Early Treatment

The American Association of Orthodontists recommends that every child have an orthodontic screening no later than age 7.

Why should my child be evaluated at such an early age?

The first molars have usually erupted by this age. These teeth establish the fit of your bite in the back of your mouth. At this time, I can determine if your bite fits together properly.
At this age, I can detect such problems as oral habits that are causing problems with the teeth, crowding, deep bites, open bites and some facial asymmetries.
For some, a timely screening will lead to significant treatment benefits; for most, the principal immediate benefit is a parent's peace of mind.

What are the benefits of early treatment?
Early treatment can:

influence jaw growth in a positive manner
improve the width of the dental arches
reduce the need to extract permanent teeth
preserve or gain space for erupting permanent teeth
reduce or eliminate the need for jaw surgery
lower the risk of trauma to protruded front teeth
correct harmful oral habits
improve aesthetics and self-esteem
simplify and shorten treatment time for definitive orthodontic treatment
increase stability of final treatment results
reduce likelihood of impacted permanent teeth
improve speech development
improve position of first permanent molars
guide erupting permanent teeth into more favorable positions
preserve or gain space for erupting permanent teeth
reduce potential for damage to jaw joints
encourage better compliance before the uncooperative teenage years.

What is your treatment philosophy regarding early treatment?

In general, I prefer to wait until all of the permanent teeth have erupted, and then comprehensively treat my patients. In many situations, the problem appears severe, but the final result is not adversely affected if we wait until all of the permanent teeth come in. In these cases, I will correct teeth that appear misaligned only if the patient or the parents have cosmetic concerns about the teeth.

There are orthodontic problems, that if left untreated, can adversely affect the bone and gum support around the teeth, jaw function, jaw growth, or wear of the teeth. If there is already an area that is compromised, or has the potential for damage to these areas, I will make you aware of this. You can then weigh the risks of waiting versus intervening at that point and decide if you should proceed with early treatment.

Do I need to wait until my dentist refers me to you for you to evaluate my child?

It is not necessary to have a referral from your general dentist in order to have an orthodontic evaluation

If my child has early treatment, will additional treatment be necessary?

In most cases, yes. Early treatment is typically focused on one area of the bite to address one or more of the above problems. It is rare that all of the permanent teeth erupt in perfect alignment, and comprehensive treatment is usually required to completely correct the bite and tooth positions.

What happens between the time your objectives for early treatment are completed and you are waiting for the permanent teeth to erupt?

This time frame is devoted to maintaining the correction, observing the child's growth and monitoring the eruption of the permanent teeth. If the early treatment involved the use of a removable appliance, I will typically have them wear the appliance full time for about 6 months after the correction is complete, and then at night time to maintain the correction. As more of the permanent teeth erupt, we usually get to a stage where it is no longer necessary to wear the appliance. Observing your child during this time period ensures that comprehensive treatment, if necessary, will be started at the optimal time.

What is your philosophy about pulling baby teeth?

I prefer to let things happen naturally as much as possible. I prefer not to extract the primary canines to align the incisors, since this creates more of a crowding problem when the permanent canines should erupt. However, there are some circumstances under which removing certain baby teeth is warranted:

Occasionally, the permanent tooth is not centered under the baby tooth (ectopic eruption), and the root of the baby tooth does not resorb (dissolve) correctly. This can lead to impaction of the permanent tooth, or the permanent tooth may start to erupt into an unhealthy position.
Some people's permanent teeth are delayed in erupting, and their preference is to try to speed up the eruption of the permanent teeth as much as possible. I can take an xray to determine which baby teeth, and in which order, can be removed to accelerate the eruption of the permanent teeth.