Early orthodontic treatment in children
Teething in children and early orthodontic treatment
When it comes to children, we talk about "dental age," meaning the state of development and replacement of teeth.
The childhood period can be divided into several stages depending on the state of tooth replacement:
1. The deciduous teeth period - This is the period when the child has only primary teeth erupted. A full set of primary teeth contains 20 teeth.
2. The mixed teeth period - This is the period in which some of the teeth that have already erupted in the child's mouth are permanent, and some are still deciduous. This period usually begins around the age of 6, when the first permanent tooth erupts.
Because there are more permanent teeth than deciduous teeth - 32 compared to 20, some of the permanent teeth replace the deciduous teeth while the rest erupt without replacing an existing deciduous tooth.
3. The permanent teeth period - This period begins when the last baby tooth falls out, and the child's mouth has only permanent teeth for the first time. This period begins on average around the age of 12-14.
What is early orthodontic treatment or Phase 1 Orthodontic treatment ?
This is a treatment that is performed well before the permanent teeth stage, usually between the ages of 8-10, and it's goal is to treat a significant orthodontic problem that has been diagnosed. These are problems for which postponing treatment will later require much more complex or prolonged treatment, or will cause additional significant side effects.
Examples of reasons for early treatment:
1. Unilateral crossbite with deviation of the lower jaw.
2. Significant tooth crowding that interferes with the continuation of the normal hatching process.
3. An impacted tooth.
How do we treat on early treatment?
The appliances and techniques we use for early orthodontic treatment depend on the type of orthodontic case and the stage of dental development.
Sometimes, the treatment is performed using removable appliances. These appliances enable orthodontic treatment for relatively simple cases, especially when the issue is localized to a specific tooth. Orthodontic treatment with removable appliances can be successful when the patient has a high level of compliance and follows the instructions for wearing the appliance.
In other cases, early treatment is performed using fixed appliances, such as braces (brackets) bonded to the teeth. Treatment with braces allows for the resolution of more complex problems and requires less compliance since it does not depend on the patient's compliance to wear the appliance.
The brackets can be bonded to all the teeth or only to some of them, depending on the specific case. Early treatment is typically shorter than full orthodontic treatment and usually concludes within less than a year.
After completing early treatment, a retention appliance is provided. At this stage, a bonded retainer is usually not used because the patient has not yet replaced all primary teeth with permanent ones.
What happens after completing early treatment?
After completing early treatment, patients attend follow-up appointments at intervals determined by the orthodontist. Performing early orthodontic treatment does not guarantee that full orthodontic treatment will not be needed later. This is because many teeth have yet to erupt, and it is impossible to predict how they will emerge.
However, early treatment improves the conditions for the erupting teeth, which in some cases can reduce the likelihood of needing full orthodontic treatment. The decision regarding the need for full treatment will be made once all the teeth have erupted. At this stage, a full orthodontic evaluation can be performed to determine the desire and need for comprehensive orthodontic treatment.
What X-rays are required for early treatment?
The type of X-rays required depends on the type of treatment. For early treatment, a full orthodontic set of X-rays is typically needed to ensure an accurate and comprehensive diagnosis without overlooking important details.
How do 8–10-year-old children adapt and cooperate with orthodontic treatment?
Part of the initial evaluation of a child includes assessing their ability to cooperate with orthodontic treatment. Cooperation involves both the in-office treatment phase and the first few days when the new appliance may be slightly bothersome to the child.
A. Do 8–10-year-old children usually request orthodontic treatment?
At the age of 8–10, children are generally happy and content regardless of their dental condition, so the motivation for treatment typically comes from the parents. Most children, after receiving an explanation from the orthodontist and their parents, agree to the treatment.
B. Do 8–10-year-old children adapt quickly to orthodontic appliances?
Children aged 8–10 generally adapt very quickly to orthodontic appliances. After a few days of complaining that the appliance is "bothersome," they forget about it and return to normal functioning. Parents are often surprised by how quickly their child adapts to orthodontic treatment. It's important to remember that at this age, the body's tissues are highly flexible, and changes are relatively easy to accept.
C. How quickly does orthodontic treatment progress for children aged 8–10?
Thanks to the fast biological processes at this age, early treatment typically progresses very quickly. Most treatments are completed within 6–12 months, and some may even finish sooner.
D. Is it recommended to perform early orthodontic treatment at ages 8–10, or is it better to wait until adolescence?
When there is a specific problem that justifies early orthodontic treatment, it should not be delayed until adolescence. Delaying treatment can significantly complicate the situation and, in some cases, make it impossible to resolve.