Early Treatment

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"Early Treatment" can best be described as orthodontic treatment prior to the eruption of all the permanent teeth.

It has also been referred to as "Interceptive Treatment" or "Phase I Treatment."

Regardless of the name, in our practice, the purpose of initiating treatment during the mixed dentition (when a patient has both baby teeth and adult teeth) is to ensure that more difficult problems can be avoided. 

It is important to be able to distinguish between tooth eruption problems and problems in regards to the growth of the jaws.  Tooth eruption problems can be addressed early.

Here is a list of the four most common dental problems that we encounter and consider treating early:

1) Crowding:  This is simply a lack of space for the erupting permanent dentition.  

Unless there was a lot of spacing around the baby teeth, it is not uncommon to see overlapped permanent teeth as they erupt.  

If the crowding is significant, it can pose a problem for hygiene and can begin to compromise the health of the surrounding gum tissue.  

A simple procedure is to have adjacent baby teeth extracted.  In most cases, the permanent teeth will spontaneously begin to align.  In other cases, a simple appliance is placed to help move these teeth.

i) Before extraction of 2 baby teeth, ii) Following extractions and placement of a holding arch (appliance is left in place until adult teeth erupt).

2) Posterior Crossbite:  This can be the result of an upper jaw that is too narrow.

The treatment involves a palatal expander to help the upper jaw grow.  Treatment lasts roughly 4 months.  It is important to correct this early in most patients to avoid asymmetric growth of the upper and lower jaw.  

i) Prior to expansion, ii) Following expansion.

3) Anterior Crossbite:  This can be the result of eruption problems with the permanent teeth.

Treatment involves either a simple retainer to correct one tooth, or a 2x4 (4 braces on the front teeth, 2 braces on the back molars).  Treatment can take 4-6 months to complete.  This condition can sometimes produce adverse affects on the gum tissue of the lower front teeth.

i) Prior to treatment, ii) Following treatment (Treatment on upper 4 front teeth only).

4) Correcting Habits:  The most common habit is a thumb/finger sucking habit.

These habits can affect the position of the teeth.  Typically it produces an "openbite" at the front of the mouth.  These habits can be broken with an appliance that interferes with the placement of the thumb against the roof of the mouth.  If corrected early enough, the permanent teeth can spontaneously improve on their own.

i) Prior to placement of the appliances, ii) 1 year after removal of the appliance (appliance can be used for 4-6 months).

Again, it is important to distinguish the difference between tooth eruption problems and growth related problems of the jaws.  

Early treatment should have a specific goal and a specifice time frame to complete.  

Early treatment does not simply mean to get your braces early!