When Are “Early Braces” Needed?

kid with braces
Why Do I See So Many Young Kids With Braces on Nowadays?

We get this question a lot. It seems that every child is being recommended for orthodontic treatment at earlier and earlier ages. Not only that but then they are having to get braces again when they are older! To break this down, it is important to understand the difference between early “Phase I” orthodontics and later “Phase II” orthodontics.

At the beginning of orthodontics, being a new specialty, there was little understanding of when patients should get treatment. Most times the answer was “Just wait until all the permanent teeth come in.” But over time it became apparent that this was not always the best way to treat each case.

As we discussed in the last post, the AAO recommends that your child see an orthodontist at age 7. The bigger question is why?

Put simply, by age 7-8 most patients will have their front upper and lower incisor teeth as well as their permanent “6-year” molars. From this point on there is usually a gap of 3 years where no more baby teeth will be lost (though this can be highly variable). When we are evaluating patients this early, we are looking to answer the question:

“Is there an issue present right now that is going to get progressively worse over time?”

If the answer to this question is “yes,” then it is likely that the orthodontist will recommend some version of “Phase I” treatment. Another more proper term for Phase I treatment is “Interceptive Orthodontic Treatment.” We are literally “intercepting” problems before they become too difficult to manage.

When considering the question “can bad teeth cause health problems,” we evaluate some of the following (among many others):

1. Are all of the remaining teeth underneath the surface going to come in properly?

2. Is there room for the remaining teeth?

3. Is there a major fit issue like a crossbite that requires treatment?

4. What will the teeth likely look like down the road?

5. Is there any evidence of chipping or wear of the teeth?

6. Are there significant disturbances in the growth pattern?

It isn’t that treatment is impossible at a later date if early treatment isn’t done – in fact, Phase I treatment many times isn’t indicated at all. But, certain problems can become so difficult to treat in one step that treatment can extend for a much longer time and the desired results are much more difficult or impossible to achieve.

It is also important to note that Phase I treatment started at an early age cannot fix ALL of the issues that we see – mainly because not all teeth are present when this is recommended. Generally speaking, orthodontic treatment is recommended again at a later date when all the teeth are present. This is also known as Phase II treatment and usually happens around age 11-14.

Stay tuned next time to hear about what makes our AOS practice different!

Please feel free to send any questions or feedback to Dr. Tyler at trathburn@atlantaortho.com