Children
Although orthodontics can be delayed until adolescence, current recommendations (American Association of Orthodontists) are for an early orthodontic screening examination of every child by the age of 8 years from a specialist orthodontist. This facilitates early treatment when appropriate. Early intervention may prevent the need for future treatment or reduce its complexity. It may also reduce the need for extraction of permanent teeth or jaw surgery as an adult. For children, it can reduce the likelihood of fractured protruding upper front teeth and improve their self esteem.
Early treatment during this stage can range from simple supervision and guidance of the maturing dentition to the use of fixed and removable appliances. The aim at this stage of therapy is to intercept and prevent a malocclusion (bad bite) from fully developing and to correctly develop the maturing jaw structure into the proper proportions in all 3 planes of space ie. transversely (width) vertically (height) and sagitally (profile view) to establish the best facial balance and harmony.
Space maintenance or regaining is a commonly performed procedure in children. This condition usually occurs where early loss of a primary tooth leads to a lack of space for its permanent replacement. Another common interceptive procedure is to orthodontically erupt a permanent tooth that has failed to take its correct position in the arch.
Lower arch development is also undertaken in children so that the lower jaw is able to accommodate the permanent teeth in proper alignment. This is usually achieved by a bonded appliance which is gently expanded over a 9-12 month period.
Bite-plane removable plates can be used to help reduce deep overbites. A simple removable device is worn full time to level the deep bite and thus prevent detrimental wear to the front teeth. This procedure also shortens the time required in full braces as an adolescent.
Orthopaedic treatments for children include upper arch expansion to widen the top jaw and Protraction Face Mask therapy can be used to improve its forward position when it lacks correct development. This type of treatment is performed around age 8 years when a moderate to severe problem is detected. Lower jaw discrepancies can often be corrected with Twin Block Plates at this stage. Further details are provided in the orthopaedic section.
Treatment results achieved during the mixed dentition period are generally retained until most of the permanent teeth have fully erupted. Therefore a transition period occurs which ranges from 6 months to 2 years. During this time a night time retainer is usually worn to maintain the early treatment results prior to the placement of full fixed appliances (braces) at age 12-14 years.