May 1st, 2017
Two-Phase (Early) Orthodontics
Does My Orthodontist Just Need a New Car?
By Jeff Wing DDS MS
So the question that’s on everyone’s mind these days (aside from “when will this flipping water bottle craze ever go away!?"), is “why are all of these 8 and 9 year-old kids walking around with braces on?” It’s an extremely valid question…after all, most of these kids still have 12 baby teeth in their mouth. Is it simply a scheme that all orthodontists came up with during their super-secret annual underground meeting so they could all upgrade their daily modes of transportation? Believe it or not, the short answer is…NO! Now, here’s the long answer:
In most cases, children’s mouths are big enough to accommodate all of their adult teeth as they continue to come in until age 12 or 13. Unfortunately, this doesn’t guarantee that these teeth will come in straight, but that’s OK — the main thing we care about in that 8-12 year age group is that all of the adult teeth do, in fact, come in. In about 10-15% of children, their mouths are so small that there isn’t enough space for all of the adult teeth to squeeze in, so one or more of them can get “stuck” or “trapped” up in the bone under the gums, or even behind other teeth. Think of the mouth as a parking lot in this situation — these adult teeth are looking for a place to park when the lot is actually FULL, and no cars/teeth are leaving.
This is one of the situations when a brief period of early limited orthodontics (usually called Phase 1) is a great idea — we can take advantage of these kids’ developing jaws and create the space needed for these trapped adult teeth to find a parking spot. By doing so, we can avoid the need to extract permanent teeth down the road…and why settle for 24 teeth when you can have 28?!
Other situations where an early Phase 1 is recommended include:
Anterior crossbite (underbite) - where the lower teeth bite in front of the upper teeth. This can wear the enamel down on these teeth and lead to chipping or fractures. This is also a sign of a skeletal jaw pattern that needs to be corrected early to avoid jaw surgery in the future
Posterior crossbite - where the upper back teeth bite on the inside of the lower teeth on one side, causing the lower jaw to shift to that side. This is due to a narrow upper jaw, and expansion or widening of the upper jaw is easily performed at an early age
Severely protruding upper front teeth - when upper front teeth are angled forward and flared out away from the lower front teeth, these teeth are at an increased risk of trauma from sports, the bottom of swimming pools, and sometimes even walls!
Anterior Open Bite - when there's an opening between the upper and lower front teeth when biting down, usually caused by a thumb sucking habit or tongue thrust habit
If your children (or any neighbor kids that don't annoy you) display any of these situations, a visit to an orthodontist is recommended. A simple x-ray and a quick exam will help the orthodontist determine whether a Phase 1 treatment would be beneficial or if we can wait until all of the permanent teeth are in before considering orthodontic treatment.
Please feel free to email me at firstname.lastname@example.org if you have any questions about Phase 1 orthodontics!