The American Association of Orthodontists® recommends that all children should have an orthodontic check-up by the age of 7. At this age, jaw growth and the positions of erupting teeth can be evaluated. While comprehensive orthodontic treatment usually begins during adolescence, some problems need to be corrected at an earlier age.
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The Process
At your initial consultation, our doctors will do a thorough examination of your child and evaluate his or her jaw growth and dental eruption. There are certain orthodontic problems we look for at this age that, if not corrected early, will lead to bigger problems down the road. In these situations, we recommend early treatment before all the permanent teeth have erupted. However, most of the time, we just plan to monitor development on a complimentary basis through our 7&Up Club and wait for ideal timing—which usually corresponds to when all of the adult teeth are present.
What is the 7&Up Club?
If your child is not ready for orthodontic treatment then we welcome them to the 7&Up Club! During this time our doctors will monitor your child’s growth. As an exclusive member of our 7&Up Club, your child will receive complimentary maintenance visits throughout their development. We will continue to take updated pictures, x-ray images, and new measurements. We work with you to determine the perfect time to begin orthodontic treatment. Be sure to spin the prize wheel when we see you at your visit!
Orthodontic Options for Children
As mentioned previously, there are certain situations that we recommend early treatment for young children between the ages of 7 to 10. The purpose of early intervention is to address an orthodontic issue when it is easiest and most practical to fix. Waiting to fix the problem later can often lead to a compromised result. The most common problems we recommend early treatment on are:
- Severe overjet which predisposes a child to traumatic injury of upper incisors
- Posterior and anterior crossbites which causes the lower jaw to shift into an unnatural and often asymmetrical position
- Thumb sucking habit which interferes with normal jaw development
- Deficient space for the erupting adult teeth which will result in increased need for permanent tooth extractions
Early intervention treatment often involves the use of an appliance followed by braces or Invisalign®. While a child is in early intervention we usually see them in office every 4 to 10 weeks depending on our goals. Upon completion of early intervention, a Theroux retainer is provided to hold the results achieved and to minimize relapse until the child is ready for full treatment.
Early Treatment with Invisalign® First
This modern-age orthodontic treatment is specially designed for little smiles. Orthodontic concerns such as arch development and expansion, tooth crowding and spacing, tooth protrusions, and the overall appearance of a child’s smile can all be resolved comfortably with this appliance. The best part of all, it still let’s the child enjoy all the sticky and crunchy joys of life!
We often will recommend Invisalign on the lower arch while the upper jaw has an expander in place. This allows us to upright the lower teeth (and move them outwards) so we can expand the upper jaw more.
Additional Early Intervention Procedures
Other common appliances for early intervention treatment include:
Palatal Expander
Palatal expanders are a common appliance in orthodontics. While a child is still young, the bones are soft enough to allow the appliance to expand the palate. This allows for the correction of crossbites which lead to jaw asymmetries while also creating more space for erupting permanent teeth. Expanders require manual turning using a key for a prescribed number of total turns as indicated by the doctor. Full instructions on turning and care of your expander will be provided!
Why, How, and When
Expander with Thumb Crib
If your child has a thumb sucking habit that has not responded well to primary therapies, we can place a palatal expander with a thumb crib. Thumb sucking tends to constrict an upper jaw, making it more narrow so almost every case benefits from palatal expansion to restore normalcy. The crib prevents the thumb from resting on the palate and acts as a reminder to stop thumb sucking. We also use this appliance in situations where there is a forward tongue thrust and retrain the tongue to stay in the correct position.
Space Maintainers
If a baby tooth is lost early, a space maintainer may be recommended. Space maintainers are usually anchored on the permanent first molars and prevent them from moving forward, which would otherwise result in less room for the future permanent teeth. Two common space maintainers are called a Nance Appliance and Lower Lingual Holding Arch. These are passive low-maintenance appliances and they generally stay in place for a few years.
Protraction Facemask
Also known as Reverse Pull Headgear, these cases typically have deficient upper jaw growth resulting in an underbite that is best treated early, around age 7 or 8. Treatment usually involves a palatal expander followed by a protraction facemask. Early treatment of an underbite can help avoid invasive surgeries later on in life. The appliance is activated by affixing elastics from the protraction facemask to hooks on the expander. Approximately 12 to 16 hours of wear per day, while at home and sleeping, is recommended.
Partial Braces
Occasionally, we may need to use a limited number of braces just to fix an isolated concern. Additionally, partial braces helps create space or gives access and a pathway for other erupting adult teeth. This would prevent adult teeth from becoming impacted, damaging adjacent roots, or requiring surgical exposures in the future. Partial braces are usually placed after an expander to consolidate all the space that has been created and move the teeth into the new room so there is more space for the erupting teeth.
Our Palatal Expanders Are Separator-less!
Traditionally, orthodontic appliances—such as palatal expanders—have been made using pre-fabricated and generic orthodontic bands. The process has historically been quite time consuming and painful. Unfortunately, many offices still use this antiquated process today.
The good news is that digital scanning and 3D printing has allowed for the creation of custom expanders without separators. The process is much easier today for our patients taking less time than ever before!
With Separators
- Appointment 1: Separator band placement — little elastics that are wedged in between the teeth to create room to fit bands.
- Appointment 2: Goopy impressions — need we say anything more?
- Appointment 3: Appliance placement — the separators are removed and the appliance is placed.
Separator-less
- Appointment 1: Appliance placement — because you were scanned at your consultation, the custom appliance can be fabricated and inserted without any additional appointments.
FAQ
Have some additional questions? Here are some common questions related to early intervention orthodontics.
Will my child need more treatment after completing Early Intervention?
It is hard to say for certain but we usually say if you want your child to have perfect teeth, then yes. The purpose of early treatment is to fix a jaw issue or to prevent an orthodontic issue from getting worse. During this time not all the adult teeth have erupted and they may very well come in malaligned later. When doing early treatment we usually use a two-phase approach. The early treatment is considered “Phase 1” and treatment to align all the adult teeth later on is referred to as “Phase 2”.
My child sucks her thumb and cannot break the habit, should I take them to the pediatrician?
We usually recommend starting with non-orthodontic treatments to break thumb sucking habits. This involves positive reinforcement, thumb covers, and sour nail polish. If the habit persists after age 7 we usually recommend orthodontic treatment since the habit can disrupt normal jaw growth.
What is the cost for early orthodontic treatment?
We strongly encourage all decision makers to be present for the consultation. Extensive information will be provided directly from the Orthodontist and Treatment Coordinator. We are prepared and devoted to ensuring any questions or concerns are addressed during the consultation. Of course, if any questions arise afterwards we are happy to assist. Learn more about our financing options here.
If my child is not ready for treatment then how often do we need to be seen by Dr. Walt or Dr. Matta?
If your child is not ready for complete treatment then we welcome them to the 7&Up club! We schedule maintenance observation visits every 8 to 12 months depending on how soon we anticipate them to be ready. These visits are complimentary, quick, and informative!
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