phase II)

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Most people begin orthodontic treatment between ages 10 and 14. In particular, middle school students often receive phase II orthodontic treatment before high school begins. This is especially true if they had phase I treatment as a child. Although, adolescents and teens are the most common age group because all of their permanent teeth have grown in. Any dental crowding, spacing, alignment, and bite issues are also evident during the teenage years. 

Orthodontic treatment improves speaking, breathing, chewing, and swallowing capabilities.

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When To Seek Orthodontic Treatment For Your Teen

Between 10 and 15 years of age, the body is rapidly changing. This includes growth spurts, puberty, and even skeletal changes in the mouth. During teeth cleanings, many teens receive routine orthodontic screenings to check for any changes. This ensures any issues are caught and treated early before the mouth and jaw fully develop. Some orthodontic issues that may indicate the need for treatment include:

  • Losing baby (primary) teeth too early or too late — this can result in irregular alignment.
  • Malocclusion is present in the mouth — this includes an underbite, overbite, open bite, overjet, crossbite, crowding, or spaced teeth
  • Over-retained baby teeth — this means the permanent teeth are blocked from growing in properly. 
  • Temporomandibular joint dysfunction (TMD) or other jaw issues — such as popping sounds or frequent pain. 
  • Chewing or biting difficulties — If your teen frequently bites his or her cheeks, this may also indicate an alignment issue. 

Advantages of Orthodontic Treatment During This Age

There are many benefits to receiving orthodontic treatment during the teenage years. Some parents may decide to start earlier, around age 6, but that isn't always the best option. This is because there is no way to guarantee against phase II treatment later on. 

The primary advantages of teen orthodontic treatment include:

  • Taking advantage of growth spurts during the teenage years helps orthodontists direct jaw growth and correct severe bite problems.
  • If your teen has jaw alignment issues, orthodontic treatment often eliminates the need for jaw surgery in adulthood.
  • Having straight teeth helps prevent the development of cavities and gum disease
  • Improves chewing and biting capabilities. 
  • Enhances your teen’s smile and overall appearance, which also boosts his or her confidence.
  • It makes the teeth less prone to trauma, chips, cracks, and wear. 
  • It helps prevent tooth loss. 

Common Types of Treatment

Three common types of orthodontic treatment for adolescents and teens include, but are not limited to:

Braces

Traditional braces are popular orthodontic appliances that correct misaligned teeth, crooked teeth, and other bite-related issues. There are three common types of braces, including metal, clear, and lingual braces. Adolescents and teens usually get braces after all of their permanent teeth erupt and before high school begins. Lastly, treatment usually takes between one and three years.  

metal braces on teeth

“Almost five million Americans, most of them being children and teenagers, get braces. Additionally, about 80 percent of people who receive orthodontic treatment are between 6 and 18 years of age.”

American Association of Orthodontics (AAO)
Braces and Gingivitis Risk

Puberty increases inflammation in the body, which can affect the gums. As a result, teens are commonly diagnosed with gingivitis (mild gum disease) around this time. Swollen, red, and tender gums are common symptoms of gingivitis. Treatment for this condition includes professional teeth cleanings and following a good oral health regimen at home. If gingivitis is left untreated, periodontal disease (severe gum disease) can form over time.

Brushing and flossing your teeth regularly reduces the chance of developing gingivitis during the teenage years. If your teen has braces, however, it is more difficult to floss and brush effectively. So, most teens abandon flossing completely while they have braces on. Unfortunately, the combination of puberty and neglecting oral care throughout treatment almost always results in gingivitis. Although, there are ways to prevent gingivitis while wearing braces:

  • Wash food particles out of the mouth by drinking water after each meal. 
  • Buy a Waterpik, which uses water pressure to floss your teeth, rather than a string.
  • Eat healthier.
  • Gargle daily with warm saltwater. 
  • Rinse with an antibacterial mouthwash every day. 

Clear Aligners

Clear aligners (invisible braces) are removable orthodontic appliances that correct crooked and misaligned teeth. In particular, adults prefer clear aligners over braces because they are invisible, comfortable, and convenient. Although, teens are also candidates for treatment because their permanent teeth have grown in by this age. 

Invisalign braces or invisible retainer isolated on white background

Visit your dentist every 4 to 6 weeks to receive the next few sets of aligners. Multiple aligners are used because a single aligner is only capable of moving the teeth 1 mm or less. On average, they must be worn for at least 22 hours per day and the length of treatment depends on individual needs. 

Headgear

Headgear is often used in combination with braces if your teen has a severe overbite, underbite, crossbite, or open bite. The appliance is usually attached to a patient’s head or face with a neck strap and influences proper jaw growth. Braces only fix teeth positioning. Common types of headgear include: 

Cervical Pull Headgear
  • Reverse-Pull Headgear — corrects an underbite or crossbite. 
  • Cervical Pull Headgear — corrects an overbite or underbite. 
  • High Pull Headgear — corrects an open bite. 

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Resources

“Braces.” Mouth Healthy TM, https://www.mouthhealthy.org/en/az-topics/b/braces.

National Institutes of Health (NIH). Periodontal (Gum) Disease: Causes, Symptoms, and Treatments. NIH Publication, 2013. https://www.nidcr.nih.gov/sites/default/files/2017-09/periodontal-disease_0.pdf

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.

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Updated on: December 1, 2020
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Alyssa Hill
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Lara Coseo
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