Phase 1 & Interceptive Orthodontics:
Problems to Watch for in Young Children
We (and the American Association of Orthodontists) recommend that children be seen for an orthodontic evaluation starting at age 7. This allows us to evaluate the jaw structures to diagnose any irregularities in the shape of the jaws, or the growth direction. We recommend early treatment (Phase I) if the child has an underbite, deep impinging bite, large overjet, crossbite, or insufficient space for the adult teeth to erupt. Early treatment allows us to guide growth to achieve facial symmetry, make room for adult teeth, and eliminate unhealthy habits, such as thumb sucking. Even if your child doesn’t need Phase I treatment, an early evaluation would help us determine your child’s future orthodontic needs.
CROWDING
Crowding is a common condition when a child's dental arches do not have enough room for the new adult teeth to grow into. While a child is still growing, intervention with "expanders" can take advantage of a child's jaw growth to help increase the arch size to allow adult teeth to emerge in better positions. Sometimes, when teeth cannot all grow in, a tooth may be come "impacted" or stuck in the jaw and possibly damage other healthy adult teeth. Another advantage of early treatment is that it may decrease the possibility for future extraction of permanent teeth in the future.
CROSSBITE
A crossbite often presents in childhood and does not correct itself with age. Normally, the upper teeth sit slightly outside or in front of the lower teeth. In a crossbite, a single tooth or multiple upper teeth bite inside or behind the bottom teeth. Early correction of a crossbite can help prevent skeletal disharmonies as the jaws grow.
ORAL HABITS
Persistent oral habits such as thumb or finger sucking can cause significant dental and jaw deformation. Most children will stop sucking their fingers and thumbs on their own; however, if your child continues this habit after the age of five, corrective actions should be taken.
Signs to look for when problems arise include:
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Anterior open bite: When there is an opening between the front upper and lower teeth when the back teeth are biting together
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Dental protrusion: When the upper front teeth flare out and the lower teeth may be tipped backwards
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Speech or chewing difficulties
If you are unable to help your child stop, we can use orthodontic appliances to help break the habit.
UNDERBITE
An underbite is when the lower teeth sit forward of the upper teeth. An underbite is often due to disharmonious growth of the upper and the lower jaws. Underbites generally have a genetic link so if your child has an underbite, another family member may have had a similar bite.
While a child is still growing, we can encourage the upper jaw to grow more forward with orthodontic treatment.
SEVERE DEEP BITE
A deep bite is a condition where there is an excessive overlapping of the front upper teeth over the lower teeth. This could cause the lower teeth to traumatically bite into the gum tissue of the palate instead of contacting the upper teeth. A deep bite will also lead to excessive wear of the lower front teeth. If the child demonstrates early wear of their lower front teeth or irritation of the palatal tissues, early intervention is recommended to prevent further damage.
PROTRUSION
Severe protrusion of teeth may be an indicator of either a skeletal disharmony of the upper and lower jaw, or an oral habit. As children are still growing, early treatment may help in redirect growth of the contributing jaw. Treatment may also be indicated for children with psychosocial concerns or increased risk of trauma to the protrusive front teeth.