Early Preventive (Phase I) Treatment | Full Braces or Phase II Treatment 

When is the best time to begin orthodontics?

Though an orthodontist can enhance a smile at any age, there is an optimal period to begin treatment. The American Association of Orthodontists recommends that the initial orthodontic evaluation should occur at the first sign of orthodontic problems or no later than age 7.

Why are children being evaluated at such an early age?

At this early age, orthodontic treatment may not be necessary, but vigilant examination can anticipate the most advantageous time to begin treatment, and prevent complex malocclusions from developing.

Why age is 7 considered the optimal time for screening?

By the age of 7, the first adult molars erupt, establishing the back bite. During this time, an orthodontist can evaluate front-to-back and side-to-side tooth relationships. For example, the position of erupting incisors can indicate possible overbite, open bite, crowding or gummy smiles. Timely screening increases the chances for an incredible smile.

If a child has treatment early, will this prevent the need for braces as an adolescent?

Not necessarily! However, early treatment can reduce the time that is needed for major orthodontic treatment at a later age, and may even prevent the need for jaw surgery in cases of jaw misalignment. Correcting alignment of the teeth early can prevent uneven teeth wear, and sometimes prevent root damage.

What happens when you put a patient in the Re-Care Program?

If at the initial exam, we have determined that the patient is a candidate for orthodontic treatment, but they need to wait to start treatment we put the patients in a Re-Care Program. In the Re-Care Program, the patient's dental development is monitored. We want to find the ideal time to begin orthodontic treatment, so the patient visits our office every 3-6 months.

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Early Preventive (Phase I) Treatment

Typically, orthodontic treatment in children will begin during the early teenage years but in some cases, starting treatment around age 7-9, can have preventive benefits. Early treatment usually lasts between 12-18 months and office visits are scheduled every 6 to 10 weeks.

This phase of treatment takes place when the child has some baby and some permanent teeth. Participating in a Complimentary Initial Exam will help determine if your child is in need of interceptive or preventive orthodontics before all the permanent teeth have erupted.

Orthodontic appliances, and possibly partial braces, may be placed during this phase, to correct an existing problem, prevent a problem from occurring or to help direct jawbone growth for improved facial balance and dental function. An additional benefit of early treatment is simpler and quicker Phase 2 treatment.

What are the advantages of Early Treatment?

Some of the most valuable results of Early Treatment are:

  • Improving facial balance by influencing jaw growth to achieve correct jaw and bite relationships.
  • Reducing the need for permanent tooth extractions.
  • Reducing the risk of traumatic injury to protruding front teeth
  • Preserving space for unerupted permanent teeth
  • Creating space for crowded, erupting permanent teeth
  • Reducing treatment time with braces: easier management of crowding when the permanent teeth erupt.
  • Increasing the chance of stability so the teeth do not shift if retainers are worn as directed.
  • Better access for cleaning, gum health and overall health.
  • Increased self-confidence and self-esteem: having crooked teeth, even at an early age, can cause a child psychological distress.
Why not wait until their teenage years for orthodontic treatment?

With Early Treatment, orthodontic issues can be dealt with more effectively. For example, if the jaws are not correctly aligned, postponing treatment until the child is close to the end of the growth cycle reduces the chance of a successful outcome, and may necessitate future jaw surgery. In a growing child, the hard and soft tissues are usually very responsive to orthodontic forces. Compliance with some orthodontic treatment modalities is also better with younger children, when social/peer pressure is less of a concern.

What is an example of an Early Treatment case?

One example of Early Treatment is when the upper jaw is narrow compared to the lower jaw, resulting in facial asymmetry, jaw shifting and crossbites: (upper teeth biting inside lower teeth). A "palatal expander" is placed in the upper jaw to widen it. The expander is left in place for at least three months after correction of the crossbite, for stability. A retainer is usually provided after removal of the expander, to prevent relapse.

Could all children benefit from Early Treatment?

For some patients, the benefits are substantial and very worthwhile but in other cases, waiting until their early teenage years might work just as well. At the Complimentary Initial Exam, all of your treatment options will be discussed, so each patient knows the choices available to them.

What is next after Early Treatment?

The period following Early Treatment is called the "resting phase", during which growth and tooth eruption are closely monitored. Complimentary office visits are scheduled every 6-12 months so that the best time to begin the second phase of treatment can be determined. Occasionally, depending on the child's dental development, Early Treatment progresses straight into the second phase of treatment without a resting phase.

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Full Braces or Phase II Treatment

Some patients who have completed Early Preventive Treatment may need more orthodontic correction after all the permanent teeth have erupted. Phase II Treatment is what most people think of as "traditional" orthodontic treatment. It involves placing braces on all the permanent teeth to accomplish some or all of the following:

  • Correct crowding of the back permanent teeth
  • Improve the bite and esthetics
  • Establish better function of the teeth
  • Improve force distributions and wear patterns of the teeth
  • Increase self-confidence and interpersonal effectiveness

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Our goal for two-phase orthodontic treatment is to create correctly aligned teeth that provide ideal function and a great smile.

Dr. Zeeny Teja, B.D.S., M.S.c., M.S.D. | 1955 6th Avenue West | Seattle, WA 98119 | Phone: 206-285-7755
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