Types of treatment

Sometimes treatment is performed on young patients before there are enough permanent teeth for full or comprehensive treatment. This is usually called “phase I” or an “early phase” of treatment. Goals are to reduce the severity of a problem, or to gain improvement at an early stage that cannot be accomplished as well during comprehensive treatment.

When the long term goal of orthodontics is to achieve proper function, it is extremely rare that an early treatment phase will eliminate the need for comprehensive treatment later. Healthy function of the chewing system requires detailing the positions of all the permanent teeth. Obviously, this cannot be carried out when many or most of the permanent teeth have not yet erupted. A good example being the twelve year molars, they are closest to the jaw joints and muscles, and have a profound affect on function.

When considering an early phase of treatment it is important to weigh carefully its advantages and disadvantages. The duration of treatment should be as short as possible (under 18 months). Patient compliance and/or insurance benefits can be exhausted, leaving little or nothing of either for the important comprehensive stage of treatment later.

Dr. G takes a conservative approach when determining if a patient needs an early phase of treatment. In most cases no early phase of treatment is recommended, but this is a case by case decision. If there is a crossbite (top teeth inside of bottom teeth), poor eruption of permanent teeth, a narrow upper jaw (a more common problem), or an especially severe problem, an early phase of treatment might be in order. Usually early treatment is six to twelve months in duration. Otherwise, we will monitor a child every 6-12 months at no charge.

At what age should children start comprehensive treatment?

It is less a matter of age and more a matter of stage. It varies from one child to another, and this is an important decision that Dr G makes with patents at initial or monitoring appointments. For example: A young lady may be 10 ½ years old, but all the permanent teeth are in; she is probably ready for comprehensive treatment. A boy may be 11 years old with a few baby teeth remaining, but the problem is severe—better get records to do the diagnosis and planning now.

In a nutshell, timing of treatment for children, early phase or comprehensive, is critical. It’s better to stay on top of the situation be seeing children sooner rather than later.