WHAT IS EARLY ORTHODONTIC TREATMENT?

Dr. Bhatia has a dual speciality degree in Orthodontics and Pediatric and Preventive Dentistry. This has helped her to gain a better understanding of developing problems with the teeth and jaws and the need for a timely intervention.

Her enthusiasm about Early Orthodontic Treatment is evident in any discussion because its benefits cannot be matched! The general dental community and our patients clearly recognize the valuable benefits obtained by this early treatment.

Early treatment enables the jaws to be better aligned as they develop and jaw size to be coordinated with tooth size. Each child's growth potential is maximized so that all of the permanent teeth have room to come in naturally. In almost all cases, future problems (such as extractions) are avoided. (see Expansion Versus Extraction)

BENEFITS OF EARLY TWO PHASE THERAPY:

• RAISES A YOUNG PERSON'S SELF-ESTEEM
• ELIMINATES UNNECESSARY PERMANENT EXTRACTIONS AND/OR SURGERY (along with discomfort and costs)
• PREVENTS IMPACTION OF EYE TEETH (by creating adequate space)
• TOTAL TIME IN BRACES IS SIGNIFICANTLY REDUCED
• TREATMENT IS TYPICALLY COMPLETED DURING MIDDLE SCHOOL
• PRE-TEENS ARE MORE COOPERATIVE AND ENTHUSIASTIC ABOUT WEARING BRACES
• REDUCES THE #1 CAUSE OF FRACTURES FOR CHILDREN - PROTRUDING TEETH
• INTERCEPTING EARLY PROBLEMS MAKES THE ENTIRE TREATMENT PROCESS MORE COMFORTABLE!

• The First Phase: Interceptive
• The Second Phase: Completion

THE INTERCEPTIVE PHASE typically begins around age seven and lasts approximately 12-18 months, with office visits scheduled every six to ten weeks. Goals are specific (achieved with a few simple appliances and sometimes partial braces):

• Expand jaws to make room for all permanent teeth
• Improve the bite
• Align permanent front teeth
• Patients are monitored every 3 months to ensure Phase I results are maintained, monitor erupting teeth and determine the optimum time to complete this two phase process.

THE COMPLETION PHASE begins when most of the permanent teeth have erupted. This last phase does involve braces on all teeth (to finish what we've started!), with treatment time ranging from 12 to 20 months. As in the Interceptive phase, goals for the Completion phase are specific:

• Aligning the remaining permanent back teeth
• Obtaining ideal function/stability by completion of bite correction

Expansion Versus Extraction

• In the past it was common practice to wait until age 11 or 12, when all of the permanent teeth were in, to begin orthodontic treatment. Findings have shown that by starting treatment between the ages of 7 and 9 it is possible to treat a patient without having to remove permanent teeth and a more esthetic and stable result is accomplished.
• Whenever the teeth are crowded (this information can be calculated ahead of time from a panoramic x-ray) it means that the bone width is smaller than the sum of the tooth width. Crowding is a result of a discrepancy between total tooth size and bone space available for the teeth.
• In order to increase size of the bone, which is an orthopedic change, it is necessary to apply a certain degree of force to the bone that braces alone cannot do. Braces can only tip the teeth out to make space, but in order to have a stable bite it is necessary for the teeth to sit as close to the middle of the bone as possible. Therefore in cases where there is moderate to severe crowding, to avoid extractions of permanent teeth, it is necessary to increase the total width of the bone with an Expander. Studies have shown that treatment with an Expander, in addition to braces, results in significantly favorable long-term changes in upper and lower arch measurements. This is a current trend among the more progressive Orthodontists to correct crowding without extractions and the results are a more esthetic and full smile.

Results of Expansion treatment in lieu of extractions